Herpes simplex viruses are ubiquitous, host-adapted pathogens that cause a wide variety of disease states. Two types exist: herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). Both are closely related but differ in epidemiology. Up to 80% of herpes simplex infections are asymptomatic. Symptomatic infections can be characterized by significant morbidity and recurrence. In immunocompromised hosts, infections can cause life-threatening complications.
HSV is transmitted via close personal contact.HSV infection occurs via inoculation of virus into susceptible mucosal surfaces (eg, oropharynx, cervix, conjunctiva) or through small cracks in the skin. HSV-1 is transmitted chiefly by contact with infected saliva, whereas HSV-2 is transmitted sexually or from a mother's genital tract infection to her newborn. However, lesion location does not always indicate viral type. There are several lab tests that can be done to determine whether ones are infected with HSV or not. For example, HSV infection is best confirmed by isolation of the virus in tissue culture (the criterion standard for diagnosis). Tissue culture success is operator-dependent, but this modality can yield positive results within 48 hours of inoculation. The characteristic cytologic changes induced by HSV can be demonstrated in Tzanck smears; however this procedure does not distinguish between HSV-1 and HSV-2. There is also PCR technique,DFA (direct fluorescent antigen) technique and antibody testing also can be done to demonstrate a primary seroconversion, particularly with HSV-1 in childhood. |
Overall, medical treatment of herpes simplex virus (HSV) infection is centered on specific antiviral treatment. The goals of pharmacotherapy are to reduce morbidity and to prevent complications. Antiviral such as Penciclovir (Denavir), Acyclovir (Zovirax), Valacyclovir (Valtrex) and Famciclovir (Famvir) are used for both HSV-1 and HSV-2.
The prevalence of HSV infection worldwide has increased over the last several decades, making it a major public health concern. Prompt recognition of herpes simplex infection and early initiation of therapy are of utmost importance in the management of the disease. By, Fifi Fariza Binti Azmi 16 June 2013 |