Herpes

 Herpes simplex virus (HSV) is a common viral infection caused by two types of herpes viruses: HSV-1 and HSV-2. These viruses are known to cause painful blisters and sores, often referred to as “cold sores” or “fever blisters” (in HSV-1) or genital herpes (usually associated with HSV-2) because the HSV virus is dormant in the body and reactivates periodically, HSV infection can last a lifetime.

Types of herpes simplex virus: 

HSV-1 (herpes simplex virus type 1): causes herpes labialis, which causes sores primarily around the mouth and face.

HSV-2 (herpes simplex virus type 2): primarily causes genital herpes and causes sores around the genitals or anus. 

symptoms of HSV:

primary infection:

 

    Oral Herpes(HSV-1) :

•           ulcers around the lips, mouth, or face. 
•           Fever, swollen lymph nodes, and fatigue.
•           Tingling and itching occur before the sores form.

 Genital herpes (HSV-2): 

•     painful blisters or ulcers on the genital or anal area. 
•     Pain and burning sensation when urinating. 
•    Flu-like symptoms including fever, body aches, and swollen lymph nodes.

 Asymptomatic infection:

 

• Most HSV-infected individuals do not show any noticeable symptoms, but they can transmit the virus.

 

Transmission:

HSV is highly contagious and is spread by direct contact with infected skin, mucous membranes, or body fluids. Common routes of transmission include:

•  HSV-1: saliva, kissing, sharing dishes, oral and genital contact.
•  HSV-2: sexual contact, including vaginal, anal or oral intercourse.
•  HSV can be transmitted without visible sores (asymptomatic shedding)
• HSV-3: contact with skin, mucous membranes, or body fluids.

 Diagnosis:

 Physical examination: based on characteristic blisters or sores. 

 Laboratory studies:

•  detection of HSV DNA by viral culture or polymerase chain reaction (PCR). 
•  Blood testsdetection of HSV-specific antibodies (IgG/IgM) to distinguish HSV-1 from HSV-2.

Tzanck test:

•  microscopic examination of cells in the sores. 

Treatment of HSV : 

There is no cure for HSV, but antiviral medications can reduce symptoms, decrease the frequency of outbreaks, and reduce the Reduce the risk of infection. Reduce risk of infection 

1.Antiviral medications: 

• acyclovir, valacyclovir, and famciclovir are commonly prescribed.
•  For primary infection: 7-10 days of antiviral treatment.
•  For recurrent infections: shorter duration (1-5 days). 
• For frequent infections: daily antiviral suppressive therapy.

2. Symptom relief: 

• over-the-counter analgesics such as ibuprofen or acetaminophen.
•  Topical lidocaine or numbing cream to reduce discomfort.
•  Compresses to cool the affected area. 

Complications:

• Herpes keratitis: eye infection that can lead to blindness. 
• Herpes neonatorum: Aggressive infection in a pregnant woman during childbirth can cause severe infection in the newborn.
• Herpetic eczema: HSV commonly infects eczematous and immunocompromised individuals.
• Psychological effects: anxiety and distress due to stigma, recurrence of symptoms.

 Prevention: 

• Avoid close contact with infected persons during outbreaks.

Use condoms or dental dams during intercourse.

• if infected with HSV, receive antiviral treatment to reduce risk of transmission.
• pregnant women infected with HSV should notify their health care providers to manage the risk of neonatal herpes.

 Prognosis : 

With appropriate treatment, most HSV patients can lead a normal life. Antiviral medications and lifestyle modifications can significantly reduce the frequency and severity of illness and the risk of infection.