Herpes information and Home Testing

What is Herpes?

Herpes is a viral infection caused by the herpes simplex virus (HSV). There are two types of herpes: HSV1 and HSV2. Herpes can affect any mucous membrane but the most common infection sites are the genital area, buttocks, thighs and around the mouth. Herpes can be passed through sexual contact so it is categorised as an STI. Unlike other STIs such as chlamydia and gonorrhoea, herpes does not have a cure. Symptoms can be managed through medication (if required) and there are precautions that that can be taken to prevent transmission to sexual partners.

Herpes Epidemiology

A significant majority of the population has antibodies for the HSV1 (70%) and a significant minority has antibodies for HSV2. Some estimates place the HSV2 antibody prevalence at 40%. Given the prevalence, we question the utility of blood screening for herpes and only advocate testing in symptomatic cases.

Herpes Symptoms

There is no absolute pattern as far as symptoms are concerned. Most people will have a primary herpes episode within 7 – 14 days of becoming infected. The primary episode is usually the most severe and will normally include painful blisters, a general feeling of being unwell, fever, pain or irritation when passing urine (especially in women). Women may also have an unusual vaginal discharge.

Some people infected with herpes will never have symptoms and sometimes the primary episode is months or years after infection. A primary episode does not always imply a recent infection.

Recurrent episodes are usually less severe and comprise a tingling sensation and sometimes painful, watery blisters.

Cold sores around the mouth are caused by the herpes virus.

HSV1 and HSV2 can affect the genital area as well as around the mouth. Contrary to what many people think, HSV1 is often detected in people with genital symptoms.

Herpes Testing

The STI Clinic has a range of tests for herpes. We only advocate testing if you are symptomatic. We have a symptomatic lesion test where you can swab the affected area and we can test for the presence of the herpes virus and syphilis. If you only want to be tested for herpes, there is a herpes swab available.

We can also test for herpes from a urine sample if you have urethral symptoms, and other possible causes (such as Chlamydia and Gonorrhoea) have been eliminated. The urine screen is not recommended if you have visible lesions that can be swabbed. Where symptoms are present in the form of blisters or sores, we strongly recommend a symptomatic lesion swab.

We do not advocate blood testing, as a positive result for antibodies has no real medical utility. The blood test is available from our clinic, but patients should be aware of its limitations.

Herpes Treatment

If the viral load is high, some people can be prescribed suppression therapy. Aciclovir is the normal medication that is prescribed but there are alternatives. If suppression therapy is not required then a short course of Aciclovir can be taken when symptoms develop.