Thursday, June 20, 2024

What Is Herpes Simplex Virus 1

Can Cold Sores Be Prevented

Herpes (oral & genital) – causes, symptoms, diagnosis, treatment, pathology

The virus that causes cold sores is very contagious. To help prevent it from spreading to others:

  • Keep your drinking glasses and eating utensils, as well as washcloths and towels, separate from those used by other family members and wash these items well after use.
  • Dont kiss others until the sores heal.
  • Wash your hands well and often, especially after touching a cold sore.

Be especially careful not to touch your eyes. If HSV-1 gets into the eyes, it can cause a lot of damage.

What Happens During Your Initial Herpes Outbreak

Your first herpes outbreak, known as the initial or primary infection, is usually the most severe. Some lucky people remain asymptomatic, but its common to experience intense flu-like symptoms within seven to 14 days of becoming infected with the herpes virus.

Symptoms of an initial outbreak often include:

  • -Fever and chills
  • -Difficult or painful urination
  • -A tingling sensation in the affected areas

You can expect your initial herpes outbreak to last two to four weeks before it finally clears up. The good news, at least, is that future outbreaks are usually shorter and less painful than the first.

What Do My Test Results Mean

There are two possible antibodies that your body can make to HSV-1 and HSV-2. These are IgM and IgG.

IgM is the antibody that is made first and typically represents a current or acute infection, although this may not always be the case.

IgG is made after the IgM antibody and typically will be present in the bloodstream for the rest of your life.

A negative test result is considered normal. This generally means that youve never contracted an HSV infection.

However, its possible for your results to come back negative even if youve contracted the infection within the past few months. This is referred to as a false negative.

Your body will typically take several weeks to develop IgG antibodies to HSV.

If youre tested earlier in your infection, its possible to have a false negative result. Your doctor may recommend that you return in 2 to 3 weeks to be retested.

A positive test result for HSV-1 or HSV-2 indicates that youve contracted either virus at some point.

The results also allow your doctor to differentiate between HSV-1 and HSV-2, which isnt always possible by visually examining the sores.

Depending on your results, you and your doctor can discuss ways to treat and prevent the transmission of your HSV infection.

When a serum antibody test is recommended for HSV, IgG detection is preferred. In fact, some laboratories are discontinuing their IgM tests in the future.


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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

Treatment Of Herpes Simplex Virus 1

Herpes simplex virus 1 (HSV
  • Acyclovir has a better therapeutic ratio and proven efficacy.
  • Acyclovir, a nucleoside analog, is monophosphorylated by the HSV thymidine kinase and is then converted to the triphosphate form by cellular kinases.
  • The acyclovir triphosphate is efficiently incorporated into viral DNA by the HSV polymerase, where it then prevents chain elongation.
  • Besides acyclovir, valacyclovir, and vidarabine are also used which inhibit DNA synthesis.

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What Happens Once You Have Hsv

Once a person becomes infected with a herpes virus, the virus never leaves the body. After the first outbreak, the virus moves from the skin cells to nerve cells. The virus stays in the nerve cells forever. But it usually just stays there. In this stage, the virus is said to be dormant, or asleep. But it can become active again.

Some things that can trigger the virus are:

What Questions Should I Ask My Doctor

You may want to ask your healthcare provider:

  • What is the best treatment for me?
  • What happens if I dont treat a cold sore?
  • What are the side effects of antiviral medications?
  • How can I reduce the risk of future outbreaks?
  • Whats the best way to prevent getting another STI?
  • How can I protect my partner from getting genital herpes?
  • Should I lookout for signs of complications?

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Is There A Difference Between Cold Sores And Genital Sores

As mentioned earlier, while each variation of the virus may have a preference for a specific area, either form can make a home orally or genitally. Once either strain enters your body, it remains dormant there for life. Typically, HSV-1 settles in nerves on the base of the neck, while HSV-2 stays close to the base of the spine. HSV-1 statistically has a lower chance of recurrences than HSV-2, but HSV-2 symptoms have been shown to become less severe as time passes. Beyond these differences, the largest difference between these two is the stigma associated with genital herpes.

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How Can You Treat Hsv

Herpes Simplex Virus

As soon as you feel that first tingling, itching or burning, apply Abreva® Cream, which can block the spread of the cold sore virus to healthy skin cells. It is clinically proven to clear up cold sores in as few as 2½ days* when applied at the first sign. However, its only suitable for cold sores caused by HSV-1, so if you have sores on your genitals or elsewhere, see your doctor. Abreva® cannot treat HSV-2 symptoms.

*Median healing time 4.1 days. 25% of users healed within 2½ days.

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How Is Genital Herpes Spread

If you do not have herpes, you can get infected if you come into contact with the herpes virus in:

  • Saliva or genital secretions
  • Skin in the oral area if your partner has an oral herpes infection, or skin in the genital area if your partner has a genital herpes infection.

You can get herpes from a sex partner who does not have a visible sore or who may not know he or she is infected. It is also possible to get genital herpes if you receive oral sex from a sex partner who has oral herpes.

You will not get herpes from toilet seats, bedding, or swimming pools, or from touching objects around you such as silverware, soap, or towels. If you have additional questions about how herpes is spread, consider discussing your concerns with a healthcare provider.

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Episodic Therapy For Recurrences

For a recurrent episode, treatment takes 1 to 5 days, depending on the type of medication and dosage. You should begin the medication as soon as you notice any signs or symptoms of herpes, preferably during the prodrome stage that precedes the outbreak of lesions.

In order for episodic therapy to be effective, it must be taken no later than 1 day after a lesion appears. If taken during prodrome, episodic therapy may help prevent an outbreak from occurring or reduce its severity. If taken at the first sign of a lesion, it can help speed healing.

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Is Herpes Simplex Related To Herpes Zoster

Herpes simplex and the varicella-zoster virus are related, but they arent the same. VZV causes chickenpox and shingles.

Like HSV-1 and HSV-2, shingles can cause a painful, blistering rash. The shingles rash usually shows up on the back, side, abdomen , neck and face. It is often only on half of your body, following the pattern of your nerves. See your healthcare provider if you have a new rash and suspect you may have shingles.

A note from Cleveland Clinic

Herpes simplex is a virus. Once you have herpes, its a lifelong condition. A herpes infection can lead to outbreaks , but youll also have times when you have no symptoms. The main sign of herpes is sores that appear on the infected skin. Some people choose not to treat herpes, especially if symptoms are mild. Others take antiviral medications to reduce the severity and frequency of outbreaks.

Last reviewed by a Cleveland Clinic medical professional on 05/17/2022.


How Is Genital Herpes Diagnosed

Herpes Simplex Type 1 Virus Photograph by Mehau Kulyk

Your doctor can diagnose genital herpes by visual inspection if the outbreak is typical and by examining a sample from the sore. But HSV infections can be difficult to diagnose between outbreaks. Your doctor may check for ulcers internally on the cervix in women and the urethra in men. Blood tests that detect HSV-1 or HSV-2 antibodies may be helpful, although the results are not always easy to interpret.

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Ruling Out Conditions That Resemble Oral Herpes

Canker Sores

Simple canker sores are often confused with the cold sores of HSV-1. Canker sores frequently crop up singly or in groups on the inside of the mouth, or on or underneath the tongue. Their cause is unknown, and they are common in perfectly healthy people. They are usually white or grayish crater-like ulcers with a sharp edge and a red rim. They usually heal within 2 weeks without treatment.

This aphthous ulcer is located in front of and just below the bottom teeth.


Oral candidiasis is a yeast infection that causes a whitish overgrowth in the mouth. It is most common in infants, but can appear in people of all ages, particularly people taking antibiotics or those with impaired immune systems.

Other conditions that may be confused with oral herpes include herpangina , sore throat caused by strep or other bacteria, and infectious mononucleosis.

Laboratory Diagnosis Of Herpes Simplex Virus 1

Specimens: vesicle swab, skin swab, vesicle fluid, corneal scrapings, skin scrapings, oral swab, blood, tissue, CSF


  • Inoculation of tissue cultures is used for viral isolation.
  • HSV is easy to cultivate, and cytopathic effects usually occur in only 23 days.
  • Virus can rapidly grow in cell cultures of fibroblasts and epithelial types where the virus produces characteristics grounding and ballooning of cell.
  • The agent is then identified by neutralization test or immunofluorescence staining with specific antiserum.


  • Cytopathology involves the detection of multinucleated giant cells in scrapings obtained from the base of vesicle by staining with Giemsa or Wrights stain, commonly called as Tzanck smear preparation.
  • Demonstration of typical giant cells or cow dry type A intranuclear inclusion bodies in the stained smear is diagnostic of HSV infection.

Antigen detection

  • The antigen can be detected in vesicle fluid, tissue smear and biopsy by direct fluorescent antigen detection and direct enzyme immunoassay.

Antibody detection

  • Antibodies appear in 4-7 days after the infection and peak in 2-4 weeks.
  • Primary infection can be detected by determining the presence of IgM or the rising titre of IgG by ELISA, IFT and Complement fixation test.
  • Serologic assays based on the type-specific antigens, glycoprotein G, can differentiate between HSV-1 and HSV-2.

Molecular Diagnosis

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Can The Virus Be Transmitted During Childbirth

According to

You may notice some tingling, burning, or itching at the site of the infection before small, painful blisters appear. There could be one blister or a small cluster. These blisters will eventually burst and crust over before they begin to heal.

The blisters that develop during a primary infection may take to fully heal. These blisters can still transmit the virus until theyve healed completely.

Sores often itch, and genital sores may cause pain during urination.

A Pregnant Woman Can Give Herpes To Their Unborn Baby

Herpes simplex virus

The estimated number of pregnant women infected with HSV-2 is 880,000. Most transmission to newborns occurs during vaginal delivery. If a woman had genital herpes before getting pregnant, their baby may be infected but the chance is very low — less than 1%. However, the risk of infecting the baby is much higher when a woman is newly infected late in pregnancy.

If you are pregnant and think you may be infected, tell your doctor right away. Women with genital herpes are examined carefully for any symptoms before giving birth. If sores or signs that an outbreak is coming are present at the time of delivery, the baby may be delivered by cesarean section .

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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.

Take Charge Of Your Health

Oral herpes can be transmitted by kissing, sharing eating utensils or drinks, or during sex. Since oral herpes can be contracted from both Type 1 and Type 2 strains of the Herpes Simplex Virus, our doctors recommend getting tested for both of these HSV strains at the same time.

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What Is Hsv Next Steps

It may be an incurable condition, but understanding what HSV-1 and HSV-2 are, their causes, how contagious they are, potential complications and how to treat them, can help you keep the condition under control and avoid spreading it to others.

Learn more about preventing cold sores and keeping your lips in great condition with our top lip care tips.

Use Abreva® Cream to treat cold sores caused by HSV-1, and find out how Abreva® Cream works.

i. Herpes Simplex Virus. World Health Organization. . Accessed 06/25/19. Referenced text is highlighted in source PDF.

ii. Does Everyone Have Herpes? And 12 Other FAQs About HSV-1 and HSV-2. Healthline. . Accessed 11/11/19. Referenced text is highlighted in source PDF.

iii. Herpes Simplex Virus: HSV-1 & HSV-2. WebMD. . Accessed 11/08/19. Referenced text is highlighted in source PDF.

iv. What’s to Know About Herpetic Whitlow?. Medical News Today. . Accessed 11/08/19. Referenced text is highlighted in source PDF.

v. Cold Sores in Children: About the Herpes Simplex Virus. Healthy . Accessed 11/08/19. Referenced text is highlighted in source PDF.

Is Cmv Rather Than Hsv1 A Cause Of Ad

Herpes Simplex Type 1 Virus Photograph by Mehau Kulyk

The possibility that CMV, another member of the herpes family of viruses, rather than HSV1 is a major factor in AD has been considered in a number of publications. This is based on the many studies that have implicated the virus in immunosenescence, although it should be said that its role in the latter is unexplained, and many aspects are controversial. However, what is presumably the most obvious requirementthe presence of CMV in brain of AD patientshas not been established. In contrast, HSV1 DNA has been found in human brain by seven independent groups, including the authors, the latter using three different methods: solution and in situ PCR, and immunological . A further general point should be considered that brains cannot be described truly as virus-negative when based on analyses of necessarily small specimens of the 1.5 kg organ.

Lurain et al. analyzed serum and cerebrospinal fluid for associations between CMV infection and AD. They found that CMV-specific serum IgG antibody levels were associated with NFT of AD brain, as, also, was CSF interferon , which was detected only in CMV-seropositive patients also, the percentage of senescent T cells was significantly higher in CMV-seropositive than in seronegative patients. Although the authors considered that CMV rather than HSV1 was implicated in AD , their data were wholly consistent with the concept that inflammation caused by infections can affect the brain, resulting in reactivation of HSV1 resident in the CNS.

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How Is Herpes Simplex Treated

Although there is no cure for herpes, treatments can relieve the symptoms. Medication can decrease the pain related to an outbreak and can shorten healing time. They can also decrease the total number of outbreaks. Drugs including Famvir, Zovirax, and Valtrex are among the drugs used to treat the symptoms of herpes. Warm baths may relieve the pain associated with genital sores.


What Is The Normal Range For An Hsv Igg Test

The test does not have a standard range of values. The test results can be indicated as positive, negative or equivocal. A positive result means that the virus was detected and a negative result means it was not found. An equivocal report indicates that the test was unable to determine any specific result.

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