Genital Herpes

What is Genital Herpes?

The Herpes Simplex Virus (HSV) causes a recurrent, incurable viral disease that has two forms,  HSV-1 and HSV-2. HSV-1, generally appears as cold sores around the face–especially the mouth. HSV-2, generally is a sexually transmitted disease that manifests as genital lesions.

Herpes zoster, shingles, is a remanifestation of chicken pox which is herpes varicella.

Can I know when I’m infectious?

No, as many as 50% of patients with genital herpes are shedding the virus without experiencing any of the symptoms. Many cases are transmitted during this time.

Signs and Symptoms

First episode, initial infection: this presents with flu-like symptoms, clusters of lesions on the genitalia that can ulcerate and spread. It may take 2-3 weeks before the lesions scab over and heal.

After the initial infection, the virus settles in the nerve root ganglia — heads of nerves that run parallel to the spinal cord — and remains dormant until stress or other factors reactivate it.

Recurrent infections begin in about 50% of patients with a “prodrome” pre-reactivation flu-like symptoms and tingling around the area where the lesions will be.

Treatment

There is no cure for herpes, however, there are a few drugs that will help shorten the duration of the symptoms and relieve the discomfort associated with herpes. These are antiviral drugs and they are available by prescription only. Therefore, see your doctor for appropriate diagnosis and treatment.

Acyclovir
(Zovirax®)
Once acyclovir enters the body, it is modified to look exactly like a natural nucleotide (nucleotides make up RNA and DNA). It then competes with the natural nucleotides to make the viral RNA. When acyclovir is incorporated into the viral RNA instead of the natural nucleotide, replication of the virus is stopped. Some of the common side effects encountered with acyclovir include headache, nausea, vomiting, dizziness, and loss of appetite.

Valacyclovir
(Valtrex®)
Valacyclovir is converted to acyclovir in the body. It therefore acts exactly the same way and has the same side effect profile as acyclovir.

Penciclovir
(Denavir®)
Penciclovir, like acyclovir, is modified once it enters the body to look exactly like a natural nucleotide. It then competes with the real nucleotides and when it is used instead of the normal nucleotides, it stops replication of the viral RNA. It is available only as a cream and is used to treat herpes sores on the face and lips. Common side effects include dulled sensitivity to touch, altered taste sensation, skin irritation or itching, and skin rash.

Famciclovir
(Famvir®)
Famciclovir is a nearly identical to Penciclovir except that it has to be altered in the body to Penciclovir first. It is the oral form of Penciclovir and comes as tablets. With the exception of the fact that is an oral drug, it otherwise acts exactly like Penciclovir. Common side effects include diarrhea, dizziness, headache, tiredness, and nausea.