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Information about HSV



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HSV FAQ

Gory Details

Ever a Cure?

Propolis for Female Genital HSV

Information about Target HF2C



Summary

The herpesvirus family is ubiquitous in human populations and many, probably the majority, harbour one or other of the virus types with no symptoms, or do not notice them. Otherwise, "cold sores" around the mouth following childhood infection are commonplace. Some are afflicted more severely, with lesions occurring in the nostrils, in the mouth and elsewhere on the face. For adults contracting the virus, there are over 30,000 attendances at British clinics annually for new genital herpes infections. Then, the average number of outbreaks in the first year is 4.6 if it is HSV-2, or 0.8 if it is HSV-1. Some people get frequent outbreaks but they usually diminish in severity over time.



1. The pathogen

Herpes simplex is a large virus, with a diameter of around 200nm. Its major components are a DNA core of over 150kbp (thousand base pairs), a capsid, and an envelope. The envelope has glycoprotein spikes by which it attaches to cells, starting the chemical process of invasion of a cell. HSV-2, normally associated with genital herpes infections, is more aggressive than HSV-1. Incidentally, it is not possible to 'kill' a virus, because it is not alive. Thus viral infections are fundamentally different from bacterial ones. A virus is an amplifying poison, and it is not killed but inactivated.



2. Effects

Herpes lesions, blisters, sores and the like can be extremely painful. If the virus is contracted in childhood then its later effects tend to be milder. However sudden onset of infection in adulthood, frequently by sexual transmission, is often traumatic. Not only can the physical effects be severe, it is an acute challenge to a person's self-perception – their self-image. It complicates future relationships. It has been said that the physical effects of genital herpes are worse for women while the psychological effects are worse for men.

Contributing to the distress is that genital herpes acquired a stigma, and became the butt of jokes. Some have blamed this situation on pharmaceutical advertising at the time acyclovir was introduced, but this may be both unfair and inaccurate. It is unlikely that arcane trade advertising could have had such wide effect. More likely is that the new awareness of HSV had struck some chord in the human psyche. A psychologist might say that the jokes reflected a), a person's fear of contracting it himself and b), relief that he has not.

Women, very conscious of their physical appearance, often find the unsightly symptoms of facial HSV infections distressing.



3. Transmission

Although pure, 'naked' virus can be evident in lesions and sores, possibly the most dangerously infective agent is virally infected cells. That is, if a ripe, virally infected cell is shed, and rests in contact with another's skin, it may later burst releasing a large amount of infective viral particles. This is likely to be far more infective than a few solitary virions. Breaks in the skin present an open door to infection.

It happens sometimes that virus is shed without there being any outward sign, or even sensation. This is called asymptomatic viral shedding.

Exposed virus is readily inactivated by detergents, e.g. soap and water. Equine herpesvirus has been shown to persist out of its horse host for several weeks, but this has not been found in the human herpesviruses. A solution of 80% ethanol, 5% isopropanol and 15% water has potent disinfectant action against many bacteria and viruses, including HSV.

Although washing with soapy water will certainly help prevent transmission, it will be insufficient to protect a partner from becoming infected during kissing or sex, so the obvious precautions should be taken.



4. Treatment

Current chemotherapy (i.e. pills) concentrate on inhibiting a particular replication phase of the virus. Latency is not affected. Chemotherapy does reduce the risk of passing the virus to someone else. If the outbreaks are serious, medical advice should be sought. That you should also do if your condition worsens. The worst infections can be so severe that hospitalisation is necessary, though normally the greatest risk is to new-borns.

A good summary of HSV is available from the Pathogen Profile Dictionary. Extensive documentation exists about valaciclovir (esterified aciclovir). DNA Viruses of Medical Importance is a video lecture with lots of information.