Does Acyclovir Help Prevent Spread Herpes

Why Is This Medication Prescribed

Acyclovir is used to decrease pain and speed the healing of sores or blisters in people who have varicella , herpes zoster , and first-time or repeat outbreaks of genital herpes . Acyclovir is also sometimes used to prevent outbreaks of genital herpes in people who are infected with the virus. Acyclovir is in a class of antiviral medications called synthetic nucleoside analogues. It works by stopping the spread of the herpes virus in the body. Acyclovir will not cure genital herpes and may not stop the spread of genital herpes to other people.

Transmission Of Genital Herpes

Genital herpes is a sexually transmitted disease spread by skin-to-skin contact. The risk of infection is highest during outbreak periods when there are visible sores and lesions. However, genital herpes can also be transmitted when there are no visible symptoms. Most new cases of genital herpes infection do not cause symptoms, and many people infected with HSV-2 are unaware that they have genital herpes.

To help prevent genital herpes transmission:

• Use a condom for sexual intercourse.
• Use a dental dam for oral sex.
• Limit your number of sexual partners.
• Be aware that nonoxynol-9, the chemical spermicide used in gel and foam contraceptive products and some lubricated condoms, does not protect against STDs.

A Study Of Acyclovir To Help Prevent Hiv Infection In People With Genital Herpes

Genital herpes is the most common cause of genital sores worldwide, and the presence of genital sores is a significant risk factor for becoming infected with HIV. This study will test the effectiveness of twice-daily dosing of acyclovir, a commonly prescribed anti-herpes drug, in preventing HIV infection in HSV-2 infected women who sleep with men and men who sleep with men .

Study hypothesis: Given that genital herpes is a significant risk factor to HIV acquisition, twice-daily HSV-2 suppressive therapy – 400 mg of acyclovir – will prevent HIV infection among high risk, HSV-2 seropositive WSM and MSM.

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Is Herpes Contagious How To Prevent It

Both kinds of herpes are contagious and are spread through saliva and sexual secretions. This means that the best way to prevent herpes is to take steps to reduce the spread.

Preventive measures include the following:

• Not sharing utensils, towels, and other similar things, especially with young children

• Avoiding unprotected sex with people you do not know well

• Using a condom or dental dam during oral sex

• Not having sex if you have an active genital outbreak

• Not kissing if you have sores in or around your mouth

• Not sharing toothbrushes or lipstick

• Washing your hands after touching a sore

• Not sharing sex toys

If you have genital herpes, have your partner tested. If you both have the same strain, you do not need to worry about it as long as you are monogamous and free of other STIs.

The Elegance Of Virology: How Acyclovir Slows Down Herpes

Earlier this month I wrote about an experimental antiviral vaginal gel that achieved modest success in preventing outbreaks of genital herpes in women Quite a few people read the article, so I’ve followed it up with a more detailed look at how herpes medications help control infections. The biochemistry of how these drugs work is fascinating.

Of the two prescription drugs approved by the FDA to treat or prevent herpes simplex outbreaks , acyclovir is more commonly used . Although many people take the drug, few understand why it works. The details of acyclovir’s mechanism of action give us a wonderful example of the interaction of chemical and biological science as it pertains to drugs. It’s also pretty cool.

The entry of HSV into its host cell triggers a series of events in which the virus “reprograms” the DNA of the cell, forcing it to make viral DNA instead of cellular DNA. This is one of several essential steps required for viral replication without the production of viral DNA new virus particles cannot be made.

One of the enzymes that HSV carries into the host cell is called DNA polymerase. Its function is assembling an enormous number of simple nitrogenous bases – the four building blocks of DNA – into long strands, which will become new DNA. DNA polymerase is essential for the replication of herpes viruses. If DNA polymerase is not functioning the virus cannot grow.

Figure 1. Double-stranded DNA biosynthesis. Images: Wikipedia.

NOTES:

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What You Need To Know

• Fifty percent to 80 percent of U.S. adults have oral herpes.
• Oral herpes can be spread through intimate contact with someone who is infected.
• Oral herpes can be difficult to diagnose. Often confused with many other infections, it can only be confirmed with a virus culture called PCR, blood test or biopsy. PCR is the preferred test for diagnosing herpes infections.
• The best treatment for oral herpes is antiviral oral medication. Symptomatic treatment may include antiviral ointment, over-the-counter topical anesthetics or over-the-counter anti-inflammatory agents.

Whether you call it a cold sore or a fever blister, oral herpes is a common infection of the mouth area that is caused by herpes simplex virus type 1 . Fifty percent to 80 percent of U.S. adults have oral herpes. According to the National Institutes of Health, about 90 percent of adults have been exposed to the virus by age 50.

Once infected, a person will have herpes simplex virus for the rest of his or her life. When inactive, the virus lies dormant in a group of nerve cells. While some people never develop any symptoms from the virus, others will have periodic outbreaks of infections.

Management Of Sex Partners

The sex partners of persons who have symptomatic genital herpes can benefit from evaluation and counseling. Symptomatic sex partners should be evaluated and treated in the same manner as patients who have symptomatic genital herpes. Asymptomatic sex partners of patients who have symptomatic genital herpes should be asked about a history of genital symptoms and offered type-specific serologic testing for HSV-2. For partners without genital herpes, no data are available on which to base a recommendation for PEP or PrEP with antiviral medications or that they would prevent acquisition, and this should not be offered to patients as a prevention strategy.

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How Long Do Sores From Herpes Simplex Last

If youre infected with HSV-1, commonly known as oral herpes, you may notice tingling or burning around your mouth in the days before a cold sore appears. These blisters break open and ooze fluid before forming a crust. Usually, sores last for seven to 10 days.

If youre infected with HSV-2, commonly known as genital herpes, your first outbreak may last between two to four weeks. Recurrent outbreaks usually last between three to seven days.

How Can I Reduce My Risk Of Herpes Simplex

Preventing HSV-1

You can reduce your risk of contracting HSV-1 by avoiding physical contact with someone who has a cold sore. People can still spread HSV-1 when cold sores arent present, but its less likely.

If someone has an active HSV-1 infection, avoid:

• Sharing utensils, cups, lip balms or other personal care products.
• Touching the skin near their mouth.

Preventing HSV-2

If youre sexually active, you can take these steps to protect yourself and others from the herpes virus and other STIs:

• Be monogamous with one sexual partner or limit your number of partners.
• Get tested for STIs and complete any prescribed treatment.
• Tell your sexual partners if you have genital herpes so they can get tested.
• Use condoms during intercourse and dental dams during oral sex.

Wash your hands often if you have an outbreak or are around someone with symptoms.

If your sexual partner has genital herpes, these actions can lower your risk of getting the virus:

• Dont have sex when your partner has active symptoms. Condoms may not cover all sores, so you may still get the virus.
• Make sure your partner takes antiviral medication as prescribed.
• Wait to have sex until scabs fall off active lesions.

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What Should I Know About Storage And Disposal Of This Medication

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture .

It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.

Recurrence Course Triggers And Timing

Course of Recurrence

Most cases of herpes simplex recur. The site on the body and the type of virus influence how often it comes back. Recurrences of genital herpes are more likely with HSV-2 infection than with HSV-1 infection.

The virus usually takes the following course:

• Prodrome. The outbreak of infection is often preceded by a prodrome, an early group of symptoms that may include itchy skin, pain, or an abnormal tingling sensation at the site of infection. Headache, enlarged lymph glands, and flu-like symptoms may occur. The prodrome, which may last from 2 hours to 2 days, stops when the blisters develop. About 25% of the time, recurrence does not go beyond the prodrome stage.
• Outbreak. Recurrent outbreaks feature most of the same symptoms at the same sites as the primary attack, but they tend to be milder and briefer. After blisters erupt, they typically heal in 6 to 10 days. Occasionally, the symptoms may not resemble those of the primary episode, but appear as fissures and scrapes in the skin or as general inflammation around the affected area.

Triggers of Recurrence

Herpes outbreaks can be triggered by different factors. They include sunlight, wind, fever, physical injury, surgery, menstruation, suppression of the immune system, and emotional stress. Oral herpes can be triggered within about 3 days of intense dental work, particularly root canal or tooth extraction.

Timing of Recurrences

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Can I Treat Herpes Simplex At Home

Avoiding known triggers, such as illness or stress, can help reduce how often you have herpes outbreaks.

How can I ease my symptoms during an outbreak of HSV-1 ?

• Over-the-counter creams such as L-lysine, benzocaine or docosanol .
• Applying ice to blisters or sores.

How can I ease my symptoms during an outbreak of HSV-2 ?

• Apply an ice pack to your genitals. Wrap the ice pack in a washcloth or apply it over your underwear.
• Keep your genitals dry. Wear cotton or other nonsynthetic underpants and avoid tight-fitting clothes. Moist sores take longer to heal.
• Soak in a warm bath.
• Take nonsteroidal anti-inflammatory drugs to relieve pain.
• Topical 1% or 2% lidocaine may be used as a topical analgesic.

Prevention And Management Of Genital Herpes

Cortney M. Mospan, PharmD, BCACPAssistant Professor of Pharmacy PracticeEast Tennessee State University

David Cluck, PharmD, BCPS, AAHIVPAssistant Professor of Pharmacy PracticeEast Tennessee State University

US Pharm. 2016 41:30-33.

ABSTRACT: Genital herpes continues to be a relevant public-health concern because of its prevalence and its association with an increased risk of acquiring other sexually transmitted diseases. Genital herpes may present as vesicular lesions that can rupture and become painful however, more than 80% of individuals are asymptomatic, which makes it difficult to contain the spread of disease. The treatment of genital herpes serves to shorten symptom duration and improve quality of life, but it does not cure the disease. Strategies to prevent transmission include chronic suppressive therapy in serodiscordant couples, safe-sex practices, and avoidance of sexual intercourse during outbreaks. Currently available therapies are well tolerated and highly effective, and some newer therapeutic options are being investigated.

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Herpes Drugs Don’t Stop Herpes Shedding

Got Genital Herpes? You’re Still Infectious, Even if Drugs Cut Symptoms

Even when they don’t have an active herpes outbreak, people who carry genital herpes viruses are at risk of infecting their sex partners. With the discovery of drugs that prevent herpes outbreaks, there was hope that the drugs would also prevent herpes transmission. But there’s been troubling evidence that this may not be true.

Now University of Washington researcher Christine Johnston, MD, and colleagues show that people with no herpes symptoms often shed infectious genital herpes virus — even while taking very high doses of anti-herpes drugs.

“Short episodes of genital shedding occur frequently with antiviral therapy, even for high-dose regimens,” Johnston and colleagues report. “These breakthrough episodes are typically , last several hours, and occur at much the same rate irrespective of antiviral dose.”

One in 5 Americans and Europeans carries HSV-2, the virus that causes most cases of genital herpes HSV-1 causes some cases. Most people have few, if any, of genital herpes’ painful symptoms: blisters on or around the genitals or rectum.

There’s no cure for herpes infections. That’s because herpes viruses travel up nerves to take up latent form in the nerve root. Powerful anti-herpes drugs — acyclovir , famciclovir , and valacyclovir — prevent most outbreaks in most people. But they don’t eliminate virus hiding in nerve cells.

How Can I Make Sure I Dont Give Anyone Herpes

If you find out that you have herpes, try not to freak out. There are a few ways that you can stop it from spreading to your partners and other parts of your body.

• Talk with your doctor about taking herpes medication every day, which can lower your chances of spreading herpes.

• Dont have sex during a herpes outbreak, even with a condom. There may be sores on places the condom doesnt cover.

• Learn how to tell when an outbreak is coming, and stop having sex right when you notice these signs. You may feel a burning, itching, or tingling feeling that lets you know youre about to get sores.

• Dont have sex until your sores are totally gone, and the scabs heal and fall off.

• Dont touch your herpes sores, because you can spread the infection to other parts of your body or other people. If you touch a sore, wash your hands with soap and water right after.

• Dont wet contact lenses with spit this might spread your oral herpes to your eye.

• If you have a cold sore on your mouth, don’t kiss anyone especially babies, children, or pregnant women.

• Always tell your sexual partners that you have herpes before you have sex, so you can work together to prevent it from spreading. Telling someone you have an STD can be hard, but herpes is super common and doesnt lead to serious health problems. So try not to be too embarrassed or stressed out about it.

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Screening For Hsv Infection

The CDC currently does not recommend routine screening for HSV-2 in the general population. This is due to several factors, such as the expense of testing, the risk of false-positives, and a lack of evidence of reduced spread of disease when asymptomatic patients are tested. Patients who should be screened for HSV-2 include those whose sexual partner has a known history of genital herpes and those who have multiple sexual partners.10 Tissue culture is the most specific and sensitive method for diagnosing the initial episode of genital herpes however, it is relatively insensitive when used during later stages of genital-ulcer healing or during recurrent infections. In those situations, viral culture is preferred. Although diagnosis can be confirmed only by laboratory testing, less stringent diagnostic criteria are frequently used in practice.1

Is There A Cure For Herpes Simplex

There is no cure for herpes simplex. Once you have the virus, its a lifelong infection.

What is the outlook for people with herpes simplex?

For many people, the first herpes outbreak is the most severe. Many outbreaks are less frequent and milder after the first year of infection. Some people may have only one outbreak and never have another again.

Herpes infection doesnt usually pose a serious health risk. The risk of a health complication due to herpes is higher in infants and if you have HIV/AIDS, cancer or an organ transplant.

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Does Herpes Go Away Everything You Need To Know

Herpes is a viral family that includes herpes simplex and varicella-zoster, the virus that causes chickenpox and shingles. Herpes viruses are known for staying in ones system and recurring, causing outbreaks that come and go over time. Does herpes go away completely?

Understanding how to deal with herpes infections can help keep you from passing these common viruses to others. However, herpes does not typically go away once you are infected, the virus will stay in your system for life.

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