Herpes genitalis
Encyclopedia
Herpes genitalis refers to a genital infection by Herpes simplex virus
.
Following the classification HSV into two distinct categories of HSV-1 and HSV-2 in the 1960s, it was established that "HSV-2 was below the waist, HSV-1 was above the waist". Although genital herpes is largely believed to be caused by HSV-2, genital HSV-1 infections are increasing and now exceed 50% in certain populations,
and that rule of thumb no longer applies. HSV is believed to be asymptomatic in the majority of cases, thus aiding contagion and hindering containment.
When symptomatic, the typical manifestation of a primary HSV-1 or HSV-2 genital infection is clusters of genital sores consisting of inflamed papule
s and vesicles on the outer surface of the genitals resembling cold sores. These usually appear 4–7 days after sexual exposure to HSV for the first time. Genital HSV-1 infection recurs at rate of about one sixth of that of genital HSV-2.
In males, the lesions occur on the glans penis
, shaft of the penis or other parts of the genital region, on the inner thigh, buttocks, or anus
. In females, lesions appear on or near the pubis
, labia, clitoris
, vulva
, buttocks or anus. Other common symptoms include pain, itching, and burning. Less frequent, yet still common, symptoms include discharge from the penis or vagina
, fever
, headache
, muscle pain (myalgia
), swollen and enlarged lymph nodes and malaise
. Women often experience additional symptoms that include painful urination (dysuria
) and cervicitis
. Herpetic proctitis
(inflammation of the anus and rectum) is common for individuals participating in anal intercourse. After 2–3 weeks, existing lesions progress into ulcers and then crust and heal, although lesions on mucosal surfaces may never form crusts. In rare cases, involvement of the sacral
region of the spinal cord
can cause acute urinary retention
and one-sided symptoms and signs of myeloradiculitis (a combination of myelitis
and radiculitis): pain, sensory loss, abnormal sensations (paresthesia
) and rash. Historically this has been termed Elsberg syndrome, although this entity is not clearly defined.
alone, 45 million people are infected, with an additional one million new infections occurring every year.
Presently, genital herpes cannot be cured. Moreover, genital herpes can be transmitted by viral shedding prior to and following the visual signs of symptoms. There are however some drugs that can shorten outbreaks and make them less severe or even stop them from happening. Among these drugs are: acyclovir, valacyclovir and famciclovir
.
Acyclovir is an antiviral drug
used against herpes viruses, varicella-zoster, and Epstein-Barr Virus
es. This drug reduces the pain and the number of lesions in the initial case of genital herpes. Furthermore, it decreases the frequency and severity of recurrent infections. It comes in capsules, tablets, suspension
, injection
, powder for injection, and ointment. The ointment is used topically and it decreases pain, reduces healing time, and limits the spread of the infection.
Valacyclovir is also used to treat herpes virus infections. Once in your body, it becomes the anti-herpes medicine, acyclovir. It helps relieve the pain and discomfort and the sores heal faster. It only comes in caplets and its advantage is that it has a longer duration of action than acyclovir.
Famciclovir is another antiviral drug that belongs to the same class of acyclovir and valacyclovir. Famciclovir is a prodrug
that is converted to penciclovir in the body
. The latter is the one active against the viruses. This drug has a longer duration of action than acyclovir and it only comes in tablets.
Herpes simplex virus
Herpes simplex virus 1 and 2 , also known as Human herpes virus 1 and 2 , are two members of the herpes virus family, Herpesviridae, that infect humans. Both HSV-1 and HSV-2 are ubiquitous and contagious...
.
Following the classification HSV into two distinct categories of HSV-1 and HSV-2 in the 1960s, it was established that "HSV-2 was below the waist, HSV-1 was above the waist". Although genital herpes is largely believed to be caused by HSV-2, genital HSV-1 infections are increasing and now exceed 50% in certain populations,
and that rule of thumb no longer applies. HSV is believed to be asymptomatic in the majority of cases, thus aiding contagion and hindering containment.
When symptomatic, the typical manifestation of a primary HSV-1 or HSV-2 genital infection is clusters of genital sores consisting of inflamed papule
Papule
A papule is a circumscribed, solid elevation of skin with no visible fluid, varying in size from a pinhead to 1 cm.With regard to the quote "...varying in size from a pinhead to 1cm," depending on which text is referenced, some authors state the cutoff between a papule and a plaque as 0.5cm,...
s and vesicles on the outer surface of the genitals resembling cold sores. These usually appear 4–7 days after sexual exposure to HSV for the first time. Genital HSV-1 infection recurs at rate of about one sixth of that of genital HSV-2.
In males, the lesions occur on the glans penis
Glans penis
The glans penis is the sensitive bulbous structure at the distal end of the penis. The glans penis is anatomically homologous to the clitoral glans of the female...
, shaft of the penis or other parts of the genital region, on the inner thigh, buttocks, or anus
Anus
The anus is an opening at the opposite end of an animal's digestive tract from the mouth. Its function is to control the expulsion of feces, unwanted semi-solid matter produced during digestion, which, depending on the type of animal, may be one or more of: matter which the animal cannot digest,...
. In females, lesions appear on or near the pubis
Mons pubis
In human anatomy or in mammals in general, the mons pubis , also known as the mons veneris or simply the mons, is the adipose tissue lying above the pubic bone of adult females, anterior to the pubic symphysis...
, labia, clitoris
Clitoris
The clitoris is a sexual organ that is present only in female mammals. In humans, the visible button-like portion is located near the anterior junction of the labia minora, above the opening of the urethra and vagina. Unlike the penis, which is homologous to the clitoris, the clitoris does not...
, vulva
Vulva
The vulva consists of the external genital organs of the female mammal. This article deals with the vulva of the human being, although the structures are similar for other mammals....
, buttocks or anus. Other common symptoms include pain, itching, and burning. Less frequent, yet still common, symptoms include discharge from the penis or vagina
Vagina
The vagina is a fibromuscular tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. Female insects and other invertebrates also have a vagina, which is the terminal part of the...
, fever
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...
, headache
Headache
A headache or cephalalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the...
, muscle pain (myalgia
Myalgia
Myalgia means "muscle pain" and is a symptom of many diseases and disorders. The most common causes are the overuse or over-stretching of a muscle or group of muscles. Myalgia without a traumatic history is often due to viral infections...
), swollen and enlarged lymph nodes and malaise
Malaise
Malaise is a feeling of general discomfort or uneasiness, of being "out of sorts", often the first indication of an infection or other disease. Malaise is often defined in medicinal research as a "general feeling of being unwell"...
. Women often experience additional symptoms that include painful urination (dysuria
Dysuria
In medicine, specifically urology, dysuria refers to painful urination.Difficult urination is also sometimes described as dysuria.It is one of a constellation of irritative bladder symptoms, which includes urinary frequency and haematuria....
) and cervicitis
Cervicitis
Cervicitis is inflammation of the uterine cervix. Cervicitis in women has many features in common with urethritis in men and many cases are caused by sexually transmitted infections...
. Herpetic proctitis
Proctitis
Proctitis is an inflammation of the anus and the lining of the rectum, affecting only the last 6 inches of the rectum.-Overview:Symptoms are ineffectual straining to empty the bowels, diarrhea, rectal bleeding and possible discharge, a feeling of not having adequately emptied the bowels,...
(inflammation of the anus and rectum) is common for individuals participating in anal intercourse. After 2–3 weeks, existing lesions progress into ulcers and then crust and heal, although lesions on mucosal surfaces may never form crusts. In rare cases, involvement of the sacral
Sacrum
In vertebrate anatomy the sacrum is a large, triangular bone at the base of the spine and at the upper and back part of the pelvic cavity, where it is inserted like a wedge between the two hip bones. Its upper part connects with the last lumbar vertebra, and bottom part with the coccyx...
region of the spinal cord
Spinal cord
The spinal cord is a long, thin, tubular bundle of nervous tissue and support cells that extends from the brain . The brain and spinal cord together make up the central nervous system...
can cause acute urinary retention
Urinary retention
Urinary retention, also known as ischuria, is a lack of ability to urinate. It is a common complication of benign prostatic hyperplasia , although it can also be caused by nerve dysfunction, constipation, infection, or medications...
and one-sided symptoms and signs of myeloradiculitis (a combination of myelitis
Myelitis
Myelitis is a disease involving inflammation of the spinal cord, which disrupts central nervous system functions linking the brain and limbs. The name is derived from Greek referring to the "spinal cord", and the suffix -itis, which denotes inflammation....
and radiculitis): pain, sensory loss, abnormal sensations (paresthesia
Paresthesia
Paresthesia , spelled "paraesthesia" in British English, is a sensation of tingling, burning, pricking, or numbness of a person's skin with no apparent long-term physical effect. It is more generally known as the feeling of "pins and needles" or of a limb "falling asleep"...
) and rash. Historically this has been termed Elsberg syndrome, although this entity is not clearly defined.
Treatment
Medical research has not been able to find a way to halt the spread of herpes and the number of infected people keeps growing. In the United StatesUnited States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
alone, 45 million people are infected, with an additional one million new infections occurring every year.
Presently, genital herpes cannot be cured. Moreover, genital herpes can be transmitted by viral shedding prior to and following the visual signs of symptoms. There are however some drugs that can shorten outbreaks and make them less severe or even stop them from happening. Among these drugs are: acyclovir, valacyclovir and famciclovir
Famciclovir
Famciclovir is a guanine analogue antiviral drug used for the treatment of various herpesvirus infections, most commonly for herpes zoster . It is a prodrug form of penciclovir with improved oral bioavailability...
.
Acyclovir is an antiviral drug
Antiviral drug
Antiviral drugs are a class of medication used specifically for treating viral infections. Like antibiotics for bacteria, specific antivirals are used for specific viruses...
used against herpes viruses, varicella-zoster, and Epstein-Barr Virus
Epstein-Barr virus
The Epstein–Barr virus , also called human herpesvirus 4 , is a virus of the herpes family and is one of the most common viruses in humans. It is best known as the cause of infectious mononucleosis...
es. This drug reduces the pain and the number of lesions in the initial case of genital herpes. Furthermore, it decreases the frequency and severity of recurrent infections. It comes in capsules, tablets, suspension
Suspension
Suspension may refer to:In science and engineering:*Suspension , in mathematics*Suspension , in mathematics*Suspension , mixture of two chemicals with the property that one does not rapidly settle out...
, injection
Injection (medicine)
An injection is an infusion method of putting fluid into the body, usually with a hollow needle and a syringe which is pierced through the skin to a sufficient depth for the material to be forced into the body...
, powder for injection, and ointment. The ointment is used topically and it decreases pain, reduces healing time, and limits the spread of the infection.
Valacyclovir is also used to treat herpes virus infections. Once in your body, it becomes the anti-herpes medicine, acyclovir. It helps relieve the pain and discomfort and the sores heal faster. It only comes in caplets and its advantage is that it has a longer duration of action than acyclovir.
Famciclovir is another antiviral drug that belongs to the same class of acyclovir and valacyclovir. Famciclovir is a prodrug
Prodrug
A prodrug is a pharmacological substance administered in an inactive form. Once administered, the prodrug is metabolised in vivo into an active metabolite, a process termed bioactivation. The rationale behind the use of a prodrug is generally for absorption, distribution, metabolism, and...
that is converted to penciclovir in the body
Body
With regard to living things, a body is the physical body of an individual. "Body" often is used in connection with appearance, health issues and death...
. The latter is the one active against the viruses. This drug has a longer duration of action than acyclovir and it only comes in tablets.