How To Access Antivirals
We are working with Healthdirect Australia, the national government-funded virtual health provider, to help people at higher risk to access antivirals. If youre identified as higher risk after completing the survey, you will receive a SMS from Healthdirect Australia about discussing antivirals with your GP.
You will only be sent a SMS from Healthdirect Australia if you have:
- received a positive COVID-19 test result or registered a positive rapid antigen test
- completed the survey you receive from NSW Health
- been identified as being at higher risk of severe illness.
3. Call your GP immediately to discuss antivirals . Antivirals work best within 5 days from the start of symptoms.
4. If your GP says you are eligible for antivirals, they will send you a prescription . Its recommended you ask your pharmacy to arrange home delivery for your medication or ask someone to collect it on your behalf and drop it off.
Genital Herpes: How Can You Prevent The Spread Of Herpes In Sexual Relationships
Herpes viruses are most likely to be transmitted during an outbreak, so it’s better to not have sex during this time. Herpes can also be passed on to others in symptom-free phases, though. This risk can be reduced considerably by using condoms.
If you have genital herpes, there are some things you can do on your own to protect your partner from infection. The main things are
- not having sex during an outbreak,
- using condoms during symptom-free phases, and
- talking openly with your partner about the disease.
Preventive treatment with antiviral medication may be an option for people who have genital herpes very frequently. This medication inhibits the activity of the virus, thereby lowering the risk of infecting partners.
How Do I Know If I Have Genital Herpes
Most people with genital herpes have no symptoms or have very mild symptoms. Mild symptoms may go unnoticed or be mistaken for other skin conditions like a pimple or ingrown hair. Because of this, most people do not know they have a herpes infection.
Herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. This is known as having an outbreak. The blisters break and leave painful sores that may take a week or more to heal. Flu-like symptoms also may occur during the first outbreak.
People who experience an initial outbreak of herpes can have repeated outbreaks, especially if they have HSV-2. However, repeat outbreaks are usually shorter and less severe than the first outbreak. Although genital herpes is a lifelong infection, the number of outbreaks may decrease over time.
Ask a healthcare provider to examine you if:
- You notice any symptoms or
- Your partner has an STD or symptoms of an STD.
STD symptoms can include an unusual sore, a smelly genital discharge, burning when peeing, or bleeding between periods .
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Ganciclovir Cidofovir And Foscarnet
In the last decade, alternatives to ACV for herpesvirus treatment have emerged and become commercially available as therapeutic drugs. Ganciclovir is a nucleic acid analog that does not require viral proteins for its activation in the cell . These compounds differ from each other either, in their molecular processing into an active form of an acyclic guanosine analog, or bioavailability which significantly determines the frequency of administration .
Ganciclovir is indicated for the treatment of CMV, particularly for systemic and ocular infections in immunosuppressed patients . However, ganciclovir has also been reported to have antiviral activity against HSV-1 and HSV-2 and may be used for the treatment of herpetic keratitis . At present, there is an ongoing clinical study that is recruiting patients for assessing the effects of oral ganciclovir, together with femtosecond laser-assisted corneal debridement in the treatment of herpes simplex virus epithelial keratitis . Of note, ganciclovir has been reported to produce considerable adverse side effects in a high percentage of individuals , such as nephrotoxicity, neutropenia, myelosuppression, confusion, altered mental status, anxiety, ataxia, tremors, convulsions, fever, abnormal levels of liver enzymes in serum, diarrhea, and nausea, among others .
Table 1. Approved and experimental antiviral drugs against HSV-1 and HSV-2 .
Home Remedies And Lifestyle
At-home treatments for herpes are used to relieve pain. They do nothing to alter the course of the infection but can make you more comfortable as the herpes sores begin to heal.
There are several things you can do if have an outbreak of oral or genital herpes:
- Use a cold compress. Place a cloth-covered ice pack on the sores for 15 minutes several times daily to reduce pain. Keep the ice pack moving to prevent frostbite.
- Do not touch or scratch. Avoid touching and rubbing the sores. Doing so can spread the infection to other areas of the skin.
- Keep the sores clean. Herpes sores can become infected with bacteria if touched with soiled hands. Wash your hands thoroughly with soap and water after going to the bathroom or before applying medications.
- Reduce stress. Stress can increase your sensitivity to pain during a herpes outbreak. You can reduce stress by performing gentle exercises or practicing mind-body therapies like meditation, yoga, and guided imagery.
To reduce the risk of spreading herpes, avoid kissing and sharing objects that come into contact with saliva, like drinking straws and eating utensils.
It’s important to note that oral herpes can be spread to the genitals, and that genital herpes can be spread to the mouth. To reduce the risk of infection, use condoms and dental dams during oral sex. Better yet, avoid sex altogether if you are having an active herpes outbreak .
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Suppressive Therapy For Recurrent Hsv
Suppressive therapy reduces frequency of genital herpes recurrences by 70%80% among patients who have frequent recurrences . Persons receiving such therapy often report having experienced no symptomatic outbreaks. Suppressive therapy also is effective for patients with less frequent recurrences. Long-term safety and efficacy have been documented among patients receiving daily acyclovir, valacyclovir, and famciclovir . Quality of life is improved for many patients with frequent recurrences who receive suppressive therapy rather than episodic treatment . Providers should discuss with patients on an annual basis whether they want to continue suppressive therapy because frequency of genital HSV-2 recurrence diminishes over time for many persons. However, neither treatment discontinuation nor laboratory monitoring is necessary because adverse events and development of HSV antiviral resistance related to long-term antiviral use are uncommon.
Valacyclovir 500 mg orally 2 times/day for 3 daysOR
Valacyclovir 1 gm orally once daily for 5 days
*Acyclovir 400 mg orally 3 times/day is also effective, but are not recommended because of frequency of dosing.
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.
Education Is An Integral Part Of Herpes Treatment
If you have genital herpes, its important for you to get educated about herpes and have the opportunity to ask questions in a supportive environment.
Becoming informed will help you learn to cope with the illness. It will also help you prevent sexual transmission of the illness, or transmission to an infant during a pregnancy.
Herpes has a tremendous psychosocial overlay. But knowledge about it and understanding about how well it can be managed can reduce that, says Handsfield.
Your doctor may be able to provide you with all the information you need, or you may choose to seek counseling from a mental health professional or at a clinic that specializes in sexual health, such as Planned Parenthood.
If you have a regular sexual partner, that person should also have the chance to learn about herpes and ask any questions they may have about it.
Recurrent Episodes Of Genital Herpes
Recurrences are usually less painful and shorter in duration than the first episode of genital herpes. Over time, episodes usually become less frequent and may eventually stop altogether. Infections caused by HSV1 are less likely to recur in the genital area than infections caused by HSV2.
Recurrences may be triggered by:
- no apparent reason noted.
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Acyclovir For Cold Sores
To treat cold sores , your doctor may prescribe acyclovir cream or an ointment containing the active ingredient.
Make sure you wash your hands before touching the infected area. Apply a thin layer of the cream up to 5 times a day, 4 hours apart. In most cases, topical treatment will last 5 to 7 days.
You should begin treatment as soon as symptoms occur. The earliest symptoms of cold sores include tingling and an itching sensation surrounding the lip. Symptoms should begin to improve within 48 hours, but it could take longer depending on the severity of the infection and when you started treatment.
Side effects of acyclovir cream include:
Get immediate medical help If you notice any of these severe side effects:
- Difficulty breathing
- Swelling of the face, lips, throat, eyes
Most people who are HSV carriers may never notice any symptoms at all, whilst others may experience frequent breakouts. Cold sores recur on avergage once yearly, but if you get them very often, your doctor can prescribe oral acyclovir to help suppress the symptoms and avoid future outbreaks.
How Can I Prevent Genital Herpes
If you are sexually active, you can do the following things to lower your chances of getting genital herpes:
- Being in a long-term mutually monogamous relationship with a partner who does not have herpes.
- Using condoms the right way every time you have sex.
Be aware that not all herpes sores occur in areas that a condom can cover. Also, the skin can release the virus from areas that do not have a visible herpes sore. For these reasons, condoms may not fully protect you from getting herpes.
If your sex partner has/have genital herpes, you can lower your risk of getting it if:
- Your partner takes an anti-herpes medicine every day. This is something your partner should discuss with his or her healthcare provider.
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When To See A Healthcare Provider
The early recognition of genital herpes, ideally during the prodromal stage, allows you to access treatments that can shorten the duration and severity of an outbreak.
Clearly, this can be difficult during your first outbreak, given that you probably won’t be expecting it. But, over time, you will be better able to recognize the tell-tale signs and know when it’s time to act.
What Happens If You Dont Get Herpes Treatment
The good news about herpes is that its not deadly or even very dangerous. It might be annoying, but herpes doesnt get worse over time or cause serious health problems like other STDs can.
If you dont get treated for herpes, you might keep having regular outbreaks, or they could only happen rarely. Some people naturally stop getting outbreaks after a while.
There are a few reasons people may decide not to get treatment. They might not have that many outbreaks, or their outbreaks dont really bother them. Or maybe theyre not having sex, so theyre not that worried about having herpes right now. Whatever your situation is, getting treatment for herpes is your choice.
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When Treatments For Genital Herpes Are Given
- Initial treatment. If you have symptoms such as sores when you’re first diagnosed with genital herpes, your doctor will usually give you a brief course of antiviral therapy to relieve them or prevent them from getting worse. Your doctor may keep you on the drugs longer if the sores don’t heal in that time.
After the first treatment, work with your doctor to come up with the best way to take antiviral therapies. There are two options:
- Intermittent treatment. Your doctor may prescribe an antiviral drug for you to keep on hand in case you have another flare-up this is called intermittent therapy. You can take the pills for two to five days as soon as you notice sores or when you feel an outbreak coming on. Sores will heal and disappear on their own, but taking the drugs can make the symptoms less severe and make them go away faster.
- Suppressive treatment. If you have outbreaks often, you may want to consider taking an antiviral drug every day. Doctors call this suppressive therapy. For someone who has more than six outbreaks a year, suppressive therapy can reduce the number of outbreaks by 70% to 80%. Many people who take the antiviral drugs daily have no outbreaks at all.
There is no set number of outbreaks per year that doctors use to decide when someone should start suppressive therapy. Rather, more important factors are how often the outbreaks happen and if they are severe enough to interfere with your life.
Side Effects And Follow
Side effects with these herpes drugs are considered mild, and health experts believe these drugs are safe in the long term. Acyclovir is the oldest of the three, and its safety has been documented in people taking suppressive therapy for several years.
People taking suppressive therapy should see their doctor at least once a year to decide if they should continue. You may find taking the pills every day to be inconvenient, the drugs may not work for you, or you may naturally have fewer outbreaks as time goes on. Your doctor can help you make treatment choices to suit your needs.
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Genital Herpes Is Spread By Skin
The virus can be spread when someone with HSV has an episode or an outbreak characterised by having a sore, blister, ulcer or skin split . It can also be spread between episodes, when there is no sore, blister, ulcer or skin split present called asymptomatic viral shedding.
During viral shedding the virus is on the skin surface and can be spread through genital skin-to-skin contact, or from the mouth or face to genital skin during contact.
Genital Herpes During Pregnancy
Prevention of neonatal herpes depends both on preventing acquisition of genital herpes during late pregnancy and avoiding exposure of the neonate to herpetic lesions and viral shedding during delivery. Mothers of newborns who acquire neonatal herpes often lack histories of clinically evident genital herpes . The risk for transmission to the neonate from an infected mother is high among women who acquire genital herpes near the time of delivery and low among women with prenatal histories of recurrent herpes or who acquire genital herpes during the first half of pregnancy . Women who acquire HSV in the second half of pregnancy should be managed in consultation with maternal-fetal medicine and infectious disease specialists.
All pregnant women should be asked whether they have a history of genital herpes or genital symptoms concerning for HSV infection. At the onset of labor, all women should be questioned thoroughly about symptoms of genital herpes, including prodromal symptoms , and all women should be examined thoroughly for herpetic lesions. Women without symptoms or signs of genital herpes or its prodrome can deliver vaginally. Although cesarean delivery does not eliminate the risk for HSV transmission to the neonate , women with recurrent genital herpetic lesions at the onset of labor should have a cesarean delivery to reduce the risk for neonatal HSV infection.
Acyclovir 400 mg orally 3 times/dayORValacyclovir 500 mg orally 2 times/day
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Protecting Your Partner And Preventing Herpes Transmission
Research shows that the single greatest fear is the fear of transmission to partners, says Dr. Handsfield.
The main ways to avoid transmitting herpes are:
- Learn to recognize how you feel when an outbreak is on the way, and stop having sex immediately.
- Dont have sex during active outbreaks.
- Always use condoms but dont rely on them during outbreaks. They dont completely cover infectious areas.
- Only after all sores have scabbed over and healed should you have sex again.
- Avoid touching your herpes sores, because you can spread them to other places on your body that way. Whenever you touch a sore, wash your hands immediately.
- Dont kiss people or have sex if you have a cold sore.
- Tell potential partners about having herpes before having sex with them, even though it may be hard.
- Ask your doctor about taking antiviral drugs regularly.
Who Shouldnt Take Antiviral Medications
Antivirals are relatively safe medicines. Children as young as two weeks, as well as pregnant and breastfeeding individuals, can take certain antiviral medications. Guidelines for who shouldnt take antivirals vary depending on the drug. Your healthcare provider can determine whether an antiviral medicine is safe for you.
A note from Cleveland Clinic
Antiviral medications can treat certain viruses, putting an end to symptoms. For people with chronic viral infections, antiviral drugs can stop the virus from multiplying and causing problems. The medicine also lowers your chances of giving the virus to others. Your healthcare provider may prescribe an antiviral as a preventive measure if you have a known viral exposure. Taking antiviral medicines for a long time, or failing to take them as prescribed, can lead to antiviral resistance.
Last reviewed by a Cleveland Clinic medical professional on 05/11/2021.
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