Herpes HSV-2: hitting below the belt
n my column last month, I discussed the first type of herpes simplex viruses (HSV-1), the highly infection virus responsible for cold sores.
This second article addresses HSV-2, a Sexually Transmitted Infection (STI) referred to as genital herpes that is found in 20 to 60 per cent of the adult population and which affects the skin or mucus membranes of the genitals.
Genital herpes infections are mostly benign conditions and, for the most part, occur between 20 to 35 years of age, which can be troublesome, as there are likely to be frequent episodes of recurrence.
Less than one third of the infected individuals go on develop symptoms after initial exposure to the virus. For those who do, the first manifestations will occur a few days after the first |contact and may include flu-like syndrome with fever, malaise, headache, muscle aches, swollen lymph nodes and tenderness in the groin. Itching and painful blisters that break to leave ulcers (sores) are often seen in the genital area and around the anus |and buttocks and these last for eight to 10 days. Difficulties in |urination and vaginal discharge in women can also be present.
In other cases, the first outbreak happens several months or even years following the first infected contact. Sadly, because of the uncertainties surrounding the time of contamination, genital herpes often creates feelings of embarrassment or distrust among sexual partners and has a negative effect on their emotional |relationship.
As with other STI, individuals who do not develop any |symptoms are unaware of their contamination and might unknowingly transmit the virus to receptive, non-infected people.
Contamination occurs during any type of sexual contact or through direct skin contact with an infected person. The highest risk is during an outbreak but infection can also happen when the infected partner looks healthy. However, due to the inability of the virus to survive outside the body, the risk of HSV-2 contamination from objects sullied by an infected individual (toilet bowl, towels) is practically non-existent.
Although HSV-2 typically affects the lower part of the body and HSV-1 is mainly present above the belt, oral sex can spread HSV-2 to the lips and HSV-1 to the genitals.
One of the notable features of the herpes simplex virus is its ability to remain dormant or hidden in the nerve cells, likely for a lifetime. The virus can suddenly become active again leading to recurrences that may be triggered by a minor feverish infection or excessive fatigue or stress.
Recurrences often appear several times per year and include broadly similar symptoms and signs as the first manifestations. The severity of genital herpes recurrences varies considerably from person to person but for most individuals subsequent outbreaks tend to become less frequent and less severe.
The presence of genital ulcers greatly increases the risk of |contracting another sexually transmitted infection including HIV so if you suspect that you have contracted HSV-2, you must seek |a specialist opinion to confirm the diagnosis and undertake the necessary tests for other possible STI.
The diagnosis of genital herpes is relatively easy especially when several outbreaks have occurred. Laboratory analyses of the secretions found in the sores may be needed to identify the virus.
Treatment relies on antiviral medication – in tablet form only – from the acyclovir group. The medicine is effective in alleviating the severity, duration and frequency of the symptoms and should be taken as soon as the first manifestations appear. However, as the drug does not reach the virus within the nerve cells, it does not eradicate the virus from the body and as a result, cannot prevent future eruptions.
Preventive treatment through a daily dose of the antiviral is proposed for those who have more than five to six recurrences per year.
Prevention focuses on avoiding any sexual contact with |people who present suspicious blisters and adhering strictly to the precautionary measures that apply to any STI.
DR GERARD LALANDE is managing director of CEO-Health, |which provides medical referrals for expatriates and customised executive medical check-ups in Thailand. He can be contacted |at [email protected].
