Treatment For Genital Herpes
Three drugs are approved to treat genital herpes:
These medications are antiviral drugs called nucleoside analogues. The drugs are used initially to treat a first attack of herpes, and then afterward to either treat recurrent outbreaks or reduce frequency of recurrences .
No drug can cure herpes simplex virus. The infection may recur after treatment has been stopped. Even during therapy, an infected person can still transmit the virus to another person. Drugs can, however, reduce the severity of symptoms, improve healing times, and prevent recurrences.
Antiviral drugs for genital herpes are generally given as pills that are taken by mouth. If people experience very severe disease or complications, they need to be hospitalized and receive an antiviral drug intravenously. Acyclovir is also available as an ointment, which can be used as an adjunct for treatment of initial genital herpes.
How Do You Get Herpes
The skin on your genitals, mouth, and eyes can be infected easily. Other areas of skin may get infected if theres a way for the herpes virus to get in, like through a cut, burn, rash, or other sores. You dont have to have sex to get herpes. Sometimes herpes can be passed in non-sexual ways, like if a parent with a cold sore gives you a peck on the lips. Most people with oral herpes got it when they were kids. A mother can pass genital herpes to a baby during vaginal childbirth, but thats pretty rare.
You can spread herpes to other parts of your body if you touch a herpes sore and then touch your mouth, genitals, or eyes without washing your hands first. You can also pass herpes to someone else this way.
Herpes is most contagious when sores are open and wet, because fluid from herpes blisters easily spreads the virus. But herpes can also shed and get passed to others when there are no sores and your skin looks totally normal.
Most people get herpes from someone who doesnt have any sores. It may live in your body for years without causing any symptoms, so its really hard to know for sure when and how you got it. Thats why so many people have herpes its a pretty sneaky infection.
Because the virus dies quickly outside the body, you cant get herpes from hugging, holding hands, coughing, sneezing, or sitting on toilet seats.
Who Might Get Herpes Simplex
People of any age can contract herpes simplex. You are more likely to get the virus if you:
- Were assigned female at birth.
- Have had multiple sex partners.
- Started having sex at a young age.
- Have a history of any sexually transmitted infection .
- Have a weakened immune system.
- Dont use condoms for intercourse and dental dams for oral sex.
Who gets HSV-1, commonly known as oral herpes?
Anyone can get HSV-1. Most people contract HSV-1 during childhood. It spreads when an adult who has the virus has close contact with a child, such as when a family member kisses a child.
Who gets HSV-2, commonly known as genital herpes?
Genital herpes affects sexually active teens and adults of all genders and races. It can spread if you have multiple sexual partners and dont use condoms or dental dams.
People assigned female at birth are more at risk. Delicate vaginal tissue can tear, making it easier for the infection to get in. Black people who were AFAB are especially vulnerable, with an estimated 1 in 2 people AFAB between the ages of 14 and 49 infected with HSV-2.
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What Happens At A Sexual Health Clinic
The doctor or nurse at the sexual health clinic will:
- ask about your symptoms and your sexual partners
- use a small cotton bud to take some fluid from 1 of your blisters or sores for testing
The test cannot:
- be done if you do not have visible blisters or sores
- tell you how long you have had herpes or who you got it from
Symptoms might not appear for weeks or even years after you’re infected with the herpes virus.
Infection In Compromised Hosts
The likelihood of complicated HSV, with attendant substantialmorbidity, parallels the degree of compromise of cellular immune function . The most frequent complication of HSV infections amongimmunocompromised patients is slowly progressive and chronic mucocutaneousinfections, accompanied by extensive tissue damage and necrosis .Contiguous mucosal spread resulting in esophageal, tracheal,pulmonary involvement or visceral dissemination also can occur but fatal infectionsare not common. Organ transplant recipients, particularly human stem cell transplantrecipients, and individuals with HIV/AIDS are at particular risk for both severe andfrequently recurrent infections.
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Can Herpes Simplex Be Prevented
Antiviral drugs will stop HSV multiplying once it reaches the skin or mucous membranes but cannot eradicate the virus from its resting stage within the nerve cells. They can, therefore, shorten and prevent attacks but a single course cannot prevent future attacks. Repeated courses may be prescribed, or the medication may be taken continuously to prevent frequent attacks.
Herpes And Newborn Infants
Herpes infection in a newborn can cause a range of symptoms, including skin rash, fevers, mouth sores, and eye infections. If left untreated, neonatal herpes is a very serious and even life-threatening condition. Neonatal herpes can spread to the brain and central nervous system, causing encephalitis and meningitis. It also can lead to intellectual disability, cerebral palsy, and death. Herpes can also spread to internal organs, such as the liver and lungs.
Infants infected with herpes are treated with acyclovir, an antiviral drug. They usually receive several weeks of intravenous acyclovir treatment, often followed by several months of oral acyclovir. It is important to treat babies quickly, before the infection spreads to the brain and other organs.
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Risk For Genital Herpes
According to the US Centers for Disease Control and Prevention , about 1 in 6 Americans ages 14 to 49 years have genital herpes. While HSV-2 remains the main cause of genital herpes, HSV-1 has significantly increased as a cause, most likely because of oral-genital sex. Except for people in monogamous relationships with uninfected partners, everyone who is sexually active is at risk for genital herpes.
Risk factors for genital herpes include:
- History of an STD
- First sexual intercourse at an early age
- High number of sexual partners
- Low socioeconomic status
Women are more susceptible to HSV-2 infection because herpes is more easily transmitted from men to women than from women to men. About 1 in 5 women, compared to 1 in 9 men, have genital herpes. African-American women are at particularly high risk.
People with compromised immune systems, such as those who have HIV, are at very high risk for genital herpes. These people are also at risk for more severe complications from herpes. Drugs that suppress the immune system, and organ transplantation, can also weaken the immune system and increase the risk for contracting genital herpes.
Herpes Simplex Virus Signs Symptoms & Treatment
Herpes simplex is perhaps one of the most common sexually transmitted diseases. But is it only transmitted through sexual intercourse? There are many facts people dont know about herpes. For example, there are many types of herpes virus, and not all of them are responsible for those painful lesions in your lips.
In this article, we are going to explore the basics of herpes simplex and how it is different from other viruses. After identifying the virus that causes this ubiquitous sexually-transmitted disease, we will review the signs, symptoms, and treatment options.
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Triggers For Cold Sores
In some people the HSV infection causes cold sores, which erupt following a trigger event such as a cold. This explains the term cold sore. Other triggers that may cause an attack of cold sores include:
- feverish illnesses, like influenza, or chest infections
- hormonal changes, such as the menstrual period
- emotional or physical stress.
It is important to remember that cold sores are a symptom of ongoing infection rather than a new infection. The sores usually recur in the same place.
Who Gets Herpes Simplex
Most people get HSV-1 as an infant or child. This virus can be spread by skin-to-skin contact with an adult who carries the virus. An adult does not have to have sores to spread the virus.
A person usually gets HSV-2 through sexual contact. About 20% of sexually active adults in the United States carry HSV-2. Some people are more likely to get HSV-2. These people:
Have had many sex partners
Had sex for the first time at a young age
Have another sexually transmitted infection
Have a weakened immune system due to a disease or medicine
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Transmission Of Epstein Barrvirus
Epstein Barr is the etiological agent responsible forinfectious mononucleosis. Infectious mononucleosis is commonly known asthe “kissing disease” because it, like all Epstein Barr diseases, istransmitted primarily via saliva. Epstein Barr Virus is not likelyto be spread by aerosol or fomites. Because of this, there is littlereason to isolate patients with active EBV infection. EBV can also betransmitted by blood transfusion. In industrialized countries, there is afirst wave of primary infections before adolescence. A second wave occurswith the onset of social activity associated with adolescence and youngadulthood. Primary infection among adolescents accounts for most cases ofinfectious mononucleosis. Most of the population is EBV-seropositive byadulthood. It should also be noted that most transmission of EBV is dueto asymptomatic viral shedding from healthy EBV-seropositiveindividuals.
EBV has also been implicated as an etiological agent inseveral human malignancies including B cell lymphomas, nasopharyngealcarcinoma, and Burkitt’s lymphoma. Cofactors are thought to play a largerole in the development of these diseases.
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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Herpes Simplex Virus Type 2
Herpes simplex virus type 2 spreads through sexual contact and is a type of sexually transmitted infection .
Both types of HSV develop as a result of direct contact with the virus.
HSV-1 most commonly spreads through oral-to-oral contact, which can be with sores, saliva, or the area around the mouth. Transmission may also occur due to sharing lip balm, a toothbrush, or any other product that has come into contact with HSV.
People have a much higher risk of contracting HSV-1 if they come into contact with someone who has an active outbreak of symptoms. In some cases, it is also possible for people to transmit HSV-1 during sexual activity.
Transmission of HSV-2
When To Call The Doctor
Even though HSV sores can hurt and be unsightly, most cases of herpes do not cause serious illness. The sores go away in a few days. Contact the health provider if:
- Sores are present and you think it might be a first herpes infection. The diagnosis is usually made by examining the sores. If the sores have not healed, sometimes a laboratory test is done.
- Sores do not heal by themselves or show signs of infection such as pus, spreading redness or fever.
- Sores are near the eyes.
- You have another health condition with a weakened immune system.
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Herpes Simplex Virus Type 1
One of the most popular sexually transmitted disease is the Herpes Simplex Virus. Herpes virus is classified into two types, HSV-1 and HSV-2. This article is about Herpes Simplex Virus Type 1 . HSV-1 is a highly transmissible disease and infected 67% of the population in the world. HSV-1 infects parts of the body above the waist and is most commonly found around the mouth orally. Statistics show the significance of this virus, which states that around 3.7 million people under 50 have HSV-1 disease as of 2016. Most people get exposure to HSV-1 by the ages of 1-5, as it can also pass from one person to another genetically.
What Are The Symptoms Of Herpes Simplex
Many people with the infection never experience any herpes symptoms. If you do notice symptoms, youll experience them differently depending on whether youre having your first herpes outbreak or a repeat outbreak. Recurring symptoms are usually milder than the first outbreak. Symptoms dont last as long with later outbreaks. Some people may only have one or two outbreaks during their lifetime. Others may have as many as four or five outbreaks a year.
People who do have herpes symptoms may experience:
- Cold sores around their lips, mouth or tongue. They may look crusty or like fluid-filled blisters.
- Tingling, itching or burning.
- Pain while urinating.
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Herpes Simplex Treatment And Management
Herpes simplex infections can’t be cured, but treatments are available to reduce the number and length of outbreaks. The risk of transmitting the infection to others is also reduced.
Daily antiviral medications, such as acyclovir, valacyclovir, and famciclovir, may be prescribed. During an outbreak, self-care strategies can also help manage pain and discomfort.
For an oral herpes outbreak featuring cold sores or blisters around the mouth, do the following:
- Clean the affected area and pat dry
- Use over-the-counter pain relievers or ointments with ingredients such as benzocaine or lidocaine
- Apply OTC antiviral cold sore medication to the lesions to help them heal quicker
- Use petroleum jelly to keep skin from drying out or cracking
- Avoid acidic, spicy, or salty foods that may irritate your lesions
Self-care for a genital herpes outbreak may include:
- Use OTC pain relievers or cool compresses to help manage pain
- Wash affected area with mild soap and gently dry
- Wear loose fitting, cotton underwear
Genital Herpes And Pregnancy
Women with herpes before pregnancy can usually expect to have a healthy baby and a vaginal delivery.
If you have genital herpes during pregnancy, there’s a risk your baby could develop a serious illness called neonatal herpes.
This can be fatal, but most babies recover with antiviral treatment.
The risk of your baby getting neonatal herpes is low if you have had genital herpes before.
It’s higher if you get genital herpes for the first time in pregnancy.
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There Is More Than One Type Of Herpes Infection
There are two types of herpes simplex infection: herpes simplex virus type 1 and herpes simplex virus type 2 . Cold sores around the mouth are generally caused by HSV-1. Most cases of genital herpes are caused by HSV-2. Cold sores on the mouth can cause genital infection during oral sex for people who do not already carry the cold sore virus. There are many other viruses that are also in the herpes virus family, however the infection and symptoms are different. One example is varicella zoster virus which causes chickenpox and shingles.
A Blood Test Can Determine If Someone Has Genital Herpes
To find out if you have genital herpes, a doctor can take a sample from a sore and test it in the laboratory. There is also a blood test that looks for antibodies to the virus that your immune system would have made. HSV-2 almost always infects the genitals, so if antibodies to HSV-2 are detected in your blood, you probably have genital herpes.
A blood test that shows antibodies to HSV-1 means you could have genital or oral herpes. That’s because oral herpes, typically caused by HSV-1, can be spread to the genitals during oral sex.
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How Herpes Is Treated
There is no cure for herpes.
- The health care provider may prescribe antiviral medicine to help speed up the healing process. It also shortens the time when the virus can spread from the herpes sores.
- Pain may be treated with medicine such as Tylenol or Motrin or by applying an ice pack wrapped in a towel to the affected area.
- If sores are in the mouth, avoid foods high in acid, like citrus fruits and juices.
- The infected area should be kept clean and dry.
- Wash hands often and avoid touching the sores to prevent spreading the virus.
- It is important to stay healthy by getting enough rest, having proper nutrition and exercise and managing stress well.
Suppressive Therapy For Recurrences
To suppress outbreaks, treatment requires taking pills daily on a long-term basis. Acyclovir and famciclovir are taken twice a day for suppression. Valacyclovir is taken once a day. The doses for these antiviral drugs are reduced in people with impaired renal function.
Suppressive treatment can reduce the frequency of outbreak recurrences by 70% to 80%. It is generally recommended for people who have frequent recurrences . Because herpes recurrences often diminish over time, you should discuss annually with your provider whether you should stay with drug therapy or discontinue it.
There is some evidence that valacyclovir may help prevent herpes transmission, particularly in situations where one heterosexual partner has HSV-2 and the other partner does not. However, this drug does not completely prevent transmission. While taking any suppressive therapy for genital herpes, it is still important to regularly use latex condoms and to avoid any sexual activity during recurrences.
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