Herpes is a group of viruses that can cause infection. Herpes virus infection is generally characterized by dry skin, blisters, or open, watery sores. Herpes simplex virus  (HSV) and varicella-zoster virus  (VZ) are types of herpes viruses that commonly attack humans.

The herpes virus can affect anyone. Having a history of contact with sufferers of this viral infection and a weak immune system are factors that can increase a person's risk of being infected with the herpes virus.

Herpes viruses are divided into three major groups, namely alpha ( α ) herpesvirus , beta ( β ) herpesvirus , and gamma ( γ ) herpesvirus . Of these three groups, there are eight types of herpes viruses that can infect humans, namely:

  • Herpes simplex virus type 1 (HSV 1)
  • Herpes simplex virus type 2 (HSV 2)
  • Epstein-Barr virus  (EBV)
  • Varicella-zoster virus (VZV)
  • Cytomegalovirus  (CMV)
  • Herpesvirus 6 (HBLV)
  • herpesvirus  7
  • Herpesvirus  Kaposi's sarcoma

Causes of Herpes

Although many types of herpes viruses can infect humans, it is the alpha herpesvirus group that causes the infection most often. Some types of viruses from this group are:

Herpes simplex virus type 1 (HSV 1)

HSV 1 is a type of herpes virus that often causes  oral herpes  (mouth) or herpes labial (lips). However, HSV 1 can also spread from the mouth to the genitals and cause genital herpes in people who receive oral sex from sufferers of oral herpes.

HSV 1 can be spread through direct contact from herpes sufferers to healthy people, for example through kissing, sharing cutlery or lip cosmetics, such as lipstick.

In most cases, HSV 1 is transmitted from asymptomatic HSV 1 sufferers. However, the risk of transmission will be higher if there is contact with sufferers who have open wounds due to HSV 1.

Herpes simplex virus  type 2 (HSV 2)

HSV 2 is the main cause of  genital herpes . This viral infection can recur with a frequency of relapses that varies in each sufferer.

The HSV 2 virus is transmitted through direct contact with sores on herpes sufferers, for example during sexual intercourse. In rare cases, HSV 2 can also be passed from mother to baby during delivery.

Varicella-zoster virus  (VZV)

VZV is a virus that causes chickenpox ( varicella ) and shingles ( shingles ). Chickenpox occurs when the varicella-zoster virus infects a person for the first time.

Meanwhile, herpes zoster, also known as skin herpes, occurs when the VZV virus that is dormant in the body recurs. A person can also be infected with this virus from shingles sufferers.

VZV is mainly transmitted through direct contact with people with chickenpox. This viral infection can be recognized by the appearance of skin nodules filled with fluid (vesicles). VZV can also be transmitted through direct contact with the fluid in the vesicles or splashes of saliva that come out when the patient sneezes or coughs.

Usually, the virus has been in the patient's body for 7-21 days before a rash or other symptoms appear. However, sufferers can transmit the varicella-zoster virus to other people 48 hours before the appearance of the rash.

Herpes risk factors

Herpes can affect anyone in any age group. However, this viral infection is more prone to occur in someone who has frequent contact with herpes sufferers, such as medical workers or family members who treat herpes patients.

For types of herpes simplex virus type 1 or type 2, the following factors can increase the risk of being infected with this virus:

  • Female gender
  • Frequently changing sexual partners
  • Having a weak immune system due to taking certain drugs or suffering from HIV/AIDS
  • Suffering  from sexually transmitted diseases

While several factors can make a person more at risk of being infected with the VZV virus, they are:

  • Under 12 years old
  • Have a history of direct contact with people with chickenpox
  • Working or doing activities at a school or special children's facility, especially if a child has chickenpox
  • Have a weak immune system, both due to disease and side effects of drugs

Besides being able to cause chickenpox, the VZV virus can also cause shingles. Several factors and conditions can increase a person's risk of experiencing herpes zoster, namely:

  • Age 60 and over
  • Have a previous history of chickenpox
  • Suffering from a disease that can weaken the immune system, such as HIV/AIDS  or cancer
  • Are undergoing  chemotherapy , radiotherapy, or using immunosuppressant drugs

Symptoms of Herpes

Herpes infection usually occurs in several stages. Symptoms or complaints that can arise at each stage can vary, as explained below:

1. Primary stage

The primary stage occurs on the 2nd to 8th day after herpes infection occurs. Symptoms that appear in this phase are blisters on the skin that are small and painful.

The blister rash is usually filled with clear or cloudy fluid. The rash of blisters can burst, causing open sores. The area around the blister rash will also be reddish in color.

2. Latent stage

At this stage, the rash, blisters and sores that previously appeared will subside. However, in this phase, the virus is growing and spreading to the nerves near the spinal cord which are under the skin.

3. Decay stage

The virus begins to multiply on the nerve endings of the body's organs. If the infected nerve endings are located in organs that produce fluids, such as the testicles or vagina, the herpes virus can be contained in bodily fluids such as semen and vaginal mucus. Usually, in this phase, sufferers do not complain of special symptoms.

4. Stage of recurrence ( reappearance )

At this stage, the blistering rash on the skin that occurs in the primary stage may reappear, but usually not as badly as the previous blisters and sores. Other symptoms that can arise at this recurrence stage are itching, tingling, and pain that appear in the area of ​​infection in the first stage.

As previously mentioned, symptoms or complaints when infected with the herpes virus can vary, depending on the phase that is going on, the type of virus that infects it, and the patient's immune system.

Keep in mind, not all herpes sufferers experience the same symptoms. In fact, this condition sometimes does not cause any symptoms. However, in some people who have a herpes virus infection, the following symptoms will appear:

  • Fever
  • Fatigue
  • Headache
  • Muscle ache
  • Loss of appetite
  • Swollen lymph nodes

Furthermore, specific symptoms will appear according to the type of herpes virus that infects and the location or part of the body that is infected, namely:

Symptoms of HSV 1 infection or oral herpes

In this condition, symptoms will appear in the mouth and the area around it. Symptoms that can appear are:

  • Pain, itching, burning, or prickling in the lips
  • Blisters, small blisters, or canker sores on the lips
  • Painful blisters that interfere with eating

Symptoms of HSV infection 2

In sufferers of HSV 2 infection or genital herpes, some of the symptoms that are generally experienced are:

  • Swelling of the genital skin or the area around it that feels itchy, painful and accompanied by a burning sensation
  • Painful sores on the genitals , buttocks, anus, or thighs
  • Pain when urinating ( dysuria )
  • Discharge from the vagina
  • The skin of the penis is dry , sore and itchy

Symptoms of VZV infection

Whereas in infection with  the herpes zoster virus  that causes chickenpox, a skin rash filled with fluid (vesicles) that feels itchy will appear. This rash can spread throughout the body.

If a person with chickenpox who has recovered has shingles, complaints will appear on one side of the body, such as pain, a burning sensation, followed by the appearance of blisters on the skin.

When to see a doctor

Check with  your doctor  if you experience the symptoms of herpes as mentioned above, especially if you have a blistering rash on your skin that has no known cause.

Examination needs to be done immediately if a blister rash appears in your child who is less than 8 weeks old. Herpes virus infection in infants can develop more quickly to cause serious complications.

If you have a weak immune system, check with your doctor when a blister rash appears on your skin. Severe infections and complications are more likely to occur in people with herpes who have weak immune systems.

Difficulty when eating due to HSV 1 infection risks causing dehydration . Seek medical help immediately if you experience dehydration due to this viral infection, which is characterized by a reduced amount of urine, dry mouth, fatigue, and irritability.

Specifically for pregnant women who are or have had genital herpes, consult with your doctor about what to do to prevent the virus from passing to your baby.

Diagnosis of Herpes

To diagnose herpes, the doctor will ask questions about the patient's symptoms, activity history, and medical history. Next, the doctor will carry out a physical examination to see if there is a fever, the type of skin rash that appears, and the pattern of the spread of the rash.

Doctors can diagnose herpes through questions and answers and the results of a physical examination. However, to strengthen the diagnosis and ensure the type of herpes virus that infects, the doctor will carry out further tests, such as:

Viral culture

A herpes virus culture aims to detect the herpes virus. Herpes virus culture is carried out by taking a sample via the swab method from the infected skin or genital area, for further examination in the laboratory.

Viral culture examination is mainly carried out to detect or confirm the presence of the herpes virus, as well as determine the type of virus that infects.

Tzank Examination

The Tzank examination is carried out by taking a sample of the skin rash for further examination under a microscope. The results of this examination can determine whether the lesions that arise are caused by the herpes virus. Even so, the Tzank test cannot identify the type of herpes virus that causes the infection.

Antibody test

Antibody tests aim to detect antibodies to the herpes virus. This test is done by taking a blood sample, then examining it in the laboratory to ensure the presence of antibodies that are formed due to infection with the herpes virus.

The results  of the antibody test  will greatly assist the diagnosis in patients who do not have any cuts or blisters on the skin. This examination is often used to diagnose HSV 1 or HSV 2 infections.

In addition to the tests mentioned above, in some cases, doctors may recommend a PCR ( polymerase chain reaction ) test, to detect herpes virus infection, especially those that have caused infection in the eye or central nervous system.

Herpes Treatment

In general, sores and blisters from herpes heal on their own within 2–4 weeks. However, the virus may remain in the patient's body without causing symptoms.

Until now, there is no treatment method that can eliminate the herpes virus from the body. The focus of herpes treatment is to help relieve complaints, prevent transmission of herpes, and reduce the risk of complications.

Some antiviral drugs can be used to treat herpes virus infections, including:

  • Acyclovir
  • Valacyclovir
  • Famciclovir
  • Penciclovir

Apart from taking antiviral drugs, several efforts can be made to relieve complaints and speed up recovery due to herpes virus infection, namely:

  • Take  paracetamol  or ibuprofen to relieve pain
  • Compress skin rashes with warm water or cold water
  • Use  lukewarm water  for bathing
  • Wear loose clothing
  • Use cotton underwear
  • Keep the wound area dry and clean

Herpes complications

In general, infections caused by the herpes virus rarely cause serious complications. Complications of herpes virus infection usually occur under certain conditions. For example, people with herpes simplex who also have HIV usually experience more severe herpes symptoms and more frequent flare-ups.

Complications due to herpes virus infection can also depend on the type of virus that infects. When infected with the herpes simplex virus, the following are some of the complications that can arise:

  • Spread of infection to other parts of the body
  • Hepatitis
  • Pneumonia
  • Inflammation of the brain  and lining of the brain
  • Retinal tissue death
  • Esophagitis

In chickenpox, the risk of complications will generally increase in children, the elderly, pregnant women, or people with weak immune systems. Some of the complications that can occur due to chickenpox are:

  • The rash spreads to the eyes
  • A rash followed by shortness of breath and headache
  • Rash followed by secondary infection

Chicken pox in pregnant women that is not handled properly can increase the risk of interference with the fetus. The disorder can be visual impairment, mental retardation, slow growth, or a smaller head.

Meanwhile, complications that can occur due to herpes zoster are:

  • Post herpetic neuralgia , which is pain that is still felt even though the lesions on the skin have disappeared
  • Bacterial infection at the site of the rash
  • Pain and rash that radiates to the eye
  • Ramsay-Hunt syndrome , which is a condition that can cause facial paralysis and hearing loss

Herpes Prevention

To avoid spreading the herpes virus to other people, some preventive measures that can be taken are:

  • Avoid physical contact with other people, especially those with open wounds.
  • Wash hands with running water and soap regularly.
  • Apply the medicine to the rash using a cotton ball so that your hands do not touch the area infected with the herpes virus.
  • Don't share items that can spread the virus, such as glasses, cups, towels, clothes, and makeup tools.
  • Do not perform oral sex , kiss, or other sexual activity, as long as the symptoms of herpes appear.
  • Avoid kissing the baby too often .

Especially for sufferers of genital herpes, avoid all forms of sexual activity as long as the symptoms of herpes are still present. Keep in mind that even if you have used a condom, the herpes virus can be spread through skin contact that is not protected by a condom.

For women who are planning a pregnancy, get tested for toxoplasmosis, rubella, cytomegalovirus, and herpes ( TORCH test ) first. Apart from being an early detection, the purpose of the test is so that infected mothers can undergo treatment before becoming pregnant so as to prevent transmission of the virus to the fetus.

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