What Is The Treatment For Hsv
- Cold sores in children and adults don’t need to be treated. Creams with anti-HSV medicine can treat cold sore symptoms, if necessary.
- Newborns with HSV require hospitalization for intravenous antiviral medication for 21 days. Even with this treatment, some newborns can suffer death or brain damage from HSV infection.
How Can Herpes Be Prevented
Correct and consistent use of latex condoms can reduce, but not eliminate, the risk of transmitting or acquiring genital herpes because herpes virus shedding can occur in areas that are not covered by a condom.25,26
The surest way to avoid transmission of STDs, including genital herpes, is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested for STDs and is known to be uninfected.
Persons with herpes should abstain from sexual activity with partners when herpes lesions or other symptoms of herpes are present. It is important to know that even if a person does not have any symptoms, he or she can still infect sex partners. Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk. Sex partners can seek testing to determine if they are infected with HSV.
Daily treatment with valacyclovir decreases the rate of HSV-2 transmission in discordant, heterosexual couples in which the source partner has a history of genital HSV-2 infection. 27 Such couples should be encouraged to consider suppressive antiviral therapy as part of a strategy to prevent transmission, in addition to consistent condom use and avoidance of sexual activity during recurrences.
How Can Neonatal Herpes Be Prevented
If you’re pregnant and have a history of genital herpes, tell your doctor or midwife.
You may need to take medication during the last month of pregnancy to prevent an outbreak of vaginal sores during labour.
Delivery by caesarean section is recommended if the genital herpes has occurred for the first time in the last 6 weeks of your pregnancy.
If you develop a cold sore or have any signs of a herpes infection, take these precautions:
- do not kiss any babies
- wash your hands before contact with a baby
- wash your hands before breastfeeding
- cover up any cold sores, lesions or signs of a herpes infection anywhere on your body to avoid passing on the virus
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Herpes Simplex Virus Infections
The herpes simplex virus causes a variety of infections, characterized by dormant periods with no symptoms and sporadic outbreaks of red, itchy, painful blisters. Generally, there are two types of herpes: genital herpes and oral herpes . However, herpes lesions from both types can be found anywhere on the body, including on the skin, mouth, eyes, and genitals.
Type 1 infections are most often found on the mouth, while type 2 infections tend to occur in the genital area.
What Are The Risks Of Genital Herpes In Pregnancy
If youre pregnant and you think that you have genital herpes, give your midwife or GP a shout straight away .
Genital herpes wont put you at higher risk of a miscarriage but it can be passed onto babies during pregnancy. It can cause a serious illness called neonatal herpes.
Neonatal herpes is rare in the UK but risks are highest if you get a new infection in your third trimester or within six weeks of having your baby .
If youre pregnant and have genital herpes, youll be referred to a genitourinary medicine physician for treatment .
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Infection In The Last Trimester Of Pregnancy
If women become infected with genital herpes in the last three months of pregnancy, the virus is passed on to their baby in about 30 to 50 out of 100 births. Because of this risk, women who get genital herpes in the last trimester of pregnancy usually have a Cesarean section in order to protect the child. Its also a good idea to talk with a doctor who is specialized in the treatment of infectious diseases.
In order to prevent infection in the last three months of pregnancy, its best to avoid sex with people who have genital herpes. This is also true when it comes to oral sex with people who have cold sores.
How Genital Herpes Can Affect Your Pregnancy
If you have genital herpes, its possible to spread the virus to your baby. A woman can spread it to her baby while she is:
-
Pregnant
-
Giving birth
-
Taking care of her newborn
If the baby gets the virus while in the womb, the mother may have a miscarriage or deliver the baby too early, causing the baby to be premature.
When the baby catches the virus during birth or shortly thereafter, this can be deadly for the baby. Be sure your OB/GYN knows that you have genital herpes so that precautions can be taken.
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What Are The Symptoms Of Herpes In Infants
After you know the answer to “Can you be born with herpes”, you may just wonder about the symptoms that will appear. The symptoms are different than when adults get the disease. Here are some symptoms:
1. No Symptoms
The baby can be infected with the herpes simplex virus and can be completely asymptomatic. Only a blood test will reveal the presence of the HSV in the system. Even if the baby has no symptoms at all, he or she can pass the infection on to another person via blood or saliva.
2. Having Lesions
The baby can have herpes at the time of birth or after birth and can develop blisters or herpes lesions. These can lead to sores in the mouth, all over the skin, or in the genital area. The infant will have an outbreak that can show itself as having irritated and red skin. The blister forms a few days later. After a while, the blister will burst open, yielding fluid and finally becoming scabs that crust over and heals. The fluid from the lesion can be a clear fluid, blood or purulent.
3. Evidence of Illness
4. Having a Systemic infection
According to the NIH, an infant can develop a disseminated herpes infection, in which the infection has spread throughout the babys body. This kind of infection can lead to damage of the lungs, kidneys, brain, and liver. This condition is quite often lethal.
5. Having Intrauterine Herpes
6. Other Symptoms
Description Of The Pathogen
HSV-1 and HSV-2 are members of the Herpesviridae family of DNA viruses, grouped along with varicella-zoster virus in the alphaherpesvirus subfamily. The alphaherpesviruses are characterized by short reproductive cycles, host cell destruction during active replication, and the ability to establish lifelong latency in sensory neural ganglia . Both HSV-1 and HSV-2 are large virions with a lipid envelope surrounding an icosahedral nucleocapsid. Within the nucleocapsid is a core of linear, double-stranded DNA of approximately 152 kbp. A proteinaceous tegument separates the nucleocapsid and envelope. The HSV lipid bilayer envelope is embedded with surface glycoproteins that mediate attachment and entry into host cells and are responsible for evoking the host response. At least 4 envelope glycoproteins have been shown to be essential to cell entry . The genomes of HSV-1 and HSV-2 are approximately 50% homologous, and as such there is considerable cross-reactivity between antigenically related glycoproteins of both HSV types . Type-specific glycoproteins exist, such as glycoprotein G , allowing for differentiation of the 2 virus types via the host’s antigen-specific antibody response.
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Knowledge Is Power: Cold Sores Genital Herpes And Babies
While this material is quite extensive, we hope that you have been informed in a positive way. Although cold sores are often dismissed when adults are infected, babies can die from HSV.
If you currently have genital herpes and are pregnant we strongly urge you to contact your physician. You can potentially save your babies life by informing your doctor of your situation. Risking a vaginal birth while having HSV-2 is indeed the ultimate risk.
As a mother, you should never be afraid, but you should always be alert. This is critically true if your baby is being handled by someone with a cold sore. Responsibility from everyone involved can go a long way and potentially prevent a lot of grief.
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How Does Genital Herpes Affect A Pregnant Woman And Her Baby
Neonatal herpes is one of the most serious complications of genital herpes.5,16 Healthcare providers should ask all pregnant women if they have a history of genital herpes.11 Herpes infection can be passed from mother to child during pregnancy or childbirth, or babies may be infected shortly after birth, resulting in a potentially fatal neonatal herpes infection. 17 Infants born to women who acquire genital herpes close to the time of delivery and are shedding virus at delivery are at a much higher risk for developing neonatal herpes, compared with women who have recurrent genital herpes . 16,18-20 Thus, it is important that women avoid contracting herpes during pregnancy. Women should be counseled to abstain from intercourse during the third trimester with partners known to have or suspected of having genital herpes. 5,11
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Are These The Only Herpes Viruses
There are actually several other subtypes of herpes viruses that are from the same family as HSV-1 and HSV-2. This family is known as Herpesviridae.
Alternatively, HSV-1 and HSV-2 are also known as human herpesvirus 1 and human herpesvirus 2 , respectively.
The other human herpesviruses include:
- Human herpesvirus 3 : Also known as the varicella zoster virus, this virus causes chickenpox lesions.
- Human herpesvirus 4 : Also known as the Epstein-Barr virus, this virus causes infectious mononucleosis.
- Human herpesvirus 5 : Also known as the cytomegalovirus, this virus causes symptoms such as fatigue and muscle aches.
- Human herpesvirus 6 : This virus can cause a serious illness in infants known as sixth disease, which is also called roseola infantum. The virus causes a high fever and distinctive rash.
- Human herpesvirus 7 : This virus is similar to HHV-6 and can cause some cases of roseola.
- Human herpesvirus 8 : This virus can contribute to a serious illness known as Kaposi sarcoma, which can lead to connective tissue cancer.
Many of these subtypes are contracted in childhood.
Treatments Your Physician May Prescribe
Your child’s doctor may prescribe an antiviral medication to speed recovery of the sores. Acyclovir is the only antiviral medication that is available as a liquid and that is approved for use in infants.Anesthetic mouthwashes or pain medication may also be given to reduce pain. If your child is unable to eat or drink because of mouth sores, he or she is at risk of becoming dehydrated. If this occurs, your doctor may recommend that your child receive IV fluids.
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What Treatment Can I Get If I Have A Genital Herpes Outbreak In Pregnancy
If you have genital herpes, an antiviral drug called aciclovir is recommended. Aciclovir isnt licensed for use during pregnancy but is considered safe and hasnt been associated with an increased incidence of birth defects . Antiviral treatment is offered:
- to treat outbreaks in pregnancy
- from 36 weeks to reduce the chance of an outbreak during birth
- from diagnosis until birth if a pregnant woman gets a primary infection after 28 weeks of pregnancy.
How Can I Prevent My Baby From Getting Neonatal Herpes
Parents or visitors can pass herpes onto a baby unwittingly in the first few weeks of their life. There are a few steps you can take to reduce the risk.
- If you are breastfeeding and develop a lesion on your breast or nipples, you should stop feeding from that breast straight away. See your GP as soon as possible, and they can test the lesion for neonatal herpes simplex virus .
- If you have a cold sore, ensure it is covered and wash your hands thoroughly and regularly. Treat the cold sore with a topical aciclovir cream until it is healed, and don’t kiss your baby while you still have the cold sore.
- Request that visitors wash their hands before holding your baby. Ask them politely not to kiss your newborn baby, especially if they have a cold sore.
- For more information see the Kit Tarka Foundation website.
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Prevention Of Vertical Hsv Transmission
Since the majority of mother-to-child transmission of HSV infection occurs as a result of exposure to virus shed from the genital tract as a neonate passes through the birth canal, the most common strategies for preventing transmission seek to reduce neonatal exposure to active genital lesions. In women with active recurrent genital HSV lesions, antiviral suppressive therapy with oral acyclovir or valacyclovir can be started at 36weeks of gestation, a practice that has been associated with decreased genital lesions at the time of delivery, decreased viral detection by viral culture or PCR, and subsequently a reduced need for cesarean delivery for the indication of genital HSV . Despite these benefits, antiviral suppressive therapy has not yet been studied well enough to definitively show that this practice prevents neonatal HSV disease.
For asymptomatic neonates born either vaginally or by cesarean delivery to women with active herpetic genital lesions, guidance has been proposed to help determine the risk of HSV transmission and to optimize intervention for the baby . This algorithm, developed jointly by the American Academy of Pediatrics’ Committee on Infectious Diseases and the Committee on Fetus and Newborn, gives guidance concerning risk stratification, diagnostic work-up, and appropriate antiviral therapy, including the use of preemptive antiviral therapy in asymptomatic neonates in certain high-risk situations.
How Is Hsv Treated During Pregnancy Or Breastfeeding
You can treat cold sores and genital herpes with:
- aciclovir cream, available from a pharmacist without prescription
- aciclovir or valaciclovir or famciclovir tablets, for which you need a prescription
These ‘antiviral’ drugs are known to be safe for pregnant and breastfeeding women and are effective most of the time.
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Babies Born With Genital Herpes
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How To Treat Herpes In Infants
Just knowing the answer to “Can you be born with herpes” is not enough. Since it is possible, you should know how it is treated. The usual treatment given is IV acyclovir. This is the most likely drug that will be used in an infant with herpes. The baby may need to take the medication for several weeks before they are healed.
You can also treat the side effects of neonatal herpes, such as seizures and shock. These babies are very sick and need to be treated in a neonatal intensive care unit. Babies who have systemic herpes may not get better with treatment and can have more health risks as a result. If they get disseminated herpes, they may develop a coma, neurologic complications or even death.
While birth-acquired herpes may be able to be treated, the virus is never completely eradicated from the body. The herpes virus will remain in the babys body for the rest of their lives but will lie dormant in many situations. If the immune system becomes suppressed, the baby may become re-infected and will develop complications, such as blindness, seizures, encephalitis, respiratory infections, and inflammation of the eye.
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How Is Neonatal Herpes Treated
Neonatal herpes is usually treated with antiviral drugs given directly into the baby’s vein .
This treatment may be needed for several weeks.
Any related complications, such as fits , will also need to be treated.
The baby can be breastfed while receiving treatment, unless the mother has herpes sores around her nipples.
If the mother is taking antiviral treatment too, this can be excreted in her breast milk, but is not thought to cause any harm to the baby.
How Can You Prevent Your Newborn From Getting Hsv
- If you are pregnant and have a history or signs and symptoms of genital HSV-2 infection, tell your doctor as soon as possible. A C-section delivery is recommended if a mother has an HSV-2 outbreak near the time of birth.
- Everyone should wash their hands before touching the newborn.
- Do not kiss your baby or let others kiss your baby if you or they have cold sores on the mouth or lips.
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Reduction Of Risk For Neonatal Hsv Infections
A history of HSV in a pregnant woman and her partner should be obtained at the first prenatal visit .1,12,17,20 Women with a negative personal history of HSV should be counseled on ways to avoid infection, especially during the third trimester. Use of condoms or abstinence must be emphasized in this high-risk set of patients, even if the male partner has no active lesions. Women who have multiple sexual partners should be counseled on reducing the risk of sexually transmitted diseases. Weekly cervical cultures in late pregnancy for women with a history of genital HSV infection are no longer recommended. Type-specific serologic testing of pregnant women at high risk of primary HSV infection has been suggested.4 At the present time, type-specific serologic tests are not widely available and their reliability is questionable.
Methods to Reduce Risk of Neonatal HSV Infection
A history of HSV infection in the woman and her sexual partner should be obtained at the first prenatal visit.
HSV = herpes simplex virus.
Information from references 1, 12, 17 and 18.
Methods to Reduce Risk of Neonatal HSV Infection
A history of HSV infection in the woman and her sexual partner should be obtained at the first prenatal visit.
HSV = herpes simplex virus.
Information from references 1, 12, 17 and 18.
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