Dr Kedar Padte
Timidita was furious, “My herpes simplex lesion has nothing to do with sexually transmitted strains. I have had this since childhood,” she claimed.
“I have never as much as interacted intimately with another person, male or female. Hence the question of getting herpes infection through sexual relations is out of the question, added Timidita. The heated discussion at the coffee table in the canteen of Elitemix University was growing more argumentative.
Herpes simplex virus has two forms HSV1 and HSV2, both of which are members of the herpesviridae family. While HSV1 produces cold sores, the HSV2 mostly produces genital herpes. They can spread when an infected person begins shedding the virus.
Almost 60 to 70 per cent of the world population has HSV-1 at sometime or the other. In the US almost 20 per cent of the population has HSV-2.
“The funny thing about HSV is that many infected individuals never develop any symptoms,” explained Prof Talkerato, “That makes them even more dangerous as they act as innocent carriers.”
Timidita said she had read a lot about it.
When symptoms first occur they may include burning watery blisters on the skin, in the mucosa or the mouth, lips, nose and genitalia. These lesions heal with a scab which is characteristic of herpes. At other times an outbreak can be symptomatic when the immune system takes over and the lesion does not appear.
Prof Talkerato was inquisitive and asked: “How is it that you get these recurrent herpes attacks, Timidita?”
She said the reason is simple and complex. “There is a form of herpes virus that attacks the nerves. It is called the neurotropic or neuro invasive virus. The HSV1 persists in the body by hiding from the immune system in the cell bodies of neurons. They remain dormant for years in the ganglionic areas of the nerve roots. When the immune system of a person weakens, due to any cause – physical or psychological – the virus multiplies, becomes active and travels along the axon to the skin causing new eruptions or sores. The dormant form is difficult to treat,” said Timidita.
Most of the time acyclovir or valaciclovir are effective and cure a person of the attack. If one is sexually active it is best that both partners get treated simultaneously. If only one partner is treated the untreated partner (though asymptomatic) will reinfect the first.
The complexity of a virus does not end there. It has a unique capacity to defend itself by confronting the human immune system head on. HSV for instance can block the transporter associated antigen processing system and prevent the immune system from attacking it.
A virtual change in the viral nucleic acid chains that make its genes can goof up the immune mechanism, and that allows the virus to survive.
Prof Talkerato was aghast. “And to think that the human brain is the most intelligent, these microbes can out do anything in the world! I am sure this is the reason why HIV is difficult to handle.”
Timidita said: “Yes, and that’s why the viruses have kept the scientists’ brains in turmoil for decades. Only a volcanic, curative eruption of human science will stop these small yet troublesome eruptions.”
“So HSV is not sexually transmitted?” asked Prof Talkerato.
“It is an STD as a rule, however the exception proves the rule and that is true of me,” laughed Timidita, emphatically.
(The columnist is a well-known gynaecologist practising in Panaji. Send in your queries to email@example.com)