Dr Phil Hammond, broadcaster and sessional GP in Bristol

Herpes Viruses Association destigmatises cold sores
 

Let’s hear it for the Herpes Viruses Association (HVA)—founded over 25 years ago to counter the herpes hype, the HVA has been a beacon of sanity, destigmatising cold sores wherever they occur; and counselling, supporting, and educating those with herpes.1 For most of its existence the HVA received a Section 64 grant of £25,000 a year from the Department of Health, but following a review of funding arrangements, this support has been withdrawn because its activities could not be redefined as a ‘new project’. Unless new funding is secured, its long-term future is in doubt.1,2

Herpes does far more psychological than physical damage. Ironically, misinformation about herpes started with the launch of a drug, acyclovir, that curtails and prevents attacks. Acyclovir was discovered in 1974 and in the long run-up to its launch in 1982,3 the relevant pharmaceutical company put its marketing department into overdrive. The media took the bait, and Time magazine took it twice, describing it as ‘the new sexual leprosy’ (1980)4 and ‘the new scarlet letter’ (1982).5 Herpes is incurable in the same way chicken pox is incurable. The virus hangs round in the nerve roots and can (but usually doesn’t) reactivate. When it does recur, each attack tends to be milder than the last and is often unnoticeable. We don’t call children with chicken pox, lepers, so why pick on herpes?

Herpes simplex virus comes in two forms. Type 1 typically causes cold sores around the mouth and type 2 affects the genital area, but both can cross over. Up to 50% of new cases of genital herpes are type 1, passed on by oral sex from someone shedding the virus without realising it. Three quarters of those with herpes have only mild or non-existent symptoms, and therefore do not realise they have the virus or are passing it on. Very few people pass an infection on deliberately; and blame is pointless and destructive. Symptoms can appear months or years after the initial infection, so a sudden crop of blisters does not mean infidelity.1

Most people, depending on their age, have antibodies to type 1 herpes. These antibodies give some protection against the symptoms of type 2 infection, so if one person in a couple has genital herpes, and the other has a blood test showing antibodies to type 1, he or she is very unlikely to be troubled by type 2 infection if they catch it.1

For the few people who get recurrent severe herpes, acyclovir works well to suppress attacks. It has now been around so long, it has had a name change (aciclovir) and is cheap as chips. A whole month’s supply costs the NHS just £9,6 though many doctors are reluctant to prescribe it because they still think of the very expensive wonderdrug launched 27 years ago, and they don’t know much about herpes.

This is precisely why the HVA is important. The advice and support it gives is spot on (which is why I became a patron). The psychological impact of herpes can manifest in a number of ways: depression; avoidance of intimate relationships; decreased sex drive; abstinence of sex; and suicidal thoughts. In the UK, it has largely been left to the HVA to fight the stigma of herpes, and many of its members are in long-term relationships thanks to the support and advice it gives out. They’re only cold sores and they go away without treatment, but without the HVA, the guilt would last a lot longer. For further information and donations, visit: www.herpes.org.uk/

  1. Herpes Virus Association website. www.herpes.org.uk/ (accessed 27 July 2009).
  2. Parliament website. Memorandum submitted by the Herpes Viruses Association (SH 155). www.publications.parliament.uk/pa/cm200203/cmselect/cmhealth/69/2112803.htm (accessed 27 July 2009).
  3. MedicineNet website. Acyclovir. www.medicinenet.com/acyclovir/article.htm (accessed 27 July 2009).
  4. Time magazine website. Herpes: the new sexual leprosy. www.time.com/time/magazine/article/0,9171,922105-1,00.html (accessed 27 July 2009).
  5. Time magazine website. The new scarlet letter. www.time.com/time/magazine/article/0,9171,1715020,00.html (accessed 27 July 2009).
  6. Joint Formulary Committee. British National Formulary 57. London: BMJ Group and Royal Pharmaceutical Society, 2009.