You Ask, They Answer
Pregnant women with symptoms of genital herpes should inform their healthcare providers so that appropriate treatment can be started promptly.
Preventing acquisition of HSV-2 infection is particularly important for women in late pregnancy when the risk of transmitting it to the newborn baby is the greatest.
Q
: When should one consult a doctor?
A
: Patients with symptoms such as fever, body aches, sore throat( oral herpes), headache, or swollen lymph nodes near the infection should consult a doctor. They are also advised to seek help from healthcare professionals if they present with painful oral or genital ulcers that do not resolve within a week.
Patients who are pregnant, young children, or those who are immunocompromised with symptoms suggestive of herpes infection should also seek help early.
Q
: What available treatments are there for HSV patients?
A
: HSV infection can be treated with a course of oral antivirals such as acyclovir, famciclovir, and valaciclovir. These treatments can reduce symptom duration and severity but can’ t completely eradicate the virus from the human body.
Treatment for recurrent episodes is most effective when started within 48 hours of when symptoms begin.
In some cases, long-term daily low dose oral antiviral treatments, called suppressive therapy, are indicated in patients who get very painful or frequent recurrent episodes, or for those who want to lower the risk of transmitting herpes infection to others.
In addition to oral antivirals, medications that help with pain related to sores such as paracetamol( acetaminophen), naproxen, or ibuprofen, as well as anaesthetic creams containing benzocaine and lidocaine, are also helpful.
For patients with extensive ulcers, dressing of wounds may also be needed.
Q
: Can HSV spread and cause other related diseases if not treated?
A
: Yes. i) HSV-2 and HIV infection: HSV-2 infection increases the risk of acquiring HIV infection by approximately three-fold. Additionally, people with both HIV and HSV-2 infection are more likely to spread HIV to others. HSV-2 is among the most common infections in people living with HIV. ii) Severe Disease: In immunocompromised people, including those with advanced HIV infection, herpes can have more severe symptoms and more frequent recurrences. Rare complications of HSV-2 include meningoencephalitis( brain infection) and disseminated infection. Rarely, HSV-1 infection can lead to more severe complications such as encephalitis( brain infection) or keratitis( eye infection). iii) Neonatal Herpes: This can occur when an infant is exposed to HSV during delivery. Neonatal herpes is rare, occurring in an estimated 10 out of every 100,000 births globally. However, it is a serious condition that can lead to lasting neurological disability or death. The risk for neonatal herpes is greatest when a mother acquires HSV for the first time in late pregnancy.
Q
: Can one make a full recovery from HSV after treatment?
A
: Symptoms can be resolved with treatment, but the virus remains dormant in the body throughout one’ s life.
Q
: What is the best management and self-treatment for a patient with HSV?
A
: To decrease symptoms of oral herpes, individuals can consume cold drinks or suck on popsicles and use over-the-counter pain medicines. For genital herpes, one can sit in a warm bath for 20 minutes( without soap), wear loose fitting clothes, and use over-the-counter pain medicines.
Q
: What is the difference between HSV and HPV?
A
: HPV( human papillomavirus) is a completely different viral infection that commonly presents as skin or mucous membrane growths, known as warts.
There are more than 100 subtypes of HPV, with some causing warts, whilst others have been known to be implicated in cancers involving the cervix, anus, vagina, vulva, and oropharyngeal.
HPV infections can be transmitted sexually or via skin-to-skin contact. Vaccines are now available to help protect against specific subtypes of HPV that cause genital warts and cervical cancer.
Dr Evelyn Yap Wen Yee
Dr Evelyn Yap Wen Yee is a consultant dermatologist and aesthetic clinician at Mahkota Medical Centre in Malaysia.
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