Case Study – Genital Herpes
Genital Herpes
Genital herpes is a type of sexually transmitted infection caused by a herpes simplex virus type 1 and type 2. Type 2 is the commonly known type to cause the disease, though type 1 is also known to cause infections. The virus is transmitted through sexual contact with an infected person. Clinical manifestations of this disease include prodromal signs of itching, burning sensations in the genital area, and tingling. The hallmark sign of this disease is the development of painful, fluid-filled blisters on the genital area, which bust and leave painful ulcers that take 2-4 weeks to heal. Also, the patient can experience other signs of infection, such as fever, headache, muscle aches, swollen lymph nodes, and malaise. However, these manifestations may vary from one person to another, where some other people may be asymptomatic but can also transmit the infection. Due to its viral nature, the virus may be intracellular and responsible for recurrent outbreaks (Johnston, 2022).
This case study involves a 20-year-old woman concerned about a possible infection of genital herpes after being engaged in unprotected sexual activity, though she has no clinical presentations. In this regard, laboratory tests were carried out to determine if the lady was infected or not through the detection of antibodies against herpes simplex virus type-1 (HSV-1) and herpes simplex virus type-2 (HSV-2). In this regard, it is important to interpret the results, elucidate the implications, and suggest the timing and nature of the infection.
Explanation of the Results
The HSV-1 IgG (negative, <0.90) indicates that the patient has tested negative for antibodies against herpes simplex virus type-1. This type of infection is associated with oral herpes but can also cause genital herpes. The absence of any of these symptoms justifies the negative results and suggests that the body has not been exposed or has not developed an immune response to the infection. The HSV-2 IgG (positive, >1.10) indicates that the body has produced antibodies against herpes simplex type-2 that is associated with genital herpes. However, the IgG antibodies indicate past and ongoing infection (Mathew Jr & Sapra, 2023).
Timing of the Infection
This infection has happened in the past. The presence of IgG antibodies in the immune system suggests a prior exposure to an infection but does not indicate the exact time the infection occurred. Secondly, the absence of IgM antibodies, which mark the initial or acute phase of an ongoing infection, further justifies the past infection. Determining the exact time for the infection in this case study is difficult. This is because the IgG tests alone only indicate past infection and do not specify when the infection occurred. Secondly, the absence of the symptoms makes it hard to trace the period when the infection might have started (Hou et al., 2020).
References
Hou, H., Wang, T., Zhang, B., Luo, Y., Mao, L., Wang, F., Wu, S., & Sun, Z. (2020). Detection of IgM and IgG antibodies in patients with coronavirus disease 2019. Clinical & Translational Immunology, 9(5). https://doi.org/10.1002/cti2.1136
Johnston, C. (2022). Diagnosis and management of genital herpes: Key questions and review of the evidence for the 2021 Centers for Disease Control and Prevention sexually transmitted infections treatment guidelines. Clinical Infectious Diseases, 74(Supplement_2), S134–S143. https://doi.org/10.1093/cid/ciab1056
Mathew Jr, J., & Sapra, A. (2023, August 7). Herpes simplex type 2. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554427/
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Case Study – Genital Herpes
Case 1
A 20-year-old woman comes in concerned that she has genital herpes as she has been having unprotected sex. She does not have any lesions but wants to be tested.
An antibody test is done and the results revealed the following:
HSV 1 IgG type-specific antibody: < 0.90 (negative)
HSV 2 IgG type-specific antibody: > 1.10 (positive)
1. How would you explain these results to her? 2. Can you tell if this is a recent or past infection? 3. Can you tell how long ago she was infected?
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