~ Weekly Health Advice from PMGH – The Herpes Simplex Virus ~

Welcome to another health update from the Port Moresby General Hospital, this week we are focusing on the herpes simplex virus. Always practice safe sex and talk to your doctor about STD testing.

For more information, please contact info@portmoresbygeneralhospital.com

What is the Herpes Simplex Virus?
Infection with the herpes simplex virus, commonly known as herpes, can be due to either herpes simplex virus type 1 (HSV-1) or herpes simplex virus type 2 (HSV-2). HSV-1 is mainly transmitted by oral to oral contact to cause infection in or around the mouth (oral herpes) while HSV-2 is almost exclusively sexually transmitted, causing infection in the genital or anal area (genital herpes). However, HSV-1 can also be transmitted to the genital area through oral-genital contact to cause genital herpes. Both oral herpes infections and genital herpes infections are mostly asymptomatic (showing no symptoms) but can cause mild symptoms or painful blisters or ulcers at the site of infection. An estimated 3.7 billion people under age 50 have HSV-1 infection globally while an estimated 417 million people aged 15-49 worldwide have the HSV-2 infection according to World Health Organization (WHO).

HSV-1 is most contagious during an outbreak of symptomatic oral herpes. Those with active symptoms of oral herpes should avoid oral contact with others including sharing objects that have come in contact with saliva and should abstain from oral sex to avoid transmitting herpes to the genitals of a sexual partner. Individuals with genital HSV infection should abstain from sexual activity whilst experiencing symptoms of genital herpes. Both HSV-1 and HSV-2 can be transmitted in the absence of symptoms which is why it is always important to always practice safe sex.

Neonatal Herpes
World Health Organization (WHO): Neonatal herpes is a rare, but sometimes fatal, condition that can occur when an infant is exposed to HSV in the genital tract during delivery. The risk for neonatal herpes is greatest when a mother acquires HSV infection for the first time in late pregnancy. Women who have genital herpes before they become pregnant are at very low risk of transmitting HSV to their infants. Talk to your doctor.

Herpes and HIV
In immunocompromised people, such as those with advanced HIV infection, HSV-1 can have more severe symptoms and more frequent recurrences. Rarely, HSV-1 infection can also lead to more severe complications such as encephalitis or keratitis (eye infection) according to World Health Organization (WHO). HSV-2 and HIV have been shown to influence each other. HSV-2 infection increases the risk of acquiring a new HIV infection by approximately three-fold. In addition, people with both HIV and HSV-2 infection are more likely to spread HIV to others. HSV-2 is amongst the most common infections in people living with HIV, occurring in 60-90% of HIV-infected persons. Infection with HSV-2 in people living with HIV (and other immunocompromised individuals) often has a more severe presentation and more frequent recurrences. In advanced HIV disease, HSV-2 can lead to more serious, but rare, complications such as meningoencephalitis, esophagitis, hepatitis, pneumonitis, retinal necrosis, or disseminated infection. 

Signs and Symptoms
Herpes simplex virus type 1 (HSV-1): Oral herpes infection is mostly asymptomatic, and the majority of people with HSV-1 infection are unaware they are infected. Symptoms of oral herpes include painful blisters or open sores called ulcers in or around the mouth, sores on the lips are commonly referred to as “cold sores.” Those infected will often experience a tingling, itching or burning sensation around their mouth, before the appearance of sores. After initial infection, the blisters or ulcers can periodically recur, the frequency of recurrences varies from person to person. Genital herpes caused by HSV-1 can be asymptomatic or can have mild symptoms that go unrecognized. When symptoms do occur, genital herpes is characterized by 1 or more genital or anal blisters or ulcers. After an initial genital herpes episode, which may be severe, symptoms may recur however genital herpes caused by HSV-1 often does not recur frequently.
Herpes simplex virus type 2 (HSV-2): Genital herpes infections often have no symptoms, or mild symptoms that go unrecognized. Most infected people are unaware that they have the infection. When symptoms do occur, genital herpes is characterized by one or more genital or anal blisters or open sores. In addition to genital ulcers, symptoms of new genital herpes infections often include fever, body aches, and swollen lymph nodes. After an initial genital herpes infection with HSV-2, recurrent symptoms are common but often less severe than the first outbreak. The frequency of outbreaks tends to decrease over time. People infected with HSV-2 may experience sensations of mild tingling or shooting pain in the legs, hips, and buttocks before the occurrence of genital ulcers.

Diagnosis and Treatment of Genital Herpes
It is important to have an open and honest discussion with your doctor about your sexual history. In diagnosing genital herpes your doctor may require blood tests or perform a swab test on a genital sore (recommended in the first 48hours of an ulcer forming for accurate results). Left untreated, the herpes virus can cause meningitis, and exposed blisters can increase the risk of acquiring HIV. Genital herpes is a life-long disease of which these is no cure. Medications are available to help reduce the severity and frequency of symptoms but does not cure the infection. Individuals with genital HSV infection should abstain from sexual activity whilst experiencing symptoms of genital herpes. HSV-2 is most contagious during an outbreak of sores however it can also be transmitted when no symptoms are present. Consistent and correct use of condoms can reduce the risk of spreading genital herpes however its important to remember that condoms only provide partial protection as HSV can be found in other areas not covered by a condom. Always practice safe sex. 

Top Tips to Reduce Your Risk of Getting an STD
Practice Safe Sex: Consistent and correct use of the male latex condom for all sexual activities reduces the risk of sexually transmitted diseases (STD's) and HIV transmission. Condom use cannot provide absolute protection against any STD however it will greatly reduce your risk.
Get Tested Regularly: Get regularly tested (even If you are in a monogamous relationship) and encourage your partner to do the same. If you are not at high risk for getting an STD (not having sex regularly), it is still important to get tested. Always get an STD test before starting a new sexual relationship and if you are being treated for an STD it is important to complete treatment before resuming sexual activity, or you and your partner could end up passing it back and forth. Seek early advice if you notice oral, genital or anal sores after recent sexual contact.
Avoid Sexual Activity: If you feel you are unable to have sex safely, you should avoid all sexual activity as you may be putting yourself or others at risk. If you are unsure if you have an STD get tested.
Have Sex Only Within a Mutually Monogamous Relationship: Two people who have sex only with one another don’t have any opportunity to bring a new STD into the relationship. If you and your partner have been tested and are healthy, remaining faithful to each other is a good way to reduce your chances of contracting an STD. 
Talk to Your Partner: It is important to be comfortable talking about safe sex with your partner as well as STD testing. Be sure to tell your partner if you are having a sexual relationship with someone else and ask your partner the same.
Don’t Drink or Use Drugs Before Having Sex: It’s difficult to make responsible choices about your sex life if you’re using alcohol or drugs. When under the influence, you are more likely to choose to have sex with someone you wouldn’t otherwise have picked as a partner, and less likely to be able to successfully negotiate safer sex.
Be Comfortable Saying No! If you don’t feel it is right, that’s ok. It’s your choice to say yes to sex, and it’s also your choice to say no. Similarly, if your partner tells you no, listen.
Be Responsible for Your Own Protection: It doesn’t matter if you’re male or female. If you’re going to have sex, you should be prepared. Bring your own safer sex supplies, the worst thing that can happen is that you’ll have extras. (it’s important to note that the birth control pill will not protect you from STD’s).

Press Release