Herpes Testing and Treatment in Malaysia

Herpes Simplex Virus (HSV) 1 and 2 are similar to other Sexually Transmitted Diseases (STDs) where they may not produce very obvious symptoms during an infection and is such easy to miss. Infections of HSV 1 usually produces cold sores whereas HSV 2 results in genital herpes. However, based on the sexual activity HSV1 can be found in the genital region and HSV2 can be found in other parts of the body. We have had a female patient who kept having blisters monthly at the location of her bra strap. We did a swab which confirmed a HSV 2 infection.

Signs and Symptoms of Herpes Infection

At times, the virus is dormant in the body and at other times it can result in blisters around the genitilia or rectum within two to seven days of infection.

Other symptoms include:

  • Itching or tingling sensation around the genital areas;
  • Pain when passing urine (usually over the open sores), most commonly in women
  • Headaches/backaches/myalgia
  • Flu-like symptoms and swollen lymph nodes or fever

The blister may often rupture leaving painful sores or ulcers that may take months to heal. Once healed, subsequent outbreaks are usually less dramatic and often gets less over time. It does not mean one is immune to the virus as it may trigger a latent infection subsequently.

Herpes is one of those viruses that remain in the body indefinitely and we have no definitive cure to the infection. We can however, control and treat flares of the disease with medications.

How can I get the disease?

Genital herpes is transmitted through skin contact during sexual intercourse. Both HSV 1 and 2 are contagious most when lesions appear on the skin during a flare up of the virus infection. It must be noted that even if there are no symptoms, the virus is still transmissible. Moreover, the condom doesn’t really protect you from it.

How can Herpes infection be detected?

In order to confirm the presence of the virus in a person, the following steps are done:-

  • A thorough clinical examination will be done on the genital area
  • A swab sample will be taken from the sores
  • Women may need to be examined internally (pelvic exam)
  • A urine sample may or may not be taken

Most times, a visual inspection of a sore will be sufficient to tell if it is a Herpes sore but the symptoms do vary quite a bit necessitating the need for the procedures mentioned. As above mentioned, the std symptoms may not be apparent all the time and if there aren’t any symptoms, a std blood test will be done to look for traces of HSV 1 or 2 antibody in the blood. These usually appear traceable three months after an initial infection. It must be noted that these blood tests cannot differentiate between an active or latent infection. It merely confirms the presence of the virus in the body.

Can Herpes be treated?

As earlier mentioned, there is no definitive cure for HSV 1 or 2. We can however, manage the severity of a flare up using antiviral medication. With ulcers rupturing, the nodules can become quite tender. We too can manage the pain and associated symptoms of a flare up.

If there are frequent relapses, a prolonged course of antivirals is recommended to further suppress the virus.

How can Herpes be Prevented?

This is rather difficult as any skin contact with a person infected by the HSV 1 or 2 virus can potentially transmit the virus. Transmission of the virus can be significantly reduced or even avoided if sexual activity is avoided during a flare where ulcers or lesions are clearly seen. As with most herpes virus infections, if there are no symptoms, using contraception such as condoms provide very limited protection against the transmission of the virus.

It is best advised to treat any outbreak of the virus promptly. At times, suppressive therapy may be considered to further reduce the risk of transmissibility from a person who has a dormant infection.

Complications of Herpes Infections

As is the case with sexually transmitted diseases (STDs), it increases the chances of concurrent infections due to the suppressed immune levels from the initial infection.

HIV Transmission: It is widely known that an infection of HSV can potentiate a HIV (Human Immunodeficient Virus) by up to threefold as it facilitates the entry of HIV into the body.

In a pregnant woman, it is possible that the virus be transmitted from mother to the fetus. This increases the risk of miscarriage especially just after the first trimester. It can also directly infect the fetus and increases the chances of a congenital herpes infection in the newborn baby.

If a pregnant mother is infected at the later stages of pregnancy (last trimester), it can result in premature labour.

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