Herpes Simplex Virus (HSV) Diagnosis and Treatment

Herpes simplex virus types

There are two main types of HSV:

• HSV-1: Typically associated with oral herpes.
• HSV-2: Primarily causes genital herpes.

Both types can also lead to infections in other parts of the body.

Areas of the body that herpes simplex virus affects

HSV can be seen in a range of body parts, including:

Brain and spinal cord

Herpes simplex virus may cause encephalitis or meningitis. In severe cases, it can lead to life-threatening conditions such as herpes meningoencephalitis.

Skin

Herpes simplex virus can affect the skin on various parts of the body, causing infections, such as herpetic whitlow (fingers), herpes gladiatorum (other skin surfaces), or eczema herpeticum in individuals that have atopic dermatitis.

Face and mouth

Oral herpes causes cold sores around the mouth and on the lips. It can also lead to herpetic gingivostomatitis, where sores develop inside the mouth. Rarely, HSV may cause nasal herpes.

Lungs and other organs

In rare cases, HSV affect organs, leading to infections like herpes oesophagitis(in the oesophagus), herpes simplex hepatitis(in the liver), or HSV pneumonia (in the lungs), particularly in immunocompromised individuals.

Eyes

Ocular herpes, such as herpes keratitis, can lead to severe infections in the eye.

Genital

Genital herpes causes sores in the genital region, including internal regions like your cervix and visible regions like the penis or vulva.

Causes of HSV

HSV spreads through direct contact with:

• Bodily fluids, including semen, vaginal secretions, or saliva.
• Herpes sore.
• Mucous membranes (such as in the vagina, anus, or mouth).

Transmission occurs in the area where the virus is active, whether oral or genital. For example, genital HSV will not spread via saliva unless oral HSV is also present.

Symptoms of HSV

The symptoms differ depending on the infection type:

• Herpes meningitis: Sensitivity to light, headaches, and fever.
• Eye herpes: Blisters around the eyes or on the eyelids, eye irritation, and sensitivity to light.
• Herpetic whitlow: Finger swelling, painful blisters on the finger, and discoloured skin around the fingernail.
• Oral herpes: Tingling, itching, or burning skin followed by blisters around the mouth or on the lips.
• Herpes gladiatorum: Blister commonly on the face, chest, ears, hands, or skin.
• Genital herpes: Fever, swollen lymph nodes, headaches, and blisters in the genital region.
• Encephalitis (HSV): Headache, behavioural change, fever, and seizures.

How the virus spreads?

HSV is transmitted through various types of contact:

The incubation period of HSV

The incubation period of HSV ranges from 24 hours to 26 days, typically lasting 6 to 8 days. The symptoms aren't likely to show immediately and could remain dormant for months or even years.

Triggers of HSV outbreaks

Certain factors may reactivate HSV and cause an outbreak:

• A suppressed immune system.
• Fever
• Stress.
• Sun exposure (specific to oral herpes).
• Hormonal changes (e.g., during menses).

Stages of HSV infection

• Primary infections: The virus enters the body, replicates, and causes symptoms. Immune responses may lead to blister formation and inflammation.
• Latency: The virus remains dormant in nerve cells but can reactivate.
• Reactivation: The virus may "wake up," potentially causing shedding, full outbreaks, or symptoms.

Diagnosis and testing

Medical professionals diagnose herpes simplex virus through physical examinations and laboratory tests. For visible sores, swabs are taken for analysis. If sores are absent, blood tests can detect antibodies against HSV-2 or HSV-1.

Treatment options

Treatment involves prescription antiviral medications in various forms:

• Eye drops for ocular herpes.
• Creams or ointments.
• Tablets.
• Intravenous medications.

Chronic suppressive therapy

This long-term treatment is recommended for frequent or severe outbreaks, reducing their frequency by 70-80% and minimising viral shedding. Common medications include:

• Valacyclovir.
• Famciclovir
• Acyclovir.

Episodic therapy

Used to manage individual outbreaks by taking antivirals early, reducing severity, and speeding up recovery. However, episodic treatment doesn't prevent future outbreaks.

Preventive methods

While preventing HSV entirely is challenging, risk can be reduced by:

• Encouraging partners to get tested for STIs (sexually transmitted infections).
• Avoiding contact with individuals experiencing an active outbreak.
• Using barrier protection (like condoms) during sexual activities.

HSV is a manageable condition with proper care and precautions.

For more information or to book an appointment for an HSV test, contact us today. Your health is our priority!