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Herpes Simplex Virus
Herpes Simplex Virus

Herpes Simplex Virus Testing in London

Herpes simplex virus is a common viral infection that affects several parts of the body, more commonly your mouth and genitals, causing oral and genital herpes. You might experience a herpes outbreak causing blisters filled with fluid that bursts and makes a crust on the spot of infection. Some others might be asymptomatic and not know they have been infected with Herpes simplex virus.

Herpes is transmitted from one individual to the other through skin-to-skin contact and is highly contagious. People get infected when the virus enters your body through your mucous membrane or skin. Once this occurs, the virus begins to replicate itself rapidly. The virus might be dormant or reactivated after being introduced into your body, leading to a herpes outbreak. Once infected, the virus stays in the body forever. The effect of this virus depends on several factors, such as your overall health and the type of virus.

There are treatments available to manage this condition and reduce your chances of transmitting this virus, but there is no cure for herpes simplex virus.

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Types of HSV

There are different types of herpes simplex virus, including:

  • HSV-1 Herpes simplex virus type 1
  • HSV-2 Herpes simplex virus 2

Both types of herpes simplex viruses (HSV-1 and HSV-2) are capable of causing genital herpes and oral herpes and infections in other parts of the body.

Parts of the body affected by HSV

The following parts of your body may be affected by this virus, including:

  • Genitals

    If you have genital herpes, you may notice sores on your genitals. These sores may appear inside your cervix, which is not visible externally or on your penis, vulva or vagina, scrotum or butt.

  • Mouth and face

    HSV on this part of the body is referred to as oral herpes. Oral herpes may cause cold sores around your mouth or on your lips. Only in rare cases will you notice sores inside or around your nose, which is called nasal herpes. Others might experience sores inside their mouths, which is called herpetic gingivostomatitis.

  • Eyes

    Ocular herpes is another type of herpes that affects the eyes and can cause a serious eye infection.

  • Skin on other parts of your body

    The Herpes simplex virus may affect the skin on other parts of your body, such as the fingers, known as herpetic whitlow. People with atopic dermatitis might notice complications on their skin if infected with HSV, known as eczema herpeticum.

  • Other organs

    One or more of your organs might also be affected. People may get infections in their lungs (pneumonic HSV), liver (HSV Hepatitis) or oesophagus (herpes simplex oesophagitis). Individuals who are immunocompromised are at higher risk of getting affected by these infections.

  • Spinal cord and brain

    Your brain might be infected, known as herpes encephalitis or the protective layers around your spinal cord and brain, known as herpes meningitis. If this viral infection affects both the protective layers and your brain, you may develop meningoencephalitis, a dangerous and life-threatening condition.

What are common symptoms to look out for?

Herpes simplex infection shows various symptoms but may differ based on the type of infection. This includes:

  • Herpes gladiatorum

    This appears as blisters commonly on the face, hands, chest or ears.

  • Herpes Keratitis

    You often may experience eye irritation or pain, blisters around your eyes or eyelids, light sensitivity, and feeling like you have something in your eyes.

  • Oral herpes

    Your skin may burn up, tingle or itch within 2 days before your blisters might appear. The blisters are found on the lips and around the mouth.

  • Genital herpes

    You may also notice blisters on or around your genital area. 2 days before these blisters, you may notice headache, fever, itching, tingling, and swollen lymph nodes around your genitals.

  • Herpetic whitlow

    Discoloured skin on your fingernail, swelling or blisters on your fingers.

  • Herpes meningitis

    Increased sensitivity to light, headache and fever.

  • Herpes encephalitis

    You may notice fever, changes in your speech behaviour, headache or focal seizures.

If you notice any of the above symptoms or feel you might have recently been exposed to someone who might have HSV-1 or HSV-2, do seek the help of a medical practitioner and get diagnosed. Early detection of herpes simplex virus can help you get treated and manage the condition to avoid health complications resulting from this viral infection.

How can I get infected with this viral infection?

HSV infection occurs when you come in direct contact with an infected person. This implies that you won't get infected unless your body comes in contact with:

  • Surfaces with mucous like the vagina, anus or mouth or skin with or without visible sores
  • Saliva, vaginal discharge or semen with or without any infection symptoms
  • Oral or genital herpes sores

Transmission through direct contact does not imply that every part of an infected person's body would transmit the virus. They only transmit the virus from the infected area, which is most commonly the entry point of the herpes virus. This means that someone who has genital herpes can only transmit the infection through the mucosa, skin and bodily fluids in their genitals. They won't be able to spread the virus by saliva while kissing unless they also have oral herpes. And if you have oral herpes, you won't be able to share this virus through genital contact.

If your partner has both genital and oral herpes, then you can get HSV from both their genitals and mouth, but how you get affected depends on which part of your body comes in contact with the infected area.

Ways by which HSV is transmitted among people

Type of contact How the virus spreads
Skin to sore It's not really common, but you can spread the infection when you touch a person's genital, oral or other infected areas.
Genital to genital The herpes simplex virus spreads when the genitals come in contact and causes genital herpes.
Oral to genital The Herpes virus spreads when an individual's mouth comes in contact with the genitals of another person, giving them genital herpes.
Genital to oral The Herpes virus spreads when an individual's genitals come in contact with the mouth of another person, giving them oral herpes.
Oral to oral HSV is transmitted from mouth to mouth, and the other person gets oral herpes.

Incubation period of Herpes infection

The incubation period is typically between 6 – 8 days but could range from 1 – 26 days. This period is the duration taken for the HSV symptoms to show after getting infected. Some people might not show any symptoms after getting infected until later. Symptoms might be dormant for several months or even years until the virus is reactivated.

What causes an HSV outbreak?

There are several triggers for the outbreak of herpes simplex virus, and they include:

  • Stress
  • Hormonal changes (such as menstruation in women)
  • Fever
  • Suppressed immune system (Due to another infection or medications)

The following triggers are peculiar to oral herpes, and they include:

  • Trauma in your buccal cavity (mouth)
  • Exposure to sun
  • Upper respiratory infection

You might also have an outbreak without any specific trigger.

Stages of Herpes Simplex Virus

The Herpes Simplex infection has 3 stages, namely:

  • HSV Primary infection
  • HSV Latency
  • HSV reactivation

Primary infection

This stage of infection is when the Herpes Simplex Virus is introduced to the body through direct contact with an infected person. The virus operates by rapidly replicating itself when it travels to nerve cells close by. If you have an oral herpes infection, it infects your trigeminal nerves. In the case of genital herpes infection, your sacral plexus, which is a nerve network in your pelvis, is infected.

The herpes virus travels from these nerves to nearby mucosa or skin. During this period, your body's immune system notices an invasion and responds by sending out immune cells. This causes blisters and inflammation on your skin. You may observe swollen lymph nodes along your groin or under your jaw. Some people might not notice any symptoms during the primary infection stage and have no idea they are infected with the herpes simplex virus.

Latent stage

After a couple of weeks, the primary infection is cleared up by your immune system, but this does not mean you are cured – the virus remains in the cells where it first infected. This stage is the latent stage, meaning the virus is dormant or asleep but still in the nerve cell.

During this period, most of the cells infected with HSV are asleep, but a few may be awake at some point but not cause an outbreak. If the cells awake cause a lot of disturbance and your immune system notices, we will enter the reactivation stage.

HSV reactivation

HSV reactivation occurs when the infected cells are woken up and cause your immune system to respond. This can cause any of the following:

  • Containment in the nerve tissue : There is viral activity at this stage, but it begins and ends in the nerve cells. Your immune system response prevents it from getting to your skin or causing symptoms. This is common with infected people, and the virus wakes up with a couple of activities, but this is mostly within a 2- 6 hour period, and it is over. You don't spread the virus to others or shed the virus.
  • Asymptomatic viral shedding: This happens if the replication of infected cells reaches the epidermis (outer skin layer) but not enough to cause symptoms – the virus may shed. Shedding of the virus means the herpes virus can leave your skin, and someone can get infected if they have direct contact with your skin. People get infected with HSV during the shedding period.
  • Symptomatic herpes outbreak: This happens if the replication of infected cells is large enough and reaches the skin's surface to cause symptoms. At this point, you notice blisters on parts of your skin, commonly called a herpes outbreak by lots of people. The virus can be transmitted to others if you have direct contact with them.

How is this viral infection diagnosed?

Your healthcare professional will conduct tests but begin with physical examinations of the infected part. The healthcare professional will look for sores or other symptoms of infection during the physical examination. They may collect samples and send them to the lab for testing. They may also do a spinal tap if they suspect you have meningitis or encephalitis.

If there are no visible signs, a blood test will be done to check for HSV-1 and HSV-2 antibodies. Antibodies are an immune response to past viral infections. Once you get your test results, your healthcare professional can plan a course of treatment for you.

Treatment for Herpes Simplex Virus

There are different forms of prescription antiviral medications for HSV. They include:

  • Topical cream or ointment to apply to your skin
  • Drops in the eyes if you have ocular herpes
  • Pills to swallow
  • Intravenous medications through an IV

Your healthcare professional will advise you on the most suitable form of treatment based on the following:

  • The severity of the infection
  • The type of infection
  • Your immune system

They will also advise you on the dosage and how long you should be on the medication.

Oral and genital herpes treatment can be subdivided into 2 broad categories, which are chronic suppressive therapy and episodic therapy.

Episodic therapy

This treatment pattern is targeted at a single outbreak and is short-term. This treatment option is advised during the earliest signs of an outbreak and you notice itching or tingling of your skin. The earlier you take it, the better the results. If you experience a primary infection or recurrences, your medical practitioner will use episodic therapy.

This treatment method can

  • Help your sores heal quicker
  • Reduce the severity of the symptoms
  • Reduce shedding of the virus from your skin
  • Make the pain go away faster

Treating this outbreak does not eliminate the possibility or severity of future outbreaks. You will need suppressive therapy to eliminate future outbreaks.

Chronic suppressive therapy

This involved you taking your antiviral medications on a long-term basis. This treatment method is recommended if you have genital herpes and:

  • Are immunocompromised
  • Have a partner or multiple sexual partners who do not have genital warts
  • Have frequent or severe outbreaks

If you have had an oral herpes outbreak severally, chronic suppressive therapy will be recommended.

You may use any of these medications, including:

  • Famciclovir
  • Acyclovir
  • Valacyclovir

If you have HSV-2, you have a higher chance of being recommended chronic suppressive therapy than people with HSV-1 due to the following reasons.

This therapy can:

  • Reduce the severity of the symptoms
  • Reduce outbreaks by 70% - 80%
  • Reduce viral shedding in asymptomatic people. This will help protect your sexual partner.

How can HSV be prevented?

The herpes simplex virus is easily spread from one person to another through direct contact, making it difficult to prevent. You can practise the following to lower your risk:

  • Always use protection when having sex. The use of dental dams and condoms will provide 100% protection but can lower your risk of spreading the virus to your partners. HSV sheds and condoms may not cover everywhere it sheds, but they will cover some areas. They will also reduce other STIs.
  • You and your partner should get tested for STIs. Even if your partner is asymptomatic (has no sores), you can still catch HSV from them. Knowing your status will help you take precautions.
  • Avoid close contact with people infected with HSV. Do not have sex with people who have genital sores or avoid kissing people with a cold sore in their mouth.

If you have genital herpes or oral herpes, having an honest conversation is very important. Both types of HSV can spread through sexual activity. You and your partner should discuss testing and precautions.

Can HSV be cured?

Herpes Simplex Virus stays with you all through your life. You may have outbreaks occasionally, or the virus may be reactivated. The occurrence of this varies between people. Most people experience fewer outbreaks as they age, especially those past age 35. People with genital HSV-2 have more outbreaks than genital HSV-1.

When should I visit my healthcare professional?

Reach out to a medical practitioner if you feel you might have been recently exposed to HSV or have symptoms of Herpes simplex infection. After this, you will be told if you need a medical examination or testing.

What questions should I ask during my appointment?

If you have genital herpes or oral herpes, you should ask the following:

  • How can I prevent a herpes outbreak?
  • What treatments are recommended?
  • How can I lower my risk of spreading HSV?
  • Is there a chance of the virus spreading to other body parts?

Frequently Asked Questions

No, HPV and Herpes Simplex Virus are 2 very different viruses. HPV (human papillomavirus) is not part of the herpes virus family. Some similarities between both include:

  • They are highly contagious
  • They are very common
  • They can affect your genitals
  • Spread through skin-to-skin contact.

Yes, this is possible if:

  • Any sores you have are healed or almost dry
  • You don't have a herpes outbreak
  • You meet the other criteria to be eligible for donating blood

Talk to your healthcare practitioner about this if you need more information.

Get tested

If you have any of the above symptoms or feel at risk of potential exposure to HSV, kindly contact our healthcare professional at STI Clinic UK to get tested today.