What is herpes?
Genital herpes is a sexually transmitted disease (STD) caused by the herpes simplex virus (HSV). There are two strains that can cause either genital or facial infections; HSV-1 generally affects the face (fever blisters and cold sores), HSV-2 typically affects the genital area.
The following is a list of the families included in the Human Herpes Virus:
• Herpes Simplex 1 -- fever blisters /cold sores
• Herpes Simplex 2 -- genital blisters Varicella-Zoster -- chicken pox and shingles
• Epstein Barr -- mono and CFS-chronic fatigue syndrome
• Cytomegalovirus -- illness in newborns
• HHV-6 -- roseola
• HHV-7 -- rash
• HHV-8 -- Kaposi's sarcoma
One out of four Americans age 12 or older, (45 million people) are infected with HSV-2. HSV-2 infections are more common in women than in men by 1-in-4 with the percentage for men being 1-in-5. HSV-2 is transmitted either through direct sexual or skin-to-skin contact, and it is possible to transmit the virus when sores or other symptoms are not evident.
Common symptoms of Herp
• Genital itching, burning, tingling or irritation
• Pain in the legs, buttocks or genital area
• Fever, swollen lymph nodes, headache, muscle ache, fatigue and other flu-like symptoms
• Decreased appetite
• Painful or difficult urination
• Vaginal discharge
• Abdominal pressure
In the first year of infection, outbreaks of painful genital blisters and sores can occur up to four or five times. The first episode usually occurs within two weeks of initial infection, and resulting sores typically heal within two to four weeks. Overall, the risk of transmitting the virus is highest within an individual's first year of infection, immediately before and after visible "outbreaks" and by those who have frequent outbreaks.
Periodic outbreaks known as "recurrences" can be triggered by illness, stress, fatigue, skin irritation, menstruation and other stress factors. "Recurrences" are generally milder than the initial outbreak and last about one week. The number and pattern of recurrences are unique to each person and can also change over time.
Prefers the trigeminal nerve area
Causes all cold sores and fever blisters
Accounts for 1/3 of new genital infections
Causes most ocular herpes and encephalitis
Presents special risks for newborns
(can make new HSV-2 more likely to be
Causes 2/3 of new genital infections
Recurs 4-5 times per year in the genital area
Is very rarely oral and recurs .01 x per year if
oral infection does occur
DOES protect against getting HSV-1
Can be present for years without symptoms
Diagnosis for HSV-1 and HSV-2 blood test can be determined through the following:
• Western Blot at UW the gold standard
• POCkit test from Diagnology
• MRL HSV-1 and HSV-2 ELISA
• MRL Immunoblot
• Meridian Premiere ELISA for HSV-1 AND HSV-2
Treatments for Herp
Medications are available to treat outbreaks and potentially reduce recurrences. However, there is "NO CURE" for herpes at this time and once an individual has been infected, they will remain infected for life.
Treatment options available are:
Acyclovir (Zovirax) -- An antiviral drug used in the treatment of herpes simplex virus 1 (fever blisters, cold sores), herpes simplex virus 2 (genital herpes) and herpes zoster (shingles). Acyclovir comes in the form of pills, ointment or injection. The drug functions as a nucleoside analog, but must be converted to an active (phosphated) form by the thymidine kinase enzyme produced only by cells infected by certain herpes viruses, including varicella zoster virus (shingles) and herpes simplex-1 and -2. Acyclovir causes few side effects--occasionally nausea, diarrhea or headaches. It is now available in a generic form.
Valtrex -- An antiviral drug used in the treatment of herpes simplex virus 2 (genital herpes)
Famciclovir (Famvir) -- A prodrug (see) for an acyclovir-like active compound. It has especially high bioavailability (see) and is an approved therapy for shingles. It also is under investigation for herpes simplex-2 (genital herpes).
Antiretroviral -- A substance that stops or suppresses the activity of a retrovirus such as HIV, AZT, ddC, ddI and d4T are examples of antiretroviral drugs.
Asymptomatic -- Without signs or symptoms of disease or illness.
CMV (Cytomegalovirus) -- A herpes infection that causes serious illness in people with AIDS, CMV can develop in any part of the body but most often appears in the retina of the eye, the nervous system, the colon or the esophagus.
Cold Sores -- Otherwise known as "fever blisters" and herpes type-1 infection.
Disseminated Infection -- A herpes infection that spreads over a wider than usual area of the body, frequently afflicting internal organs.
Encephalitis -- A brain inflammation of viral or other microbial origin. Symptoms include headaches, neck pain, fever, nausea, vomiting and nervous system problems. Several types of opportunistic infections can cause encephalitis.
Epstein-Barr Virus (EBV) -- A member of the herpes virus family that causes one of two kinds of mononucleosis (the other is caused by CMV). It infects the nose and throat and is contagious. It lies dormant in the lymph glands and has been associated with Burkitt's lymphoma and oral hairy leukoplakia.
Ganglion -- A knot-like grouping of the nerves that serve a particular part of the body.
Herpes -- While "genital herpes" can cause symptoms in a variety of sites below the waist, the term is used to denote all HSV infection that is latent in the sacral ganglion, at the base of the spin. An estimated 45 million Americans have genital herpes, with 500,000 new cases each year. Approximately two-thirds of who are infected do not know they have genital herpes, either because they have no symptoms or because their symptoms are so mild they go unnoticed. Symptoms of the first infection usually appear one to twenty-six days after exposure and last two to three weeks.
Herpes Encephalitis -- A rare, severe illness that occurs when the brain becomes infected with HSV.
Herpes Gladiatorum -- The presence of herpes lesions on the body caused by HSV infection that is transmitted usually through the abrasion of skin in a contact sport. Also known as gladitorum.
Herpes Whitlow -- The presence of herpes lesions on the fingers or toes.
Herpes Zoster -- Acute inflammatory disease with vesicles grouped in the course of cutaneous nerves. See Shingles and Varicella Zoster Virus (VZV).
Herpes Zoster Auricularis -- Herpes zoster of the ear.
Herpes Zoster Opthalmicus -- Herpes affecting the opthalmic nerve
HHV-6 -- A newly observed agent found in the blood cells (Tlymphocytes) of a few patients with a variety of diseases affecting the immune system. This virus causes roseola infantum, a common childhood infection of children under 4. Symptoms of roseola infantum include high fever and listlessness followed by a rash.
HHV-7 -- This virus has been identified in the laboratory, but has not been associated with any diseases to date. It infects T-cells, and genetically resembles HHV-6.
HHV-8 -- A recently recognized virus that has notable homology with several known herpes viruses. Detection of HHV-8 in peripheral blood mononuclear cells or HHV-8 antibody seroconversion is associated with an increased risk of developing Kaposi's sacroma.
Kaposi's Sarcoma (KS) -- An AIDS-defining illness consisting of individual cancerous lesions caused by an overgrowth of blood vessels. KS typically appears as pink or purple painless spots or nodules on the surface of the skin or oral cavity. KS also can occur internally, especially in the intestines, lymph nodes and lungs, and in this case is life-threatening. There has been considerable speculation that KS is not a spontaneous cancer but is sparked by a virus. A species of herpes virus similar to Epstein-Barr virus is currently under extensive investigation. Up to now, KS has been treated with alpha interferon, radiation therapy (outside the oral cavity) and various systemic and intralesional cancer chemotherapies. KS frequently occurs in immuno-compromised patients.
Malaise -- A vague feeling of bodily discomfort and fatigue. This is a common sympton of many illnesses, including many STDs, and can often be the result of infection or a drug's side effects.
Ocular Herpes -- Herpes infection in the eyes.
Oral-Facial Herpes -- The presence of latent herpes simplex infection in the trigeminal ganglion, at the top of the spine. When reactivated, oral-facial herpes can cause symptoms anywhere on the mouth, face, but typically cold sores are on the lips. Recurrent oral-facial herpes is largely caused by HSV-1.
Oral Hair Leukoplakia (OHL) -- A whitish lesion that appears on the side of the tongue and inside cheeks. The lesion appears raised, with a ribbed or "hairy" surface. OHL occurs mainly in people with declining immunity and may be caused by Epstein-Barr virus infection.
Prodrome -- An early warning symptom of illness (i.e., prodrome for a genital herpes outbreak often involves an aching, burning, itching, or tingling sensation in the genital area, buttocks, or legs).
Recurrence -- The return of symptoms after a remission (time without symptoms). An example of this is outbreaks of herpes after periods of time without herpes lesions.
Roseola -- Skin condition marked by red spots of varying sizes on the skin. Measles or German measles.
Sacral Ganglion -- The never root at the base of the spine. (The sacral ganglion serves as the site of the latency in genital herpes infections).
Serostatus -- The condition of having or not having detectable antibodies to a particular microbe in the blood as a result of infection -- for example, HSV-1, HSV-2 or HIV. One may have either a positive or a negative serosatus.
Shingles -- A skin condition caused by reactivation of a Varicella Zoster Virus (VZV) infection, usually acquired in childhood (when it appears as chicken pox). Is consists of painful, inflammatory blisters on the skin that follow the path of individual peripheral nerves. The blisters generally dry and scab, leaving minor scarring. Standard treatment is with famciclovir or acyclovir.
STD (Sexually Transmitted Disease) -- Any infection that is acquired through sexual contact in a substantial number of cases.
Trigger -(factor) -- Any biologic or behavioral event that influences latent HSV to reactivate.
Varicella Zoster Virus (VZV) -- The cause of chicken pox in children. Its reactivation in adults causes shingles.
Viral Replication -- The process by which a virus makes more copies of itself.
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