There are three herpes virus:
Herpes simplex 1 which typically causes cold sore on lips,
Herpes simplex 2 which causes genital herpes and
Herpes zoster which causes chicken pox in both child and adults
Some infectious disease physicians may consider Epstein-Barr virus which causes glandular fever or infectious mononucleosis.
Herpes virus is a very infectious virus when it appears as blisters on skin whether it is in a form of chicken pox, cold sore or genital herpes. Therefore it is a very common infection in all age groups. Researches done in various countries showed that 90%+ people had been infected with herpes zoster, 80%+ with herpes simplex 1 and 20-30% with herpes simplex 2.
The common characteristic of all three or four herpes viruses is that once infected, the virus stays within the body for life. It is normally being suppressed by one's immune system. But when one's immune system is weaken by what ever means, the virus reactivates and outbreaks may occur as cold sores, genital blisters or shingles.
Viral shedding refers to HSV being shredded on skin during an asymptomatic period. Some researches had shown that viral shedding may occur in 15-25% of days.
Viral shedding can be reduced by taking antiviral medication - such as Valtrex, by the infected person. This reduces viral shedding by at least 50% and minimise the risk for outbreaks.
There are two ways for testing herpes.
1.HSV DNA test
2.HSV 2 ELIZA test.
HSV DNA test requires taking a swab sample from the new blisters and the window of opportunity in collecting the sample is very small. This is the most accurate method for confirmation and determination of whether the infection is HSV 1 or HSV 2.
HSV IgG test which is a blood test. A HSV IgG test can only tell if a person had been infected by HSV 2.For primary infection (first time) which is an early infection, there is not sufficient time for the body to produce IgG and therefore the result will be negative. However, it the symptoms and signs are typical of HSV infection, the test should be repeated in 4-8 weeks to see if the antibody result turns positive.
The sensitivity of HSV 2 IgG test varies greatly. The ELIZA test reagent that we use in our laboratory is EUROIMMUNE which had been shown to have sensitivity >99% in detecting positive IgG level. The best time in performing HSV test is when there are blisters or 4 weeks after at-risk exposure.
However HSV IgG may be tested at 2 weeks after exposure to determine if an infection is a new infection or due to reactivation. Although HSV infection is usually minor and does not lead to major consequence, one should have HSV test before entering into a new relationship and regularly after causal encounters.
There is no cure for herpes to eliminate the virus from the nerve cells.
However, there are two ways in controlling HSV 2.
The first method is :
to take antiviral medication when there is an outbreak.
The second is :
to take a lower dose continuously to prevent outbreaks and viral shedding.
For treatments for outbreak, one needs to take antiviral medication ASAP (within 72 hours) to benefit most from the treatment.
There is a vaccine being developed and under going third phase of clinical trial.
It will be help those who have not been infection and perhaps those who have recurrent attacks.