The herpes simplex virus infection

The herpes simplex virus outbreak remains a major global problem, owing to the medical world's continued lack of an appropriate vaccine that can kill the herpes virus. However, with the advancement of science and technology, the modern thinking design has aided researchers in going forward with the production of future vaccines. Herpes simplex virus comes in two varieties: herpes type 1 or HSV-1, also known as oral herpes, and herpes type 2 or HSV-2, also known as genital herpes (Arvin et al., 2007). The herpes simplex virus is a sexually transmitted illness that can affect someone who engages in sexual activity. Indeed, most people having the virus do not exhibit the symptoms, and it can be spread to other people even without the signs and symptoms. About 90% of the world population have one or both of the viruses with HSV-1 being the most prevalent with over 65% of people in the United States of America having antibodies to the HSV-1 virus (Arvin et al., 2007).

In the United States of America, the prevalence rates among the African-Americans, and Asians of HSV-1 is the highest among the races. Most cases of the infection of the herpes simplex virus are oral with most of them being asymptomatic (Arvin et al., 2007). There is the association of HSV-1 with oral lesions, and it is recognized as the cause of genital herpes in the United States and other developed nations. Clearly, the HSV-2 infections are markedly lower compared to HSV-1 infection with about 15% to 80% of the population infected (Arvin et al., 2007). Indeed, the rates of infection vary from country to country depending on the levels of sexual activity. The HSV-2 is a lifetime disease which leads to the occurrence of painful genital sores and thus increases the susceptibility of the HIV. Babies born to mothers with HSV-2 have an 80% mortality rate if left untreated (Arvin et al., 2007). The role of this paper is to highlight the histological, common location, radiological appearance, and prognosis of the herpes simplex virus.

Diagnostic Information of Herpes Simplex Virus

Prognosis

While in the United States of America the infection rates are around 15% to 20% it is imperative to note that the infection rate in sub-Saharan Africa is high with about three to four women infected with the virus (Koelle, & Corey, 2003). The statistics indicate the main reason why Sub-Saharan Africa has a prevalence rate of the HIV. According to Arvin et al., (2007), the developing nations have a higher HSV-2 infection with most countries in Africa having over 50% infection rate in their populations. Indeed, women have an increased risk of HSV-2 infection, which translates to biological susceptibility and their pattern of relationships with older men who in most cases are seropositive (Arvin et al., 2007. As stated prior, the prevalence rates in the United States of America is highest among the African-Americans compared to whites and Asians. Arguably, the difference in infection rates among the races and genders contributes to a disparity in the infection rates.

Herpes Simplex Histology



Fig 1 Fig 2 Fig 3

Courtesy of DermNet New Zealand.

The herpes simplex infection shows an identical histology which indicates a pattern of a typical lesion containing blisters. In most cases, the skin cells lose the key feature of acantholysis and lacking in keratinocytes within the lesions with blisters as shown in fig1, 2, and 3 (Tallon, 2010). The lack of keratinocytes responsible for the production of the protein keratin in the skin indicates the nuclear changes because of the viral infection (Tallon, 2010). Due to infection of the virus, the skin forms small pink deposits with clear halos seen within the nucleus. Those cells infected by the herpes simplex virus and the nucleus exhibit changes are referred to as Cowdry Type A inclusion. The pictures above demonstrates the herpes simplex infection pathology (Tallon, 2010).

Clinical Presentation of Herpes Simplex

In most cases, the frequency of the occurrence of the herpes simplex virus depends on the virus type, gender, and the immune status of the host (Ayoade, 2017). The incubation period of the virus is three to seven days but can range from one day to three weeks. The symptoms include the host having headache, fever, malaise, and myalgia. Other symptoms can include itching, pain, dysuria, vaginal, and urethral discharges (Ayoade, 2017). In women, the features of the virus appear on the external genitalia where in most cases the host can experience the rapturing of the vesicles leaving them tender with ulcers. In men, the herpetic vesicles appear on the glans of the penis, the shaft, and in other cases the scrotum, thighs, and buttocks (Ayoade, 2017).

Diagnosis of Herpes Simplex Virus Infection

In most cases, a clinical diagnosis of herpes simplex virus should be confirmed by the use of laboratory testing (Singh, Preiksaitis, Ferenczy, & Romanowski, 2005). In most cases, the specimens obtained from the lesions within the first few days of infection are the best specimens. There are various diagnostic tests such as the direct method which endeavor to demonstrate the presence of the herpes simplex virus in the lesions (Singh, Preiksaitis, Ferenczy, & Romanowski, 2005). The other method is the viral isolation with the standard viral culture being the gold standard for the detection of the HSV and sets the standard for which other tests take place (Singh, Preiksaitis, Ferenczy, & Romanowski, 2005). The sensitivity of the tests depends on the time of specimen collection as late collection makes the test sensitivity to decline.







References

Arvin, A., Campadelli-Fiume, G., Mocarski, E., Moore, P., Roizman, B., Whitley, R., & Yamanishi, K. (2007). Human herpesviruses (1st ed.). Cambridge: Cambridge University Press.

Ayoade, F. (2017). Herpes Simplex Clinical Presentation: History, Physical, Causes. Emedicine.medscape.com. Retrieved 4 April 2017, from http://emedicine.medscape.com/article/218580-clinical

Koelle, D., & Corey, L. (2003). Recent Progress in Herpes Simplex Virus Immunobiology and Vaccine Research. Clinical Microbiology Reviews, 16(1), 96-113. http://dx.doi.org/10.1128/cmr.16.1.96-113.2003

Singh, A., Preiksaitis, J., Ferenczy, A., & Romanowski, B. (2005). The laboratory diagnosis of herpes simplex virus infections. Canadian Journal of Infectious Diseases and Medical Microbiology, 16(2), 92-98. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2095011/

Tallon, B. (2010). Herpes virus infection pathology | DermNet New Zealand. Dermnetnz.org. Retrieved 4 April 2017, from http://www.dermnetnz.org/topics/herpes-virus-infection-pathology/