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Herpes virus exists in two different forms and can cause serious illness depending on which subtype of the virus infects a person. However, regardless of which subtype infects a person, the herpes virus cannot be entirely eliminated from the body and continues to live inside the body for a lifetime.
There are two types of herpes virus: herpes simplex and herpes zoster. Herpes simplex causes a sexually transmitted disease known as herpes. Herpes simplex has two subtypes: herpes simplex virus 1 and herpes simplex virus 2. Herpes zoster virus, with only one subtype, causes two types of illnesses: chickenpox (commonly in children) and shingles (commonly in adults).
To fully understand both the herpes simplex virus and the herpes zoster virus, we must look into the detail of how these viruses are transmitted, how they infect a person, and how they can be treated.
UNDERSTANDING THE HERPES VIRUSES
To understand the disease that herpes viruses cause, we first have to understand the viruses themselves. There are two types of herpes viruses: herpes simplex and herpes zoster.
Herpes simplex virus has two further subtypes: HSV-1 and HSV-2. Both HSV-1 and HSV-2 are double-stranded DNA viruses that target human cells' nuclei. These viruses mainly infect the epithelial cells (skin or mucosa) and make their way into the nucleus, taking over the protein creation mechanisms.
Here, the virus replicates by coding for the proteins necessary for its survival using the host cell's protein generation mechanisms. Once replicated enough, the virus then strikes and lowers the immune health of an individual. The initial lytic infection of the epithelial cells manifests as blisters, boils, rash, or open sores on the skin or mucosal surfaces.
When an individual is infected with HSV-1, these lytic lesions appear on the oral mucosa: i.e., inside the oral cavity. These lesions can also appear on and around the lips. Lytic lesions in an HSV-2 infection appear on and around the genital region, including the buttocks, penis, vagina, anus, scrotum, and inner thighs.
Once the initial infection is complete, the virus then finds its way into the neuronal ganglion cells. Here, the virus becomes inactive and stays “dormant” for some time before emerging again to cause similar symptoms.
The herpes zoster virus, also known as the varicella-zoster virus or herpes virus type 3, is also a double-stranded DNA virus. This virus is different from HSV because it is not transmitted sexually and does not cause a sexually transmitted disease. Another key difference between herpes simplex and herpes zoster is that while herpes simplex is fairly common globally, herpes zoster is virtually inside every human being.
The varicella-zoster virus causes two common illnesses, usually depending on the person's age group getting infected: chickenpox in children and shingles in adults. Almost everyone on the planet has had chickenpox at least once in their life. After the initial infection, the virus stays dormant inside ganglion cells and rarely becomes active.
However, when it does become active, it causes an excruciatingly painful condition called shingles. Shingles are characterized by a vesicular rash covering a dermatome (a section of skin supplied by a single sensory nerve). This rash is painful and has a blister-like characteristic. Shingles can take weeks or even months to cure, but it does go away only very rarely to come back.
HOW IS A HERPES VIRUS DETECTED?
Infections caused by herpes simplex and the zoster virus are diagnosed through careful history, physical examination, and specialized tests. The specialized tests may not be necessary in some cases, but they provide a confirmatory diagnosis whenever there are any doubts.
Your doctor may ask about the onset, duration, and severity of your symptoms. If you have had blisters forming in either the genital or oral regions, which are painful, red in color, and itchy, your doctor may suspect herpes simplex.
Further questions about your sexual history, use of protection, and the number of active sexual partners in the last couple of months may reveal important information regarding your diagnosis. Your doctor may also take scrapings off of the open sores or blisters and send them for examination. Additionally, a blood test that detects antibodies to the herpes simplex virus, called the anti-HSV antibodies, may also be employed.
Suppose your history reveals painful blisters appearing on one side of your body, with no high-risk sexual encounters in the past couple of months and no previous histories of any such symptoms. In that case, the diagnosis may point towards an infection with the varicella-zoster virus.
WHY IS THE HERPES VIRUS SO PREVALENT?
An estimated 13% of the world’s population is living with HSV-2, while a staggering 67% of the population has HSV-1, according to WHO. The main reason the herpes virus is so prevalent is that many people who acquire this virus never develop any symptoms. Moreover, even when symptoms develop, they are either mild or resemble a common cold. Many people with herpes never find out about their condition until they have a couple of episodes of herpetic outbreaks, which are not relieved with medication.
HOW IS A HERPES INFECTION CURED?
There is no cure for herpes. Once acquired, the virus lingers on inside the body and hides in the dorsal root ganglion.
There is effective treatment available in the form of anti-viral medication. These include Acyclovir, Valacyclovir, and Famcyclovir. All these drugs target the virus inside the host cells and prevent its replication. However, these drugs cannot reach every reserve of the virus, and, therefore, the virus survives even after aggressive therapy with these medications.
The end result is that using these treatments lowers the frequency and the severity with which the symptoms of herpes appear. However, herpes itself is never cured.
Supportive medication also plays a role in the effective management of herpes. Painkillers provide relief from body aches, and topical ointments can relieve the pain associated with blister outbreaks.
IS HERPES FATAL?
While the herpes virus is rarely life-threatening, it can lead to terrible complications that might prove to be more than just nuisances.
Herpes virus can especially wreak havoc if acquired during pregnancy. The virus causes preterm and low-weight births in pregnant women. Preterm births and low birth weight babies are at risk of developing fatal conditions and expiring within days of their birth.
Herpes can also cause serious complications such as blindness, deadness, hepatitis, and other end-organ damage, which are usually irreversible even with aggressive management.
