Genital Herpes

           
Multiple intact vesicles, which will finally breakdown into ulcers


WHAT IS GENITAL HERPES?
It is a sexually transmitted infection caused by the herpes simplex virus (HSV). There are two types of HSV: type I and type II

  • HSV –1 is the usual cause of cold sores. Most infections are acquired during early childhood. It is estimated that more than 50% of adults have evidence of previous exposure to the virus.
  • Most genital infections are caused by HSV –2.However, the practice of oral sex has meant that HSV-1 can also appear on genitals


HOW DOES ONE GET GENITAL HERPES?

  • Sexual intercourse with an infected person
  • Your infected sexual partner may not have any visible sores or ulcers
  • Mother-to-child transmission during the passage through the birth canal
  • The are two presentations in genital herpes: primary/first episode herpes and recurrent herpes



WHAT IS PRIMARY / FIRST EPISODE HERPES?

  • Primary infection with genital herpes is usually more severe and lasts longer than recurrent attacks, generally 2 to 3 weeks
  • Groups of small blisters are the first signs
  • The blisters usually break down to form erosions (shallow ulcers) in the genital/anal area
  • Swelling of groin lymph glands



WHAT IS RECURRENT HERPES?

  • Recurrent herpes is usually milder than the primary infection and usually heals within a week
  • Recurrent herpes may be preceded by itch and irritation in the area where the blisters have not yet appeared
  • Not everyone who is infected with HSV gets recurrent attacks and there is no way of predicting how often the attacks will occur
  • In general, the attacks tend to become less frequent as time goes by
  • Herpes recurs because the virus hides in the nerve roots between attacks and reappears periodically to cause symptoms and signs



WHAT HAPPENS WITH PREGNANT MOTHERS WHO HAVE GENITAL HERPES?

  • Infected mothers may pass on the infection to their babies
  • The baby may be infected during the passage through an infected birth canal
  • Mothers should inform their obstetrician or STI specialist to determine the best method of delivery
  • Herpes infection in newborns may be serious, eg. blindness, mental retardation



HOW DOES ONE DIAGNOSE GENITAL HERPES?

  • Herpes is often diagnosed by its characteristic clinical appearance
  • A culture test helps to confirm the diagnosis
  • Culture tests are however only available in some centres
  • Another test called the Tzanck test is the examination of the infected fluid in the blisters for special cells.
  • The Tzanck Test can be used as a diagnostic aid
  • DSC offers Type Specifi Serological Tests for HSV which is a blood test that indicates previous exposure to HSV.
  • Many people have had previous exposure to oral herpes infection (cold sores on the lips) which is usually caused by HSV Type I, they will show positive blood tests but this does not mean they have genital herpes (which is usually caused by HSV Type II)
  • A person who has acute infection with HSV for the first time may not have a positive blood test till 6 weeks later.
     
 Interpretation of HSV Type-specific serological Test (TSST) Results 
HSV-  1
HSV-2
 Interpretation
   -
  -
This result implies that the individual has not been infected with either of these two viruses. However, as these tests may take up to six weeks to become positive, the test results will be unreliable if there has been a recent sexual exposure.
 
   +
   -
This result implies that the individual has been infected with HSV-1 at some time in the past. Usually the infection is acquired in childhood and involves the oro-facial region. However, genital infection with HSV-1 is increasingly common because of the practice of oral sex.
 
   +
   +
This result indicates that the individual has been infected both with HSV-1 and HSV-2.The most likely explanation is that the individual acquired oro-facial HSV-1 as a child and then acquired genital HSV-2 as an adult.
 
   -
   +
This result implies that the individual has been infected with HSV-2 at some time in the past, almost always sexually.
 

 

WILL THERE BE ANY TREATMENT IF BLOOD TEST SHOWS ABNORMAL RESULT?
There will be no treatment for the time being even if the result/s shows positive because at present, there are no symptoms


IS THERE A CURE FOR GENITAL HERPES INFECTION?

  • No, genital herpes is not curable
  • However, it is not a life threatening infection in adults
  • Treatment is aimed at each episode or attack
  • Oral antiviral agents like acyclovir, valacyclovir and famciclovir, are useful in reducing the severity of attacks if given early
  • They are usually given for the more severe primary genital herpes attacks
  • Antiviral creams may be useful for recurrent genital herpes attacks, they should be applied during the prodromal (early) stage of the recurrence
  • No drugs to date have been shown to halt or reduce the number of recurrent attacks permanently



WHAT SHOULD I DO?

  • Seek treatment immediately from medical experts
  • Refrain from all sexual activity until all the sores have healed
  • Do not self medicate
  • Be on the lookout for prodromal symptoms as they may be signs of an impending recurrence
  • Condoms reduce the transmission of genital herpes
  • Seek expert advice if you have questions regarding future children or pregnancy



WHAT IS SAFER SEX?

  • This is sex without the exchange of body fluids, e.g. vaginal secretions or semen, during sex
  • Use condoms correctly and every time you have sex
  • Do not consume alcohol before or during sex, this may impair your judgment

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