VZV, HSV, HPV — Oh My!

VZV, HSV, HPV — Oh My Indeed!

A point of confusion for many patients (because it is legitimately confusing) is the difference between VZV, HSV, and HPV viruses.  First, let’s clarify these acronyms.

VZV = Varicella Zoster Virus

HSV = Herpes Simplex Virus

HPV = Human Papillomavirus

So the reason it is confusing is because A) the acronyms sound somewhat similar, B) VZV and HSV are both part of the Herpes family of viruses (Herpesviridae), and C) VZV can cause a diagnosis called herpes zoster which has the word herpes in it. Herpes zoster is not caused by the Herpes Simplex Virus.

So let’s do a quick synopsis of each one.

VZV = Varicella Zoster Virus

Conditions it causes: Chickenpox, Herpes zoster – aka Shingles

Chickenpox is something most of us are familiar with (at least those of us old enough to remember having had it). These days, most kids are immunized to it in the US when they are young.  It is characterized by little blisters with some surrounding redness, along with fever and feeling tired.  For those who want a descriptive analogy of what the rash looks like, check out “dew drops on a rose petal.”

Herpes zoster, aka Shingles, is something that occurs most frequently in adulthood. Classically, it occurs on one side of the body, with the same little blisters which can be grouped together. It can be burning, stinging, painful or itchy.  There is a vaccine that is recommended for most people over 60 years of age since the risk of getting this rash is more frequent with increased age.  Shingles occurs because the varicella zoster virus reactivates.  After initial exposure, the virus lays dormant in the nerves and with some trigger or waning immunity, it can reactivate and cause shingles.

HSV = Herpes Simplex Virus

Conditions it causes: Cold sores/oral herpes/herpes labials/fever blisters, Genital herpes/Anogenital herpes, herpes simplex

There are two types of the herpes simplex virus – HSV1 and HSV2.  Generally, HSV1 favors the oral area and HSV2 favors the genital area.  That being said, either could be found in either place.  Herpes can also infect skin besides the oral area or the genital area.

Like the Varicella Zoster Virus, the herpes virus can reside in the nerves  after initial infection. Then, it can reactivate (e.g. during times of trauma, stress, decreased immunity or otherwise), and show up.  Like shingles, it also shows up with little blisters. These tend to be small clustered blisters.  More on herpes in a future post to follow.

HPV = Human Papillomavirus

Conditions it causes: Warts including warts on the skin and genitalia, can also cause cancer like cervical cancer, penile cancer, and other cancers

Most commonly, the HPV virus causes common warts. These could be on the hands, fingers, soles of feet, or other areas.  However, HPV viruses can also cause cancers in various areas including the anal canal, cervix, vulva and vagina in women and the anal canal or penis in men (thus the need for Pap smears, and the development and recommendation of the HPV vaccine).  There are many different strains of HPV, with some considered relatively benign strains (e.g. those commonly causing warts) and some considered higher risk strains (e.g. those responsible for HPV induced cancers).  Check out this link from the CDC for more info and more on HPV in a future post to follow.



Herpes from wrestling?

Courtesy of Wikipedia user David MonniauxYes, it is possible. And we dermatologists have a fancy term for it: “herpes gladiatorum.”  It is also referred to as “wrestler’s herpes,” “mat pox,” or “scrumpox.”  In previous posts, we learned that the herpes virus (HSV) is transmissible through various means of contact with other infected individuals and can occur in various places (lips, hands, eyes, genital area, etc…).  Well, wrestlers are frequently in close physical contact with each other and with the mat during matches or practice.  As such, the herpes virus can spread.  Usually, the herpes rash breaks out over the face, neck or arms.  The rash can be tingling, painful, and can show the same little blisters which pop and crust over as in other herpes infections.

If you suspect that you have a herpes infection (or your opponent has herpes), get it checked out before your wrestling match (or any other close contact sport for that matter).  Prevention is key!

Herpes in the eye?!

Yes, herpes can infect your eye. When it affects the front part of your eyeball (the cornea), it is called herpes keratitis. The cause of this herpes eye infection is none other than the herpes simplex virus (HSV). It is the same virus that can cause cold sores/fever blisters/orolabial herpes. In the same way that it affects the skin of and around your lips, it can affect your eye.

Herpes eye infection may be accompanied by pain, redness, tearing, irritation, blurred vision or difficulty tolerating the light. You may or may not have little water blisters around the eye. These blisters can not only affect the area around your eye, but also the tip of your nose!

Herpes infection of the eye is serious and is an emergency. If you have any concerns of this, see your doctor immediately. The consequences are scarring of the eye which could lead to blindness.

Just like cold sores, herpes eye infection can reappear. That’s because the herpes virus can lay dormant inside the nerves underneath your eye and skin. During flares, the virus reawakens and travels to the skin or eye. If you have frequent herpes eye infection, you may need to take a medication to suppress the virus from reactivating.