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herpesvirus 2; genital herpes; herpes simplex - genital
A sexually-transmitted viral infection that is characterized by repeated episodes of developing an eruption of small and usually painful blisters on the genitals.
Causes, incidence, and risk factors:
Genital herpes is caused by two viruses belonging to the Herpes virus hominus group and known as herpes simplex virus type 2 (HSV-2) and by herpes simplex virus type 1 (HSV-1). HSV-1 is responsible for approximately 5 to 10% of genital herpes. Both viruses are transmitted by sexual contact. Cross-infection of type 1 and 2 viruses is thought to occur during oral-genital sex. (Note: HSV-1, the virus responsible for common cold sores, can be transmitted through oral secretions during kissing, and by eating and drinking from contaminated utensils.) Initial oral herpes infection usually occurs in childhood and is not classified as a sexually-transmitted disease. Eighty per cent of the adult population is thought to carry HSV-1 and to have acquired it in a non-sexual manner.
The overall incidence of genital herpes is thought to be 1 out of 1,000 people.
For people with no prior contact with HSV 1 or 2, the initial infection is characterized by systemic (whole body) as well as local symptoms and signs. Systemic symptoms include fever, malaise, generalized achiness (myalgia), and decreased appetite. Localized symptoms are described in the symptoms section.
Since the virus is transmitted by virus-containing secretions from the oral or genital mucosa, the primary lesion is at the primary site of infection. Common sites of infection include the shaft and head of the penis, scrotum, inner thighs, and anus in men; and the labia, vagina, cervix, anus, and inner thighs in women. The mouth can also be a site of infection in both sexes.
Prior to the appearance of blisters, the infected individual can experience increased skin sensitivity, tingling, burning, or pain at the site where the blisters will appear. The skin becomes reddened and multiple small blisters (vesicles) filled with a clear straw-colored fluid appear. The blisters break leaving shallow painful ulcers which eventually crust over and slowly heal over a period of 7 to 14 days. The outbreak may be accompanied by enlargement and tenderness of the lymph nodes in the groin or inguinal fold. Women may develop vaginal discharge and painful urination (dysuria). Men may have dysuria if the lesion is near the opening of the urethra (meatus).
Once a person is infected, the virus finds a hiding place within nerve cells where antibodies, the body's normal infection fighters, cannot reach. Within the nerve cells the virus may remain dormant, a period called "latency", for an extended period of time then suddenly the infection becomes reactivated and the individual has another attack of pain and blistering. Recurrent attacks may be rare, occurring only once per year or so frequent that the symptoms seem continuous. Recurrent attacks may be triggered by many things including mechanical irritation, menses, fatigue, sunburn, and so on. Recurrent infections in men are generally milder and of shorter duration than those experienced by women.
Research suggests that the virus can be transmitted even in the absence of clinical disease, so that a sex partner without obvious genital herpes may still transmit the illness. Asymptomatic spread may actually contribute more to the spread of genital herpes than does active disease.
The herpes virus is of special significance to women for several reasons. It has been implicated in causing cancer of the cervix, especially when it is present in combination with Human papilloma virus (HPV), the virus responsible for genital warts (condyloma). For the pregnant women, the presence of either HSV-1 or HSV-2 on the genitalia or in the birth canal is a threat to the infant. Infection in the newborn infant can lead to herpetic meningitis, herpetic viremia, chronic skin infection and even death.
The herpes infection also poses a serious problem for the immunocompromised person (someone with AIDS, undergoing chemotherapy, radiation therapy, or taking high dose cortisone preparation). These people may suffer infections of various organs including:
Prevention is difficult since the virus can be spread to others even when the infected person has no evidence of a current outbreak. However, avoiding direct contact with an open lesion will lower the risk of infection. People with genital herpes should avoid sexual contact when active lesions are present. People with known genital herpes but without current clinical symptoms should inform their partner that they have the disease. This will allow both parties to use barrier protection (condoms) to prevent the spread of the illness.
Condoms remain the best protection against acquiring genital herpes when sexually active. CORRECT and CONSISTENT use of a condom will help prevent the transmission of the disease.
Testing of condoms is maintained at high standards to insure that virus cannot pass through the material of the condom. There has been research on condoms with anti-herpesvirus properties.
Pregnant women with the herpes simplex infection should receive weekly viral cultures of the cervix and external genitalia as the delivery date approaches. At the time of delivery, if active lesions are present, or if the viral culture is positive for herpes, a cesarean delivery (C-section) is recommended to avoid infecting the newborn.
Treatment of genital herpes does not cure the disease but can relieve the symptoms. Treatment can rapidly decrease the pain and discomfort associated with an outbreak and shorten the healing time.
Oral acyclovir (Zovirax) does not cure the infection, but it reduces the duration and severity of the symptoms in primary infection, and to a lesser extent in secondary attacks. It also reduces viral shedding, which affects the duration of contagiousness. It may be used in the first episode and for recurrence. For maximum benefit during recurrences, therapy should be started as soon as the tingling, burning, or itching (sensations before the blisters) starts, or as soon as the blisters are noticed.
Topical acyclovir (Zovirax) is also effective but must be used more frequently than the 5 times per day which is typically prescribed. During the first 24 hours application of the ointment every hour (during the waking hours) will dramatically shorten the duration.
Warm baths may relieve the pain associated with genital lesions. Gentle cleansing with soap and water is recommended. If secondary infection of the skin lesions occur, a topical antibiotic such as Neomycin and Polymyxin B and Bacitracin ointment can be used, or sometimes oral antibiotics are needed.
Acyclovir-resistant strains of herpes virus are appearing rapidly. If symptoms are not rapidly relieved by acyclovir, further evaluation by a physician is indicated.
The stress of illness can often be helped by joining a support group where members share common experiences and problems.
Once infected, the virus stays in the body for the rest of a person's life. Some people never have another episode, and some have frequent recurrences throughout the year. Subsequent infections tend to occur after sexual intercourse, exposure to the sun, and after stressful events. In individuals with normal immune systems, genital herpes remains a localize and bothersome infection but seldom a life-threatening infection.
Calling your health care provider:
Call for an appointment with your health care provider if you have any symptoms suggestive of genital herpes.
Call your health care provider if fever, headache, vomiting, or widespread symptoms develop during or after an outbreak of herpes.
Notice: The information provided herein should not be used for
diagnosis or treatment of any medical condition. A licensed physician
should be consulted for diagnosis and treatment of any and all
medical conditions.
Drug OK'd To Reduce Spread Of Herpes
Herpes Can Help Cause Cervical
Cancer
Cold sore virus can also cause genital
herpes
The team also reports that about 40% of people who are newly infected with HSV-2 -- the herpes virus commonly associated with genital herpes -- develop symptoms, a figure higher than that previously reported. But the study confirms that the majority of people who are infected with genital herpes do not develop symptoms, and can unwittingly pass the virus to their partner during sex.
Dr. Andria G.M. Langenberg, who at the time of the study was with Chiron in Emeryville, California, together with colleagues at several centers involved in the Chiron HSV Vaccine Study Group, followed 2,393 men and women who were not infected with genital herpes (HSV-2) but who had participated in HSV-2 vaccine trials starting back in 1993.
The vaccine did not turn out to be effective against herpes, but investigators kept track of what happened to study participant during the trials. During the time the trials were being conducted, the group documented 155 new cases of genital herpes infection due to HSV-2 and 19 new cases of oral herpes (HSV-1). They found that close to 40% of people newly infected with genital herpes developed symptoms of painful blisters in the genital area -- a much higher rate than was previously believed, explained co-investigator Dr. Stephen E. Straus of the National Institutes of Health, Bethesda, Maryland, in an interview with Reuters Health. Previous studies had suggested that between 9% and 25% of people newly infected with HSV-2 developed symptoms.
The group also discovered that people who are infected with genital herpes may not develop typical painful blisters in the genital area, which are characteristic of genital herpes, but rather a much wider range of symptoms such as cystitis that are usually associated with other types of sexually transmitted diseases. Although these unusual symptoms do not happen that often, about 750,000 new cases of genital herpes occur in the US every year, as investigators point out, so they are not all that rare.
Another major finding in the study was that among those people who acquired new genital herpes infection, "we found that about 15% of the cases were associated with type 1 herpes simplex virus, so that type 2 herpes is not the only cause of genital herpes," said Straus.
This means that a sexually active person might acquire herpes wherever they have direct intimate contact, regardless of whether the active infection is in the mouth or in the genitals, he added.
Another finding which Straus felt may have "important future implications" was what happened to people who had a prior infection with oral herpes (type 1) and their subsequent risk of becoming infected with genital herpes (type 2).
"We used to believe that if you had type 1 infection, you were less likely to get type 2 genital herpes -- in other words, type 1 infection would protect you against type 2," said Straus. But results from this study indicate that prior infection with HSV-1 -- which the majority of study participants had at the start of the vaccine trials -- did not protect people from becoming infected with HSV-2. What HSV-1 infection did appear to do was to prevent symptoms when the individual became infected with the genital herpes virus, HSV-2.
"This suggests that the immunity people develop when they are infected with one type of the virus makes a difference to the severity of infection if they become infected with the other type of herpes," Straus noted, adding that the finding suggests that it may be possible to protect people from developing symptoms of genital herpes with a vaccine even if the vaccine can't protect people from actually becoming infected.
"Right now, about 23% of people living in the US have been infected with type 2 herpes so this infection remains extremely prevalent," said Straus.
And while herpes has been virtually eclipsed with so much
attention now focused on HIV and AIDS, "there is a lot of morbidity
(illness) associated with genital herpes -- more in fact than we had
previously predicted," Straus said.
Source: www.healthcentral.com/News/NewsFullText.cfm?ID=21337&storytype=ReutersNews
Some herpes patients unwittingly spread the
disease
As many as 25% of American adults are believed to be infected with the sexually transmitted herpes simplex virus type 2 (HSV-2), which can cause recurrent outbreaks of small, painful lesions on the genitals. However, only 10% to 25% of people who carry HSV-2 report ever having genital sores.
Now, results of a study indicate that even those individuals who are not aware of the lesions can have the virus in their genital tract, suggesting that they have the ability to spread the virus to sexual partners.
According to a report in the March 23rd issue of The New England Journal of Medicine, Dr. Anna Wald, of the University of Washington in Seattle, and colleagues looked at 53 people who tested positive for HSV-2, but who said that they had never had an outbreak of genital herpes. The study also included 90 people with the virus who had a history of genital sores.
Each day for 3 months, all participants were instructed to swab their genitals to collect any virus being shed. The subjects kept a diary of symptoms and were asked to report to the clinic if they detected any suspicious lesions.
During the study, HSV was detected in swabs taken from 72% (38 of 53) of those who said they had never had genital sores, according to the report. And more sensitive testing detected the virus in another six people. In contrast, about 80% to 90% of those who had a history of genital lesions had detectable virus in the genital tract.
Part of the problem may be that many individuals may not recognize that the small sores on the genitals, buttocks or anus are herpes-related.
After undergoing the education session, 62% of women and 64% of men in the asymptomatic group reported having symptoms of genital herpes, the authors note.
In an interview with Reuters Health, Wald said that people who originally did not report any symptoms tended to have shorter and less frequent outbreaks compared with people who reported having symptoms, but they had a similar rate of shedding the virus.
"This makes this particular group of people potentially infectious," she said. People whose outbreaks are short and infrequent may not need to be treated, but it is important to identify people who are infected with herpes, according to Wald.
The hope is that if people know that they have herpes, even if they don't have any symptoms, they will be more likely to take precautions -- such as practicing safer sex -- to keep from spreading the virus, Wald explained.
While research laboratories have had herpes screening tests for several years, commercial versions of the test only recently have become available, Wald noted.
There is no cure for herpes infections, although medications can
reduce the length and severity of outbreaks.
Source: www.healthcentral.com/News/NewsFullText.cfm?ID=30157&storytype=ReutersNews
Deep kissing ups risks for Kaposi's
virus in gay men
They report that deep kissing with an HIV-infected partner and use of amyl nitrite capsules or inhaled nitrites ('poppers') in association with sex both seem to increase gay men's risk of contracting human herpesvirus 8 (HHV-8), which is thought to cause the disease.
Kaposi's sarcoma is an otherwise rare condition linked to HIV infection, especially among HIV-positive gay men. In Kaposi's, tumors arise in tissues below the skin surface or in mucous membranes. Lesions appear as raised blotches on the skin.
The mouth seems to be the primary source of HHV-8 in gay and bisexual men, according to Dr. Lawrence Corey, of the Fred Hutchinson Cancer Research Center in Seattle, Washington, and colleagues. The team believes, therefore, that "safer sex practices, such as consistent use of condoms, although important in preventing other sexually transmitted infections, may not protect against HHV-8 infection."
The report is published in the November 9th issue of The New England Journal of Medicine.
Corey's group collected 880 samples from 27 HHV-8-positive men, with samples coming from the throat, nose, urethra and anus, as well as saliva, semen, urine, blood and prostate secretions.
HHV-8 DNA was detected in 56% of the study participants, most often in samples from the mouth. Twelve percent of saliva samples and 11% of throat swabs were positive, compared with 4% of genital tract samples and 2% of anal swabs.
As Dr. Patrick S. Moore of Columbia University in New York points out in a related commentary, questions remain as to why male homosexual couples are at so much higher risk for Kaposi's than heterosexual couples, since many of the implicated sexual behaviors are common to both groups.
"If the virus is spread through contact with oral secretions, why
isn't the infection more common among heterosexuals?" Moore asks.
Source: www.healthcentral.com/News/NewsFullText.cfm?ID=44097&storytype=ReutersNews
Kissing tied to AIDS-related virus
Herpes virus 8 was discovered six years ago and causes a skin cancer called Kaposi's sarcoma. In the United States, the cancer occurs almost exclusively in people with AIDS.
Some had suspected that the virus was transmitted through sexual intercourse, but the new research from the University of Washington, reported in Thursday's New England Journal of Medicine, contradicts that idea.
Dr. John Pauk and others tested 39 gay men who were infected with the virus but did not have Kaposi's sarcoma. They found the virus in 30 percent of their saliva samples and mouth swabs, compared with 1 percent of anal and genital samples. When present, the virus levels were also much higher in saliva than in semen.
"The important thing is it suggests that oral-oral contact plays some role in transmission, although more study is needed to confirm that," said Pauk.
The study also found that homosexual men who engaged in "deep kissing" - kissing that involves a lot of contact with saliva - appeared to be at substantially higher risk of catching the virus.
Kaposi's sarcoma causes purple skin blotches and can also attack the internal organs. Like many other diseases that kill people with AIDS, it usually affects those with weakened immune systems. The virus alone rarely causes sickness among people with normal disease defenses.
The research "definitely has public health implications for people infected with HIV," said Dr. Ronald O. Valdiserri of the U.S. Centers for Disease Control and Prevention. However, he said there was not enough data to recommend that people with HIV avoid deep kissing.
Thirty percent to 50 percent of HIV-infected people who catch herpes virus 8 will eventually get Kaposi's sarcoma. Kaposi's sarcoma has been present for centuries in Southern Europe, the Middle East and Africa. But it was rare in the United States until the start of the AIDS epidemic in the early 1980s.
Experts say the virus is still largely confined to homosexuals in the United States, and that is why kissing has not yet spread herpes virus 8 among heterosexuals.
Dr. Anna Wald, another University of Washington researcher, noted that herpes virus 8 is closely related to the common Epstein Barr virus, which causes mononucleosis, long known as the kissing disease.
"Teen-agers tend to get this when they start kissing," she said. "The reason they get Epstein Bar virus and not herpes virus 8 is that most people have Epstein Bar virus, but relatively few have herpes virus 8."
Dr. Patrick S. Moore of Columbia University, who discovered the virus, said exposure to saliva may explain the high rate of infection in parts of Africa, where more than 70 percent of people may carry herpes virus 8.
Other forms of the herpes virus cause chicken pox, shingles, cold sores and genital herpes.
Source: The New England Journal of Medicine:
www.nejm.org/content/index.asp
or www.healthcentral.com/News/NewsFullText.cfm?ID=44085&storytype=APNews
Study: Genital herpes can spread during
'symptomless' outbreaks
Previously, patients and most doctors thought people with herpes were unlikely to be infectious when they had no symptoms, which can include painful, oozing blisters, ulcers and fissures and tingling and burning.
In a study disproving several myths about the incurable, widespread virus, University of Washington researchers found the virus present in genital secretions even when patients didn't notice any symptoms.
"The message from this study is first to encourage people who might be at risk for genital herpes to be tested and, No. 2, they should abstain during outbreaks and use condoms at all other times," said Dr. Anna Wald, an assistant professor in the department of medicine and epidemiology.
The study was reported in Thursday's New England Journal of Medicine.
Genital herpes, usually caused by the herpes simplex virus type 2, lurks in about one-fourth of U.S. adults, although only an estimated 20 percent of them know it.
Herpes is spread through sexual contact when it enters the body through tiny passages in the skin. The virus lies dormant in nerves at the base of the spinal cord until something triggers an outbreak. Flare-ups generally last for a few days.
There is no cure, but drugs can reduce the severity and frequency of flare-ups.
While herpes isn't fatal, the sores can make it easier to become infected with the AIDS virus. Without precautions, herpes can be transmitted during childbirth, infecting the baby and sometimes causing brain damage or death.
Wald's team studied 53 men and women who were unaware they had the virus until it was spotted in a blood test on a routine visit to a medical clinic in Seattle. Those patients were then asked to participate in the study, along with another 90 clinic patients with a history of symptoms.
Each swabbed specimens from around the anus and genitals daily for three months and kept a diary of symptoms.
But both groups had the virus present in secretions at the same rate on symptom-free days: about 3 percent, or one day a month on average.
The researchers also found that men were potentially infectious at the same rate as women when no symptoms were noticeable, disproving the myth men can't spread the virus while symptom-free.
Dr. Judith Wasserheit, head of sexually transmitted disease
prevention at the Centers for Disease Control and Prevention, said
the study confirms other research but brings some good news: "It is
possible to learn how to recognize many of your symptoms and to use
that knowledge to help protect your partner."
Source: www.healthcentral.com/News/NewsFullText.cfm?ID=30112&storytype=APNews
One in five Americans has herpes
The study says the number of Americans living with this incurable sexually transmitted disease (STD) has increased by 30 percent since the late 1970s.
According to the report, almost 22 percent of the population now carries the virus. Among African Americans, 45.9 percent are infected, compared to 17.6 percent of Caucasians. More women (25.6 percent) are infected than men (17.8 percent).
But the sharpest rise in herpes infection since the last national survey in the late 1970s occurred in young, white teens: the number of 12-19 year olds infected with HSV-2 has increased by five times.
"Herpes is perhaps the most common sexually transmitted disease in America today. It continues to spread across all economic and social boundaries and is spreading fastest among teens," said Dr. Helene Gayle, director of the CDC's National Center for HIV, STD, and TB Prevention.
According to study co-author Dr. Robert E. Johnson, a medical epidemiologist at the CDC, the findings are based on questionnaire responses and blood sample analyses for HSV-2 antibodies obtained during the National Health and Nutrition Examination Surveys (NHANES) II (1976 - 1980) and III (1988 - 1994).
"Individuals who participated in the survey were asked whether they ever had a diagnosis of genital herpes, and only a very small proportion of those who actually had antibody (to herpes) said they ever had symptoms of genital herpes or had a diagnosis of it," Johnson said.
Specifically, "less than 10 percent of all those who were seropositive (whose blood tested positive) reported a history of genital herpes infection," the CDC report states.
Agency officials note that genital herpes is believed most infectious when sores or blisters are present, but can be transmitted even when there are no symptoms. Some STD experts believe that the increase in genital herpes prevalence underscores the fact that the virus is most often transmitted by asymptomatic people who are unlikely to be taking an antiviral medication for it.
"Although this survey didn't look specifically at the efforts that have been made to increase safe sex, use of condoms to prevent sexually transmitted infections, we know that clearly, there is still a problem, particularly among the younger age groups in terms of adopting safer sex lifestyles," Johnson says.
"Improvements in the prevention of HSV-2 infection are needed, particularly since genital ulcers may facilitate the transmission of the human immunodeficiency virus (HIV)," the authors conclude.
In a statement released by the U.S. Department of Health and Human
Services, the CDC announced that it is working with other public
health experts "to develop a national plan which will specifically
address the prevention of herpes." The plan will include the
development of comprehensive national prevention guidelines, step up
herpes monitoring, and propose new educational programs.
Source: www.healthcentral.com/News/NewsFullText.cfm?ID=3780&storytype=ReutersNews
Lasting stress, anxiety linked to
repeat episodes of genital herpes
"Our results indicate that a stressor might have to persist for it to trigger a herpes recurrence," explain the investigators, led by Dr. Frances Cohen of the University of California, San Francisco.
Cohen and colleagues followed 58 women who had had genital herpes for at least 1 year, and who had regular herpes outbreaks. The women were interviewed every month for 6 months and completed a questionnaire about their life, and also completed a weekly stress log, health form, and mood questionnaire. The study findings are published in the November 8th issue of the Archives of Internal Medicine.
The women had an average of three herpes episodes during the 6-month study. The researchers looked to see if stress that only lasted up to 1 week, stress that lasted for more than 1 week, depression, anger, anxiety, or negative life experiences were related to genital herpes outbreaks. They found that the only factors that predicted a repeat episode of genital herpes were stress or very high levels of anxiety that lasted for more than 1 week. Alcohol use, lack of sleep, and menstrual cycles were all unrelated to the chance of herpes recurrence.
"The results of our study suggest that transient mood states or short-term stressors do not put women at risk for increased genital herpes recurrence," Cohen and colleagues write.
The authors note that long-term stress can have a negative effect
on the immune system, which could cause a herpes outbreak. They
recommend that women experiencing stress for long periods of time
might benefit from counseling and training in stress management.
Source: www.healthcentral.com/News/NewsFullText.cfm?ID=22022&storytype=ReutersNews
Cold sores linked to heart attack
risk
The results of one new study suggest that people who have been infected with the herpes simplex virus type 1 (HSV-1), which causes cold sores on the mouth, are more likely to have a heart attack than people who have not been exposed to the virus.
In a study of more than 600 people aged 65 and older, those who had HSV-1 antibodies in their blood were twice as likely to have had a heart attack or to have died from heart disease, researchers report in the November 7th issue of Circulation: Journal of the American Heart Association.
How infection with HSV-1 may increase the risk of heart disease is unclear, but the study's authors, led by Dr. David S. Siscovick, of the University of Washington in Seattle, conclude that the connection may be important, given that HSV-1 is a common infection.
But infections with the organisms Chlamydia pneumoniae and cytomegalovirus were not linked to a higher risk of heart attack or heart-related death, according to the researchers. But in people with very high levels of Chlamydia, the results of the study suggest that there may be some connection.
Assuming that infection with Chlamydia may increase the risk of heart disease, the results of another study published in the same issue identify a possible way that infections from other parts of the body can move to the heart.
In a study of 28 people with heart disease and 19 healthy blood donors, researchers at the University of California at Davis found that Chlamydia bacteria, which primarily cause lung infections, were able to spread to major blood vessels, apparently through white blood cells called T lymphocytes, one of the authors of the study, Dr. Ravi Kaul told Reuters Health. These cells carry an immune marker called CD3 on their surface, and DNA tests showed signs of Chlamydia bacteria in these cells, according to Kaul.
"What makes the present study more interesting is the fact that CD3 immune cells which carry Chlamydia are supposed to protect an individual against the invading organism," Kaul said.
"The concept that infections such as Chlamydia pneumoniae may participate in hardening of the arteries is revolutionary in that it may mean that some forms of heart disease are treatable or preventable with antibiotics," according to Kaul.
A third study in the journal helps explain why people with high levels of inflammation often do not survive a heart attack.
Knowing that people with high levels of inflammation are more likely to have a heart attack--and less likely to survive--researchers at the University of California, San Francisco, analyzed inflammation and blood flow in 975 people enrolled in a study of a clot-busting drug. Some of the participants had clogged arteries and some had clear arteries.
"Patients with inflammation--elevation of their white blood cell count--had poorer blood flow into the heart muscle and more blood clots in the artery receiving the clot-dissolving drug than patients with low white cell counts," one of the study's authors, Dr. C. Michael Gibson, said in a statement released by the American Heart Association.
People with inflammation were also more likely to develop congestive heart failure, according to the report.
"These relationships may explain the higher mortality rates observed among (heart attack) patients with an elevated white blood cell count and help to clarify the growing body of evidence that links inflammation and cardiovascular disease," Gibson and colleagues conclude.
The study received funding from Genentech, Inc.
Source: www.healthcentral.com/News/NewsFullText.cfm?ID=43922&storytype=ReutersNews
Compound from red wine could treat cold
sores
The research, which is being directed by Dr. John J. Docherty of Northeastern Ohio Universities College of Medicine, was presented during a poster session here at the Interscience Conference on Antimicrobial Agents and Chemotherapy, sponsored by the American Society for Microbiology.
Currently, there are about a half dozen oral and topical treatments for cold sores. But the herpes simplex virus that causes the cold sores has developed resistance to treatments. The herpes virus "mutates and changes over time and the drugs no longer work," researcher Mathew Lesniewski explained in an interview.
"This compound, found in red wine, has previously been shown to inhibit the replication of the herpes simplex virus," Lesniewski, a graduate student at Kent State University, told Reuters Health. "After we isolated the compound and figured out its chemical structure, we then modified it in an effort to make a more potent inhibitor (of the virus)."
The researchers made five different chemical compounds based on the original one from red wine. In laboratory experiments, the investigators infected cells with the herpes virus, and then added the compounds and monitored the virus's ability to live and grow. One of the compounds demonstrated success in thwarting the nasty bug.
"The initial studies have shown that our compound attacks a different part of the virus's life cycle--a very early stage--compared to other treatments that are currently out there," Lesniewski said.
"The next step is going to focus on making more modifications to
the compound that stopped the virus from replicating so we can have
the most potent drug," he told Reuters Health. "We are also going to
start planning animal studies.
Source: www.healthcentral.com/News/NewsFullText.cfm?ID=41495&storytype=ReutersNews
Vaccine may protect against herpes
The findings, reported Sunday, are a surprise. Until now, no vaccine has ever been shown to work in one sex but not the other. Experts say this could present unexpected trouble for creating other vaccines for sexually transmitted diseases, such as AIDS.
The results were not the clear home run that the vaccine's developer, SmithKline Beecham, had hoped when it began designing the latest studies a decade ago. Further testing will almost certainly be required for the drug to be approved, assuming that the company keeps working on the product.
Nevertheless, doctors say a vaccine that offers even partial protection against a chronic disease is noteworthy. The only other sexually transmitted disease that can be stopped with a vaccine is hepatitis B.
"I would say the chances are good but not at all certain" that the herpes vaccine will eventually be approved for routine use, said Dr. Spotswood Spruance of the University of Utah, one of those who tested it.
He predicted the vaccine would be given to adolescent girls. Widespread use of the vaccine this way would probably reduce genital herpes for both sexes, since it would lower the chance of men coming in contact with infected females.
Genital herpes and cold sores result from closely related bugs. Herpes simplex virus type 1, or HSV-1, causes fever blisters on the mouth, while HSV-2 triggers sores on the genitals. Once acquired, both infections last a lifetime.
Both infections grow more common with age. Recent surveys suggest that in the United States, 45 million people ages 12 and older are infected with the genital herpes virus.
Spruance and colleagues reported the results of two major studies of the vaccine at a meeting in Toronto of the American Society for Microbiology. Both were conducted on couples in which one partner had genital herpes but the other did not. The studies involved more than 2,700 people in the United States, Canada, Australia, Italy and New Zealand.
In one of the studies, the partners who were free of genital herpes had never been infected with either HSV-1 nor HSV-2, while the other included those who had HSV-1 but not HSV-2.
During 19 months of follow up, it turned out that the vaccine did nothing to protect men or to protect women who already had HSV-1. However, it was about 75 percent effective in warding of genital herpes sores in women who had never had either form of the virus.
About 3 percent got genital herpes after taking the vaccine, compared with about 11 percent of those receiving dummy shots. Another 3 percent of those getting the vaccine became infected but never developed genital sores.
The researchers said that being infected with HSV-1 probably helps protect people from getting genital herpes, and the vaccine does little to increase this natural barrier.
Why the vaccine works in women but not men is unclear, although the researchers said it probably has something to do with differences in sexual anatomy. Perhaps the vaccine boosts the immune system so it can attack the herpes virus while still in the vagina, but it is unable to stop the virus after it gains access to the bloodstream through tiny tears in the penis.
"The results are not exactly what we expected," said Gary Dubin, who heads adolescent vaccine development for SmithKline Beecham in Belgium. He said the company is getting reaction from regulators and public health officials before deciding what to do next.
However, Spruance said the vaccine could be targeted at girls ages 10 to 13. At this age, he said, about half have not been infected with either form of the herpes virus and so could benefit from the vaccine.
Despite its drawbacks, the vaccine "really looks very effective. It seems potentially useful," commented Dr. William Craig of the University of Wisconsin, head of the conference program committee.
The vaccine is made from a protein taken from the outer surface of the herpes virus. It is combined with a bacterial toxin that acts as an immune system booster.
Source: On the Net: Microbiology society:
www.asmusa.org/
or www.healthcentral.com/News/NewsFullText.cfm?ID=41416&storytype=APNews
Did She Get Herpes From The Dummy?
I have herpes. I know that a person can have it for years without being aware of it, so how can a lawyer possibly prove that the plaintiff's herpes infection came from the dummy?
Dr. Dean: The answer is that lawyers have learned the truth doesn't matter; a lawyer doesn't have to prove anything in order to win a lawsuit.
As you mentioned, far more than half of Americans have the herpes virus although most people are not aware of ever having an outbreak. The only way to legitimately point fingers at the dummy would be if following the class eight out of ten people broke out with herpes lesions.
In addition, transmittal of the virus could only occur at the class under a nearly perfect set of circumstances. Person A sheds the virus onto the plastic dummy, and the virus survives -- which is possible but unlikely -- and Person B has a crack in her skin that lines up on the exact spot where Person A deposited the virus.
Herpes is a ubiquitous organism that we encounter everyday, everywhere. We think that traumas to the body, like sunlight exposure or bumping ourselves, trigger outbreaks. So statistically, what is most likely is that this woman already had herpes and something triggered the outbreak.
It will be interesting to see what happens. Very often, the
defense settles because proving a negative -- that something didn't
happen --is very difficult. Everyone goes away counting their money.
That's the nature of our legal system.
Source: www.healthcentral.com/drdean/deanfulltexttopics.cfm?ID=42551&storytype=DeanQuestions
Does Fruit Cause Genital Herpes
Attacks?
Dr. Dean: I'm not aware of, and I have no reason to believe, there's any relationship between eating fruit and having outbreaks of genital herpes.
There is a link between irritation and herpes outbreaks, though. I think it's likely that along with increasing your fruit consumption, the summer brought more exposure to sun into your life or more sexual activity, or something is stressing you out. Any of this can be irritating, making you vulnerable to herpes.
Herpes does seem to be seasonal. Some herpes sufferers have a major attack and then don't have any for years. Some get a cluster of them -- two or three or four in a season -- and then don't have any at other times of the year.
There are anti-herpes drugs that are helpful. They will shorten the duration of the outbreak -- not by much, but listen, five days of suffering is still better than seven.
If you can feel an attack coming on, as many people do, or if you have outbreaks seasonally, you will be able to get away with taking the pills during your vulnerable times only. That way you can avoid taking them everyday.
By doing research on HealthCentral.com you can arm yourself for a
visit to your doctor. You can go in and ask for the drugs you think
will help you.
Source: www.healthcentral.com/drdean/deanfulltexttopics.cfm?ID=39686&storytype=DeanQuestions
She Had Acanthamoeba In Her Eye. Why
Did They Call It Herpes?
She was misdiagnosed with herpes simplex of the eye and given the wrong medication for six months. She lost her vision in that eye and is now scheduled for a cornea transplant.
Is there even such a thing as a herpes eye infection? If so, how do you catch it? Does genital herpes spread to the eye?
Dr. Dean: First let me warn everyone that contact lenses should never be washed in tap water, or in anything other than a sterile saline solution. Acanthamoeba is not just a Third World thing. It lives in water in this country too.
Follow the manufacturers' instructions on contact lenses, and do not wear the extended wear type beyond their end date.
The good news is that corneal transplantation has a high success rate, so your mother is likely to recover well.
Yes, herpes in the eye is real. It is called herpes keratitis and I'm afraid it's fairly common. It has a distinct look -- what is called a dendritic or branching ulcer -- so I'm disturbed by the misdiagnosis. Also, a herpes diagnosis can be confirmed by a culture.
We don't know exactly how herpes infects the eyes, but it hides out in the nervous tissue of most human beings. Possibly the virus travels through the nervous system to the eye and an eruption is triggered by an irritant the same way that oral and genital herpes outbreaks occur.
Most people with cold sores know the specific triggers that spur outbreaks. And a study found that men with genital herpes that had been dormant for years got an attack when their genitals were exposed to a sunlamp.
Perhaps an outbreak of herpes keratitis is triggered by the
irritation of a contact lens against the cornea. It can be very
difficult to treat, and because of that challenge, ophthalmologists
were the first physicians to use the anti-herpes drugs that are now
commonly used to treat genital herpes.
Source: www.healthcentral.com/drdean/deanfulltexttopics.cfm?ID=37088&storytype=DeanQuestions
Will Zovirax Help With Herpes?
A. Zovirax (acyclovir) was originally developed to treat genital
herpes, or herpes II. It is prescribed to treat an acute outbreak, or
may be taken on a daily basis to prevent lesions.
Source: www.healthcentral.com/peoplespharmacy/pharmfulltext.cfm?ID=17976&storytype=PPColumn_question
Online Help For Herpes: What To Know,
Where To Go
I thought it odd that the first time I'm asked about herpes, it was by three different people in one day.
That was my first inkling of what became an explosion of information about herpes. With 45 million Americans having the disease, and about half a million new cases occuring every year, it is no wonder it remains a topic of high interest.
And because it is a sensitive and highly private topic, many people might like to research it from the comfort and privacy of their computer. So, here are some suggestions about where to look online find out more about herpes simplex, particularly genital herpes.
A Technical Explanation Of Herpesviruses
The National Library of Medicine Medical Subject Headings (MeSH) lists eight different human herpesviruses. We are concerned with herpes simplex, a group of infections caused by herpesviruses 1 and 2. "Herpesvirus 1, human" causes most non-genital herpes; "herpesvirus 2, human" causes most genital herpes.
Not to get confused, there is also herpes zoster or shingles (herpesvirus 3, human) a very painful outbreak of rash and blisters that is a reactivation of the herpesvirus causing chicken pox. Herpesviruses get around; they can be found in horses, puppies, chickens, pheasants, mice, pigs, rats, wild birds, cattle, marmosets and monkeys.
It occurs mainly around the face, mouth, lips and eyes and may be better known as fever blisters or cold sores. It can be triggered by stress or exposure to sun or heat. (I know someone who used to take trips to China, and invariably would return with a herpes blister on his lip triggered by the long ride in an overheated plane.) HSV-1 can on occasion cause genital herpes.
Herpesvirus 2, human/Genital Herpes (HSV-2)
HSV-2 occurs in the genital region the thighs, buttocks, penis, scrotum, labia or vagina and is characterized by small painful blisters and fever, headaches, muscle aches. Genital herpes is usually, but not always, transmitted by sexual contact. HSV-2 can on occasion cause non-genital herpes.
HealthCentral has comprehensive information on herpes simplex, with particularly good encyclopedia articles with pictures. Start with the Herpes Topic Center for a collection of the best information.
The best way to search for information on HealthCentral.com
is to go to the Advanced Search mode. Under "must contain the words,"
type in herpes; under "must not contain the words," type in zoster.
Typing in only the word "herpes" will result in many articles on
herpes zoster or shingles.
You can specifically find what Dr. Dean has to say about herpes by
limiting the search to Dr. Dean Edell on the pull-down menu. The
People's Pharmacy section has good information on drug treatment of
herpes simplex.
This antiviral medicine has revolutionized the way the medical profession treats viruses. Prior to Zovirax, many researches believed that it would be impossible to develop safe and effective virus treatments. This medicine proved that such compounds are practical.
Zovirax is used to treat genital herpes and zoster infections or shingles. Although it is not a cure, it can speed healing and can be used to prevent recurrences of genital sores.
Another potential use may be the treatment of chicken pox. Studies are underway to determine the drug's effectiveness.
Special Precautions
If Zovirax is being used to treat genital herpes it is best to
avoid intercourse when active sores are apparent. B ecause virus can
be shed even in the absence of lesions, it makes sense for the male
partner to use a condom.
Source: www.healthcentral.com/peoplespharmacy/ppdrugfulltext_overviewBrand.cfm?id=5&brandname=Zovirax
and type in the word herpes. There are over 60 questions and very
helpful answers on herpes.
They also sponsor a helpful genital herpes interactive resource
for people with genital herpes. This new (6/02) web site offers
expert information from leading authorities in the field and gives
users the opportunity to interact online with people living with
genital herpes. It can also provide ongoing emotional support for
those who are confused or upset about their condition. www.healthandhope.comDietary Information
The Medical Literature
www.healthcentral.com/Columnists/ColumnistsFullText.cfm?ID=28169&storytype=Column_Schmal
www.racoon.com/herpes/
www.ama-assn.org/insight/spec_con/patient/pat019.htm
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