Herpes Simplex Virus


By: Dr. S. Lawson

breast&doctor-lawson.jpgHerpes Simplex Viruses (HSVs) are ubiquitous organisms whose antibodies can be detected in one fifth of the US population. Worldwide prevalence of HSV has increased significantly in recent decades. HSV-1 and HSV-2 are two types of this virus.

HSV-1 infections are transmitted primarily by contact with infected saliva and airborne droplets and usually affect the surface area of the lip, nose, the oral mucosa and tonsils. Congenital (intrauterine acquired) infection with HSV-1 is rare. HSV-1 invades the trigeminal nerves (the cranial nerve the controls the most of the facial and oral region) where they lie dormant until they are reactivated by a stressor (i.e. temperature).

HSV-2 infections are transmitted sexually in adults or during passage through the genital track in the newborn. Perinatal HSV-2 infection is more common than congenital (intrauterine acquired) HSV-2 disease. Women infected in their third semester of pregnancy (congenital HSV infection) have a high incidence of premature birth and intrauterine growth retardation. Cesarean delivery is given to women with active HSV-2 genital lesion at the time of delivery. Sexual activity should be avoided in active HSV-2 disease.

Eighty percent of infected patients are asymptomatic. Symptomatic infections can result in complications during reactivation after primary infection. Complications include herpetic whitlow (finger ulceration), blindness, as well as painful oral and genital lesions (vesicles). Spread to visceral organs, HSV can cause arthritis, multiple sclerosis, pneumonia, esophagitis, adrenal necrosis, meningitis, encephalitis (brain matter infection).

HSV-1 can present itself as painful ulcerating vesicles on and around the lips and in the oral cavity (mucosa and tonsils). Constitutional symptoms include fever, myalgia (muscle aches), malaise, headache, itching and anorexia and intractable pain. HSV-1 can also cause urithritis (inflammation of the urinary tract). Ruptured vesicles formed by HSV-1 infections create ulcers covered with a white coating that can be confused with thrush (candidosis).

There is strong association of HSV-1 with Bell's palsy and multiple sclerosis. HSV-1 is the most common cause of Herpes Simplex Encephalitis beyond the newborn period. Patients with Herpes Simplex Encephalitis can develop memory loss, seizures, hallucination and can produce similar features of psychosis and delirium tremens. The temporal region of the brain is the most common site of infections.

Primary genital tract HSV-2 is asymptomatic in most patients. HSV-1 can also cause genital tract infection with similar clinical presentation but is less common. After the primary infection with HSV-2, it invades the sacral nerve root where they lie dormant (latent period). Recurrence is triggered by a stressor (i.e. depression, menstruation). A burning pain precedes the formation of herpetic vesicles on the labia and vestibule of the vagina. Cervical and vaginal mucosal lesions can ulcerate and progress to necrosis. Urinary retention can result from pain on urination in women. Herpetic lesions may appear on the penis, scrotum, thigh and buttocks, and the perianal area in individuals who practice anal sex. Women tend to have more complications and more severe symptoms. Individuals who have subclinical infections can still shed virus and infect their partner.

Detect, Protect, Treat Magnetic resonance imaging MRI and HSV DNA amplification by PCR are diagnostic modalities with high sensitivity.

Condoms are only protective at the surface it covers. Polymerase chain reaction (PCR) can identify asymptomatic viral shedding by detecting HSV DNA. Duration of symptoms and viral shedding from acute HSV lesions is reduced by oral acyclovir (Zovirax), valacyclovir (valatrex). Alternatively, anti-viral essential oils have been effective in treating herpes lesions and reducing their onset. Essential oils such as Melissa, Melaleuca, and Rosemary are oils that have been used successfully in clinical practice to treat herpes. By reducing foods high in the amino acid arginine (chocolate, peanuts, seeds, and other nuts) and increasing foods high in the amino acid lysine (vegetables, legumes, fish, and chicken) can effectively reduce the frequency duration and severity of recurrences can be effectively minimized. Pure uncontaminated Omega 3 fatty acids EICOSA-PENTAECNOIC ACID (EPA) and DOCOSA-HEXAENOIC ACID (DHA) derived from fish oil have been used in clinical practice to safely and effectively treat herpes infections.