Understanding and empathy: management of genital herpes patients
When patients receive a diagnosis of genital herpes, the news is often devastating. Infections with herpes simplex viruses 1 and 2 (HSV-1 and HSV-2) are life-long.
The key to productive doctor-patient interactions is an appropriate level of understanding and empathy with regard to what the patient is experiencing. Genital herpes is a complex disease process whose symptoms may manifest in dozens of ways. Doctors who say “Herpes is just a skin disease” have simply not been adequately trained to understand the many subtleties and ramifications of herpetic disease.
For example, many doctors are unaware that in a subset of genital herpes sufferers, who are fully immunocompetent, subclinical reactivation events that do not progress to visible skin lesions may produce frequent, even daily, neuropathic pain analogous to that which accompanies shingles. Doctors should know that (1) varicella-zoster virus (VZV) shares a common neurotropic life cycle with HSV-1 and HSV-2, and (2) VZV encodes 60 viral proteins that are direct, functional homologs of HSV-encoded viral proteins. These three infectious agents are far more similar than they are different. Based on this basic biology, it is self-evident that reactivation of HSV-1 and HSV-2 may, in some patients, cause neuropathic pain that is similar in nature to the post-herpetic neuralgia that accompanies VZV reactivation (shingles). Learn more about HSV-associated neuropathic pain.
The ramifications of a genital herpes diagnosis last a lifetime, and raise a wide variety of concerns in patients including:
- Will the lesions and/or physical pain ever get better?
- Do I have to avoid relationships forever?
- What is this virus doing to my body?
- Can I unknowingly spread this virus to my friends, family, or children?
Such human concerns are all too real, and reinforce the point that herpes is more than just a skin infection. Rational Vaccines (RVx)’s position on this issue is that too many doctors are trying to treat genital herpes patients based on an incomplete understanding of the condition that is often (1) overly simplistic and (2) at least 20 years out of date relative to current knowledge of HSV’s in vivo biology. Learn more about the in vivo biology of HSV infections.
Most doctors strive to serve their patients to the best of their ability. However, if doctors are to to succeed in these efforts, they must be provided with up-to-date information that accurately describes the underlying biology of recurrent genital herpes.
At RVx, we believe that in the age of the internet, access to accurate information about the biology of HSV infections should not be the rate-limiting factor that determines the quality of medical care delivered to genital herpes patients. To learn more, download RVx’s Accurate Info for Doctors document, which summarizes:
- The Relationship between Latent HSV Infections and Genital Herpes Disease
- Strategies to Manage Genital Herpes: Present and Future.
This page will be refined and updated quarterly.