H
erpes is a sexually transmitted disease (STD) caused by the herpes simplex virus (HSV). It is one of the most common STDs in the world, and it is estimated that approximately one in eight people have been infected by the virus. Around 80% of those infected don’t even know they have the virus. It is impossible to know exactly how many people have the virus, since many cases are asymptomatic or never diagnosed.
Herpes is caused by two different viruses: HSV1 and HSV2. HSV1 usually causes sores around the mouth, while HSV2 causes genital herpes.
The infection is spread by skin-to-skin contact, and it can be transmitted through oral, vaginal, and anal sex, and kissing. It can also be spread through contact with lesions from other areas of the body. The virus goes into the body through small lesions in the skin, or through the mucosae in the mouth, penis, vagina, cervix, or anus.
After the infection, the patient might develop unspecific symptoms such as fever, fatigue, nausea, myalgia, adenopathy, along with the characteristic sores. Sores are small blisters which can sting or burn. They are usually grouped in clusters and they become crusted before healing. They don’t leave scars and resolve spontaneously. In some cases, patients won’t develop sores, instead displaying only irritated skin. Women can also present with vaginal discharge. Some people can be infected and remain asymptomatic; however, they can still spread the virus to other people.
After the first episode, the virus can become latent and remain in sensory nerves. This is known as the latent stage; afterwards, the virus can affect the skin again, usually along the pathway of the nerve where it has remained. These are the recurring episodes of the virus.
Fortunately, outbreaks tend to become less frequent and painful over time.
Risk factors for acquiring the infection include:
A sample will be taken from a sore and tested to determine whether HSV is present in the lesion, thus confirming the diagnosis. However, a negative result does not rule out herpes. Samples should be taken from new ulcers, where it is more likely to find the virus.
Blood tests are also carried out to determine the presence of antibodies against HSV. This test can determine if the infection is new or a repeat outbreak. It is usually very difficult, if not impossible, to point to the exact moment a person was infected with the virus. If herpes is diagnosed, tests should be carried out to discard other STDs, since they can exist as comorbidities.
Treating Herpes
There isn’t a cure for herpes, and although the sores heal in days or weeks, the virus never leaves the body. However, some medications can help make the outbreak pass faster.
NSAIDs such as paracetamol can be taken to reduce the discomfort during an outbreak. Ice packs, salt baths, and local anesthetic creams can also be applied.
Antiviral medications:
- Acyclovir
- Valacyclovir
- Famciclovir
- Penciclovir: only available for topical application
The dosage and length of treatment with these medications will depend on the location and chronicity of the lesions. Immunocompromised patients can develop life-threatening infections due to HSV (such as encephalitis or pneumonitis), and in these cases, acyclovir is often used in high doses. If acyclovir-resistant HSV is encountered, it is usually treated with cidofovir and foscarnet; however, these drugs can cause kidney toxicity. Prophylactic treatment can also be administered with antiviral drugs to prevent or shorten future outbreaks.
Clinical trials are carried out before a new drug or treatment is released to the public to test its efficacy and safety. They are led by a team comprised of researchers, doctors, nurses, and other healthcare personnel. Participation in these trials is entirely voluntary, and patients can leave the trial at any point if they wish to do so. Joining a clinical trial allows patients to gain more control over their treatment, and to be treated by experts in the field.
Herpes clinical trials are carried out to test new treatments that could possibly cure the disease, and to create and test vaccines to prevent infection. If you are interested in joining a clinical trial, ask your doctor about any trials open in your area, or contact hospitals and/or universities to find out about clinical trials available for you.
Lifestyle Changes
If you have been infected with the herpes simplex virus, make sure to adopt habits that minimize the risk of infecting other people, such as using condoms to prevent infection during intercourse, avoiding having multiple sex partners, avoiding intercourse during an active outbreak. Be honest with your partners about having the virus, and consider contacting previous partners if you aren’t sure where you became infected.
Make sure to discuss all your therapeutic options with your doctor, since the proper treatment can make outbreaks shorter and less painful. Seek professional help if you are having difficulty coping with the diagnosis. It is normal to feel shock, anger and embarrassment after diagnosis; however, it is important to know that although there is a stigma associated with herpes, it is a manageable condition that hardly ever leads to serious complications and you can lead a normal life after being infected.
Tips For Friends and Family
- Be kind to your partner if they have HSV and don’t make them feel ashamed or stigmatize the disease. Practice safe sex, and ask your doctor about prophylactic treatment to minimize the risk of infection.
- Herpes can’t be spread through contact with personal objects, so there is no danger in sharing objects like towels, sheets, toilets, or going swimming together.
- Avoid intimate contact with your loved one when they have active sores.
- Consider couples counseling to deal with the diagnosis.
