Herpes: Getting the Facts

Herpes: Getting the Facts

I remember the “Facts Pack” campaign early 00’s aiming to educate newly diagnosed patients on genital herpes. At the time new antiviral treatments became available and large investment by pharmaceutical companies to create resources had influence on how patients perceived their diagnosis.

The viruses that are responsible for genital herpes are very common. In fact the “family” of herpes viruses, know asherpesviridae,is prevalent in our population. Most of us would be more familiar with chicken pox or shingles borne of a similar viral behaviour by hiding in the nervous system until a reason to be noxious e.g. stress, delivers a debilitating expression like a blister.

Until medications became available two decades ago (or even today) discussions on genital herpes and other STI’s were largely taboo and associated with shame of contracting a genital issue. An honest observation I have on general practice is that older male doctors are adept at handling chronic conditions like diabetes, hypertension and asthma, rather than managing patients with STI’s and the cycle of care that ought to be offered. Conversely, female GP’s, not only attract patients needing attention on genital problems, but seem better equiped at counselling the patient when diagnosed. For some a diagnosis of genital herpes can be a very traumatic experience and surely to the GP’s what was initially intended to be a short consult for relaying the lab results has now become a much longer consultation to handle such grief. I come back to the resources developed by pharmaceutical companies as these resources assist in the cycle of care for the patient to uncover the when? why? how? in understanding genital herpes.

Today, genital herpes is not a routinely screened STI unless an obvious lesion or lesions are present. Therefore at an STI checkup you are not likely to have any herpes investigation. Why? 1) The presence of the herpes-simplex virus (HSV) is very common; 2) A swab is the only accurate investigation for genital herpes and 3) Swab samples are generally taken when symptoms are present.

HSV-1, commonly associated with cold sores, affect 80% of the Australian population and HSV-2 affecting 1 in 8, 12.5% is largely responsible for genital herpes. Genital herpes does not exclude causality by HSV-1, suggesting the prevalence of 1 in 8 could be much higher with those who have acquired genital herpes by HSV-1. The rise of these numbers is assured with unsafeoral sexual practices, or transmission of HSV-1 to the genitals by oral sex.

A blood test doesn’t tell you whether virus is located on your genitals or on the mouth, a serological test can only tell you that HSV is somewhere in you. A swab is a better measurement of where the virus is located, and can deliver a diagnosis for HSV-1 or HSV-2 with accuracy.

80% of those with herpes-simplex virus do not present with symptoms, the virus can lay dormant in the spinal nerve and then ‘shed” on the dermatome pertaining to that nerve. To shed means viral reproduction or replication and this may manifest as a symptom, called symptomatic viral shedding or without symptoms, asymptomatic shedding.

It is misleading to think that one can avoid transmission of herpes if you avoid sexual activity when symptoms are present. Asymptomatic shedding is also responsible for transferring the herpes virus to a sexual partner too. There is some clinical evidence showing antiviral medications reduce transmission to a partner and safe sexual practices are recommended but neither guarantee prevention. However these measures can also alleviate stress or anxiety associated with entering a new relationship.

Antiviral treatments for genital herpes are now off-patent and are commonplace in managing symptoms and transmission of genital herpes. Big Pharmamay have retracted their investment into educational resources, but have given rise to much needed conversations with those affected by this affliction.

For more information on Genital Herpes visit: www.thefacts.com.au

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Nia Amaro is a health writer specialising in general wellness, women’s health, men’s health, pelvic floor dysfunction and gender dysphoria. Nia is a current contributor to The Profile Shop.

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