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Discover how Herpes can affect your pregnancy - click here !
Discover how condoms can help protect you and learn the latest
news about the medications that help
October 16, 2002, Acurian
Source: U.S. Food and Drug Administration
by: Linda Bren
Genital herpes is spread only through direct skin-to-skin
contact or mucous membrane contact. It can be
transmitted through penile-vaginal intercourse, anal
intercourse, oral-genital sex, and other sexual
body-to-body contact.To reduce the risk of
transmitting genital herpes, people who have the virus
should avoid sexual contact from the time they first
feel any symptoms until their lesions are completely healed.
During times when there are no symptoms, using latex male condoms for genital-to-genital contact reduces the risk of transmission, according to the American Social Health Association.
But condoms are only effective if they cover or prevent contact with the area of the body that has a lesion or active virus.In one study of more than 400 monogamous couples in which one partner had genital herpes and the other didn't, condoms were found to offer significant protection against HSV-2 infection in women, says study leader Anna Wald, M.D., medical director of the virology research clinic at the University of Washington in Seattle.
Since women shed the virus from a wide genital area, condoms may be less protective for men than for women, says Wald, whose study was published in the June 27, 2001, issue of the Journal of the American Medical Association.
However, more studies are needed to address how well condoms work for men, she says.Lambskin or other natural membrane condoms should not be used for disease protection because the naturally occurring pores in the material are large enough to allow some viruses to pass through.
Latex Condoms Can Help
The FDA recommends latex condoms or polyurethane condoms for those sensitive to latex.Partners can be infected with different strains of herpes, but are highly unlikely to reinfect each other, says Ashley. Even if they did, each person's symptoms are unlikely to change.
"You're not going to be suddenly having twice the attacks because you have [your partner's] strain too."
For Extra Protection......
The virus is not transmitted through the air, nor are there any documented cases of a person getting genital herpes from an inanimate object such as a toilet seat or hot tub. "Herpes doesn't do well in chlorinated water," says Ashley. "The virus can be present in a hot tub, but it won't be active."
The virus doesn't survive well in the environment, even on a wet towel, says Ashley. However, she advises to avoid sharing razors, especially with someone who has an active cold sore. The virus can be transmitted from the razor to the skin.
Other viruses, such as hepatitis C, also can be transmitted by sharing razors.Spreading herpes from one part of your body to another (autoinoculation) is possible, but unusual. To be safe, wash your hands with soap if you touch a herpes sore.
The Medications That Can Help
Although there is no cure for genital herpes, there are medications that significantly reduce the frequency and duration of outbreaks and have few side effects in most people.In 1985, the FDA approved Zovirax (acyclovir), the first genital herpes drug, which is now available in a generic form.
More recently, the FDA approved two other drugs to treat genital herpes: Famvir (famciclovir) and Valtrex (valacyclovir).All three of these oral antiviral drugs can be taken either episodically--when a person has an outbreak or feels one coming on, or suppressively--daily to help prevent the recurrence of outbreaks.
Acyclovir and valacyclovir are also FDA-approved to treat an initial episode of genital herpes to help heal the lesions and to lessen the pain.When taken episodically at the first sign of a tingling or itching sensation, an antiviral drug may prevent an outbreak altogether.
"Once an outbreak occurs, if the treatment is started soon enough, the drugs can lessen the severity and shorten the healing time," says the FDA's Kukich.
When taken suppressively, the drugs don't always prevent outbreaks, but help them to occur less frequently.All three of the drugs work by interfering with DNA synthesis to prevent the virus from reproducing, says Kukich. Famciclovir and valacyclovir, which are better absorbed by the body, can be taken less often than acyclovir.
Diagnosing Genital Herpes
Herpes can be detected by a viral culture of a lesion, if one is present, or a blood test. Ashley recommends both methods.
With a viral culture, a doctor swabs a lesion to pick up cells, puts the swab in a special solution, and sends it to a lab for growing and analyzing.Although a doctor may recognize a herpes lesion by examining it, a viral culture will confirm the presence and type of HSV, says Ashley.
Once they know whether they have HSV-1 or HSV-2, people have a better idea of how often they will have recurrences.
But viral cultures do have their drawbacks. If the lesion has started to heal (usually 48 hours after its appearance), the swab may not pick up enough virus and the culture result will be a "false negative." (False positives in cultures are rare.)A blood (serology) test can be used to confirm a negative culture.
It can also be used to diagnose herpes in a person who has no symptoms, who has genital irritation but isn't sure it's herpes, or who has a sexual partner with herpes and wants to find out if he or she has already become infected.
"Diagnosing whether someone has herpes or not is quickly done by a serology test because once you've become infected, an immune-competent [healthy] individual will develop antibodies to the herpes that is infecting them," says Thomas Simms, a biologist in the FDA's Center for Devices and Radiological Health.
Herpes antibodies will usually show up in the blood several weeks after a person first becomes infected. Some blood tests can determine the type of herpes infection, but cannot indicate whether the herpes is oral or genital.
So people without symptoms may not know for certain if their herpes is oral or genital.In the past several years, the FDA has cleared three blood tests that accurately determine if a person is infected with HSV-1 or HSV-2.
The HerpeSelect ELISA Kits and the HerpeSelect Immunoblot Kit made by Focus Technologies of Herndon, Va., detect both types. The POCkit Rapid Test made by Diagnology Inc. of Cary, N.C., detects HSV-2 only.
Another blood test is the Western Blot. Although not 100 percent accurate, the Western Blot is considered the "gold standard" of blood tests and is used to determine the accuracy of other herpes blood tests that are developed.
The University of Washington is the premier institution for performing and interpreting the test.
Many older FDA-cleared blood tests for herpes are still on the market, and many labs use these tests because they are widely available and inexpensive.
Although they may be labeled type-specific (can determine whether the infection is HSV-1 or HSV-2), they are not reliable, says Simms.But it's difficult for people to make sure they are getting one of the newer, accurate tests, says Wald. Doctors and even lab workers may not know what test they're using.
"The patient needs to ask, but it's a very tall order. It will take a significant amount of work on their part and phone calls to the lab themselves."This is where a herpes support group can help, says Adams, who facilitates a group called HELP of Washington.
"We keep a list of doctors who are up to speed, knowledgeable, and know what the right tests are.
A Herpes Vaccine: Is It Possible ?
Researchers have found that daily doses of antiviral herpes drugs reduce asymptomatic shedding, but whether this suppressive therapy can help prevent transmission is not yet known.Another area of long-time study is a herpes vaccine.
No vaccine has been shown to be effective in human studies, but researchers continue to work toward that end.In the meantime, learning about the disease and talking openly with a partner can help people with herpes take control of their lives.
"Once they understand it and recognize it, control is a lot easier," says Ashley. "Over time, it becomes a nuisance rather than a mind-altering and life-changing event."
Intimate Health Care For Women
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www.TheVzone.net - Genital Herpes - Prevention and Treatment
