WHAT IS HERPES?

Herpes is a group of viruses that can cause infections. The infection is commonly marked by dry skin, watery open sores, and blisters. Herpes Simplex Virus (HSV) and Varicella-Zoster Virus (VZV) are two common types of herpes viruses that affect humans. Herpes simplex is an infection caused by the Herpes Simplex Virus (HSV), leading to vesicles on the skin or orofacial, genital, and anal mucosa.

HSV-1 often causes orofacial infections, while HSV-2 frequently results in genital infections. However, in certain situations, it can be severe, causing encephalitis in neonates and immunocompromised patients.

Herpes simplex infections can be asymptomatic. If symptoms appear, they might include herpetic gingivostomatitis, herpetic pharyngotonsillitis, herpetic whitlow, or eczema herpeticum. Primary infections come with systemic symptoms, last longer, and have a higher chance of complications. In contrast, recurrent infections are usually milder and shorter.

WHAT CAUSES HERPES?

The cause of herpes simplex is the Herpes Simplex Virus (HSV) type 1 and type 2. Generally, type 1 is associated with infections above the waist or upper belt infection, which includes the eyes and mouth, commonly referred to as orolabial herpes.

Whereas HSV type 2 is associated with infections below the waist or lower belt infection, in the genital area, known as genital herpes. However, both virus types are increasingly overlapping in infections, with a significant rise in genital herpes caused by HSV type 1. This is believed to be due to orogenital sexual practices in patients.

HOW IS HERPES TRANSMITTED?

The pathophysiology of herpes simplex starts with a viral infection, but the transmission method differs slightly between HSV type 1 and type 2. HSV type 1 infection is primarily transmitted through direct contact with contaminated saliva or the bodily secretions of an infected individual. Meanwhile, HSV type 2 mainly spreads during sexual contact.

The HSV virus adeptly evades the human immune system through several mechanisms. One of them is by inducing an accumulation of CD1d molecules on antigen-presenting cells. Normally, CD1d molecules are transported to the cell surface, where antigens are presented as a response to the stimulation of natural killer T-cells, which then mediate the immune response. When CD1d molecules accumulate inside cells, the immune response is hindered.

HERPES SYMPTOMS

Symptoms usually appear within 3-7 days after someone is exposed to the virus, and they are classified based on the severity experienced by the sufferer. Here are some of the symptoms:

• Primary Infection Early symptoms often include white vesicles filled with fluid. Initially, these vesicles appear white but eventually may contain green pus. Sometimes, these vesicles rupture, looking like mouth sores on the skin. This primary infection phase lasts about 3 weeks and often accompanies other symptoms like nausea, vomiting, fatigue, and fever.
• Latent Phase When symptoms improve, it doesn't mean the virus is dead. Instead, it lies dormant in the spinal nerve cells. In this phase, the virus continues to be released, albeit in small amounts.
• Recurrent Infection The dormant virus can reactivate. Factors or conditions that can activate the infection include:
  • Physical trauma, like fever, other diseases, lack of rest, etc.
  • Psychological trauma, such as depression and emotional disturbances.
  • Use of medications and undergoing cancer therapy.
• These symptoms are generally milder than the primary infection and last for 7-10 days. In addition to the above phases, there are several other potential symptoms:
  • Vaginal discharge.
  • Neuropathy symptoms, including constipation, difficulty urinating, or loss of skin sensation.
  • For female patients, symptoms include dysuria or pain when urinating.

HERPES PREVENTION

To prevent the spread of the herpes virus to others, several preventive measures can be taken: • Avoid physical contact with others, especially those with open sores. • Regularly wash hands with soap and running water. • Don't share personal items that can spread the virus, like glasses, dishes, clothes, towels, and makeup tools. • Apply medicine to rashes with cotton so hands don't touch the infected area directly. • Avoid frequently kissing babies. • Refrain from sexual activities, kissing, or oral sex while herpes symptoms are present.

Author: dr. Nurmalia Purnama Sari, Sp.PK., M.Si., Med (Responsible Doctor of PRAMITA Clinical Laboratory Branch Jl. Veteran No. 173 Palembang)