9743 herpes ssr

Sector Summary Report:
Before the emergence of HIV and AIDS, herpes was the most feared sexually transmittedinfection (STI). Anxiety around herpes stems from it being an incurable, life long infection,about which there is a lack of knowledge and many misconceptions. This sector summaryreport seeks to provide an overview of herpes to health promoters working in sexual health.
particular part of the body, both can infect either above the neck or below the waist.
herpes simplex virus. These are part of a group of eight herpes viruses(1) that infect three quarters of the population have been infection with HSV-1 (the ‘cold sore’ virus). infected (usually in childhood) with HSV-1 and around 10-20% (2) of the population have through a minute break in the skin, travels of HSV-2 is rising due to increased sexual the nerve until it reaches the ‘ganglion’ (a junction for several nerves supplying an being infected in childhood thanks to higher similar in structure and are identical in area of the body). There the virus will lie standards of living and hygiene. As having their modes of transmission and symptoms.
Both cause skin ulceration, especially of trigger at a later date. Then it will travel protection against getting genital herpes, cells; as the virus kills these cells it causes the tell-tale skin inflammation or blisters.
or lips – known as ‘cold sores’). Classically shut down replication of the virus but cannot The extent of both infections is hidden oral herpes is associated with herpes simplex totally eradicate it, leaving virus to persist because in many people the virus does notvirus 1 (HSV-1), with genital herpes linked reactivate, or if it does, symptoms are mild enough to go unnoticed. Rates of HSV -1and HSV- 2 infection are considerably higheramong those with high numbers of sexual “The herpes simplex viruses are extremely
partners, GUM clinic attendees and gay men.
In 2004 around 1,000 gay or bisexual men common. In 2004 around 1,000 gay or bisexual were seen in sexual health clinics with their
first episode of genital herpes (with thousands men were seen in sexual health clinics with
more experiencing recurrences but not seeking their first episode of genital herpes (with
thousands more experiencing recurrences but
not seeking medical attention).”

inside the mouth and throat, as well as in or around the nose. In a rare complication The symptoms of the first or ‘primary’ (such as reddened skin, a tiny pimple or a break in the skin resembling a paper cut).
(antibodies) against the virus, allowing blisters are in the urethra. Milder symptoms The classic symptoms of the first (primary) spot or general reddening of the skin.
ten days (or longer) after infection. Where herpes simplex viruses will never lead to the virus first entered the skin it causes reddening and possibly an itching, burning, Blisters may appear on the entrance to or the site of infection may swell, possibly particularly painful, especially during a (often so mild that they are overlooked).
Other areas of the body
appear in the same part of the body asthe primary episode – or a site close by if The reddening or tingling of the skin are the virus travels down a different nerve to thigh, buttocks and groin. Herpes blisters herald the arrival of blisters. Sometimes on the finger are called ‘whitlows’ and tend to decrease over time, but up to four an episode (3) may abort itself despite the resulting from touching a blister. A rare either on their own or in clusters. These HSV-2 and are detectable in blood tests.
grow, filling with a clear, highly infectious four weeks. Genital and anal blisters can the other HSV strain, or, if infected withthe other variant, may experience no ormilder symptoms. Triggers
‘suppressive therapy’ for a period of but several designed to prevent infection have blisters six or more times a year.
• lack of sleep or being ‘run down’ viral shedding entirely and may itself lead USA since late 2002. It is only partially resistance. Alternatively individuals may virus is reactivated by Ultraviolet light) vaccinated - at preventing infection with – if prone to cold sores, apply sun block strain to begin with, without ever having used anti-virals themselves. Treatment is • friction against the skin - including sexual prescribed for more than six months.
intercourse (reduced by use of lubricant) • foods containing the amino acid Arginine Symptom management includes:
To prevent the spread of herpes:
• pain-killing creams or sprays (such as of the prodromal stage until the blisters Health impact on those with HIV
In people with HIV, especially those
• Condoms provide a degree of protection • To avoid spreading the infection to a widespread and longer lasting. As a result HIV positive individuals are more likely to be given suppressive anti-viral therapy to prevent or reduce herpes episodes.
Disseminated infection (when the virus • drying blistered skin with a hair dryer • Sex toys used on more than one person affects organs such as the brain, causing should be covered by a fresh condomwhen used with each new sexual partner.
• tannin in cold, wet tea bags held to the Impact on HIV transmission
• ice held to the blister eases pain (ice should not be placed directly on skin.
positive people with herpes are more able • applying lemon balm (Melissa) cream.
The following can transmit herpes, if they Although genital ulcers were once believed involve contact with skin that is shedding The herpes viruses cannot survive outside so cannot be spread through toilet seats, • unprotected anal or vaginal intercourse ‘cold sores’). This may be attributable to or a decrease in the proportion of people takes place when the virus is being ‘shed,’ i.e. released from the skin of an infected • sharing sex toys without covering with tingling in the skin until after the blister clear fluid inside the herpes blister carries a lot of virus and is highly infectious.
• flannels and towels may cause the virus occurs, when virus is present in skin that from a herpes blister. Alternatively, the virus can be cultured from blister material.
The virus can also be present in the saliva Two to six weeks after infection blood tests of someone with a ‘cold sore’ and, if used as lubricant, carries the risk of transmitting screening is of limited use as the majority days in the year. Shedding is believed to have antibodies to one or both viruses.
Wherever it affects the body, HSV-1 causes but the virus itself is not – it is in nerves.
severity, and reducing viral shedding.
HSV-1 traditionally is a facial infection currently are the anti-viral drugs Acyclovir, the area it is classically associated with. given in tablet form (or intravenously if an episode is very severe, as experienced against one of the herpes simplex viruses of Acyclovir for cold sores do not contain • Herpes pushes up HIV viral load
(1) Others in this group include varicella zoster virus A herpes diagnosis can have a psychological (the cause of chicken pox or shingles), Epstein Barr impact disproportionate to the condition’s virus (glandular fever), cytomegalovirus – or ‘CMV’ (another cause of glandular fever) and the virus recently identified as responsible for Kaposi’s load. High viral load is linked to increased Sarcoma, the skin cancer associated with AIDS. it is and that those with it are a medical oddity (when in fact most of us are infected (2) HSV-2 prevalence in the UK is estimated at around 5% (and rising), lower than most developed nations.
Herpes skin disruption facilitates
with one or both herpes simplex viruses).
(3) Other terms for an episode of herpes such as HIV transmission
The fact that herpes is sexually acquired, ‘attack’ or ‘outbreak’ are seen by some as causing In HIV positive individuals HIV is present in their herpes blisters, allowing contact (4) For more on the connection between HIV between HIV and an uninfected person.
anxiety and depression (doubly unfortunate transmission and herpes (and other STIs) Blisters may also bleed, allowing contact as stress itself can trigger recurrences).
see the 2000 Sigma Research briefing paper
The facilitation of HIV transmission by other
The following points may be useful in
sexually transmitted infections during sex
reassuring and allaying fears:
between men Peter Weatherburn, Chris Bonell,
Ford Hickson and William Stewart - available to download from www.sigmaresearch.org.uk Written by Richard Scholey
November 2005
attaches itself to CD4 cells, so increased indistinguishable infections, yet no stigma blisters of HIV negative people furtherenhances risk of HIV transmission. Also, • The primary episode will usually be the worst – recurrences are less severe and The STIs causing ulceration (syphilis and transmission; herpes more so, as syphilis • Support is available around disclosing ulcerative STIs is related to increased risk HIV positive individuals are more likely tohave more frequent, widespread and longerlasting herpes blisters. They also shedherpes virus for longer. On a populationlevel, all these factors facilitate the spreadof herpes and, in so doing, that of HIV.(4) The HIV and sexual health charity for life
Website: www.tht.org.uk THT Direct: 0845 12 21 200 Registered office: 52-54 Grays Inn Road, London WC1X 8JU Tel: 020 7831 0330 Email: info@tht.org.uk
Terrence Higgins Trust, November 2005. Terrence Higgins Trust is a registered charity no. 288527. Company reg. no.1778149. Registered in England. A company limited by guarantee.
Design Felton Communication 020 7405 0900 Ref: 9743

Source: http://www.infections.chapsonline.org.uk/VirtualContent/270/1111059743_Herpes_SSR.pdf

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