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What Is Suppressive Therapy For Herpes

Usual Adult Dose For Herpes Simplex Labialis

Should You Be On Suppressive Therapy When In a Relationship?

2 g orally every 12 hours for a total of 2 dosesHIV-infected adult :1 g orally twice a day for 5 to 10 daysComments:-Therapy should be started at the earliest sign of a cold sore, e.g. tingling, burning, or itching.-Efficacy of treatment when initiated after the development of clinical signs of a cold sore have not been established.-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Infected Adults and Adolescents may be consulted for additional guidance.Use: For the treatment of cold sores .

How Can I Prevent Herpes Outbreaks

If you have lots of herpes outbreaks, your doctor may tell you to take medicine every day this is called suppressive therapy. It can help prevent future herpes outbreaks, and lower your chances of giving herpes to your partners.

Whether or not you take medicine to treat herpes, taking care of yourself by eating healthy foods, getting enough sleep, and avoiding stress might help keep future outbreaks from popping up.

No one knows for sure what triggers genital herpes outbreaks. Other infections, surgery, sex, your period, skin irritations, and stress may cause outbreaks. Sunburns, injuries to your lips, or other infections can cause oral herpes flare-ups. Try to avoid getting sunburned if you have oral herpes.

Genital herpes outbreaks usually happen less often and become shorter and weaker after a few years whether or not you get treated.

Episodic Vs Suppressive Therapy For Herpes

Herpes is a global problem that is becoming more prevalent as adolescents are becoming sexually active. This paper will talk about how herpes simplex 1 is often treated by each occurrence which is known as episodic treatment and how herpes simplex 2 can be treated both by the occurrence and long term which is known as suppressive therapy. Research is now being done to determine whether episodic or suppressive antiviral therapy is more effective in decreasing the spread of the herpes simplex 1 and 2 viruses.

Three Journal articles are used to analyze this information. Keywords: Episodic and Suppressive Herpes simplex 1 and simplex 2: Episodic vs. Suppressive Antiviral Therapy becoming sexually active. This is a major health concern especially for parents with soon to be or currently sexually active teens. There are three categories of herpes herpes simplex 1 , herpes simplex 2 and herpes zoster . Research is now being done to determine whether episodic or suppressive antiviral therapy is more effective in decreasing the spread of the herpes simplex 1 and 2 viruses. Herpes Simplex 1 Oral

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Treatment For Oral Herpes

The antiviral medications available in pill form have been specifically developed for the treatment of genital herpes. However, it is not uncommon for healthcare providers to prescribe the antiviral drugs to those who have frequent or severe outbreaks of oral herpes.

A recent study found valacyclovir to be effective for treating oral herpes in a one-day treatment of 2 grams taken at the first sign of a cold sore, and then again about 12 hours later.

There are two topical antiviral medications prescribed for the treatment of oral HSV symptoms: acyclovir ointment and penciclovir cream. Both work to speed up the healing process and reduce the viral activity. These topical drugs are put directly on the lesions themselves, but can also be used at the onset of prodrome.

Other topical treatments for oral herpes are available over-the-counter , but are not antiviral compounds like acyclovir and penciclovir. Some also contain ingredients that numb the area and induce temporary relief from the discomfort of an outbreak. Unfortunately, some OTC treatments may actually delay the healing time of symptoms because they can further irritate the area with repeated applications. There is only one OTC FDA-approved cream, called Abreva®, which has been clinically proven to help speed the healing process.

Find A Doctor You Feel Comfortable With

Suppressive herpes treatment

While some doctors have a special interest in sexual health, others may not be familiar with, or comfortable discussing, these issues. Finding a doctor with whom you can openly and comfortably discuss these issues is important. There are doctors who specialise in this area: some are in private clinics, while others belong to sexual health services. There are also sexual health services in country areas. All sexual health services are strictly confidential.

Talk to your doctor if you are feeling worried about the impact of genital herpes on your sex life, relationship or future relationships. Your doctor can give you advice on how to discuss sexually transmitted infections with your partner, and can recommend support groups.

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How To Use Famciclovir

Read the Patient Information Leaflet if available from your pharmacist before you start taking famciclovir and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth with or without food, usually 2 to 3 times a day or as directed by your doctor.

This medication works best when started at the first sign of an outbreak, as directed by your doctor. It may not work as well if you delay treatment.

The dosage is based on your medical condition and response to treatment.

This medication works best when the amount of drug in your body is kept at a constant level. Therefore, take this drug at evenly spaced intervals. To help you remember, take it at the same times each day.

Continue to take this medication until the full prescribed amount is finished. Do not change your dose, skip any doses, or stop this medication early without your doctor’s approval.

Tell your doctor if your condition persists or worsens.

Home Remedies And Lifestyle

There are some things that you can do at home to lessen the pain of a cold sore or genital herpes, prevent worsening of your condition, and reduce the risk of spreading the infection to others.

  • Apply cold compresses: Place a well-insulated ice pack on your lesions for as long as it makes you feel better. The cold will not worsen or improve the lesion, but it can lessen the pain.
  • Don’t scratch: Avoid touching and scratching lesions caused by herpes, as this can spread the infection to other areas of your own skin.
  • Keep the sores clean: Cold sores and genital herpes infections can become infected with bacteria from your hands or, in the latter case, from urine or feces. Keep the sores and blisters, and the areas around them, clean and dry to avoid an additional infection.
  • Reduce stress: Stress can affect how well your immune system can keep your herpes infection in check. Reducing your stress may help prevent excessive herpes recurrences.

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Is There A Cure Or Treatment For Herpes

There is no cure for herpes. Antiviral medications can, however, prevent or shorten outbreaks during the period of time the person takes the medication. In addition, daily suppressive therapy for herpes can reduce the likelihood of transmission to partners.

Several clinical trials have tested vaccines against genital herpes infection, but there is currently no commercially available vaccine that is protective against genital herpes infection. One vaccine trial showed efficacy among women whose partners were HSV-2 infected, but only among women who were not infected with HSV-1. No efficacy was observed among men whose partners were HSV-2 infected. A subsequent trial testing the same vaccine showed some protection from genital HSV-1 infection, but no protection from HSV-2 infection.

Genital Herpes: A Review

A Novel Therapy for Genital Herpes Engages Immune Cells to Provide Significant Benefits

Am Fam Physician. 2016 Jun 1 93:928-934.

Patient information: See related handout on genital herpes, written by the author of this article.

Genital herpes is a common sexually transmitted disease caused by herpes simplex virus and characterized by lifelong infection and periodic reactivation. HSV, a DNA virus, is named from its protein coat as HSV-1 or HSV-2. HSV-1 is the chief cause of orolabial herpes. Until recently, genital herpes was more likely to be caused by HSV-2. However, the incidence of primary genital infection with HSV-1 is now as common or more common than HSV-2 in the United States.1

SORT: KEY RECOMMENDATIONS FOR PRACTICE

Type-specific laboratory confirmation of HSV is recommended in patients with clinical disease to guide counseling and management.

Clinical recommendation Evidence rating References

Polymerase chain reaction assay is the preferred test for confirming HSV in clinically apparent lesions.

Type-specific serologic testing should be offered to partners of patients with HSV infection to determine the risk of HSV acquisition.

Suppressive therapy reduces symptom severity, duration, and recurrence in patients with genital herpes. In HIV-negative patients, it is also effective in reducing transmission to at-risk partners.

In persons with HIV and HSV-2 infections, suppressive therapy does not reduce the transmission of HSV-2 to at-risk partners.

24, 36

HIV = human immunodeficiency virus HSV = herpes simplex virus.

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What Is Suppressive Treatment For Genital Herpes

Suppressive treatment involves taking medication on a daily basis to reduce the chance of a genital herpes outbreak.

Taking antiviral medicines on a daily basis also reduces the amount of virus that is shed, both when sores are present and in between outbreaks, when the skin looks normal.

Suppressive treatment does not guarantee that you will not get a herpes outbreak, but should reduce the severity and frequency of herpes outbreaks.

Over time, your immune system tends to exert better control over the herpes virus, so your doctor may suggest stopping treatment every 6 months to see whether you have any further outbreaks. Treatment can be re-started if you do have a recurrence.

How Do Dermatologists Treat Herpes Simplex

There is no cure for herpes simplex. The good news is that sores often clear without treatment. Many people choose to treat herpes simplex because treatment can relieve symptoms and shorten an outbreak.

Most people are treated with an antiviral medicine. An antiviral cream or ointment can relieve the burning, itching, or tingling. An antiviral medicine that is oral or intravenous can shorten an outbreak of herpes.

Prescription antiviral medicines approved for the treatment of both types of herpes simplex include:

  • Acyclovir

  • Famciclovir

  • Valacyclovir

Taken daily, these medicines can lessen the severity and frequency of outbreaks. They also can help prevent infected people from spreading the virus.

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Suppressive Valacyclovir Therapy To Reduce Genital Herpes Transmission: Good Public Health Policy

Paul Bonnar

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License, which permits for noncommercial use, distribution, and reproduction in any digital medium, provided the original work is properly cited and is not altered in any way. For details, please refer to

Treatment Of Common Cutaneous Herpes Simplex Virus Infections

PPT

DAVID H. EMMERT, M.D., Lancaster General Hospital, Lancaster, Pennsylvania

Am Fam Physician. 2000 Mar 15 61:1697-1704.

Herpes simplex virus infection is increasingly common in the United States. New antiviral medications have expanded treatment options for the two most common cutaneous manifestations, orolabial and genital herpes. Acyclovir therapy remains an effective and often less expensive option. Famciclovir and valacyclovir offer improved oral bioavailability and convenient oral dosing schedules but are more expensive than acyclovir. Patients who have six or more recurrences of genital herpes per year can be treated with one of the following regimens: acyclovir, 400 mg twice daily valacyclovir, 1 g daily or famciclovir, 250 mg twice daily. These regimens are effective in suppressing 70 to 80 percent of symptomatic recurrences. Episodic treatment of recurrent genital herpes is of questionable benefit, but it may be helpful in appropriately selected patients. There is little evidence indicating benefit from treatment of recurrent orolabial herpes, which tends to be mild and infrequent.

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Nongenital Herpes Simplex Virus

RICHARD P. USATINE, MD, and ROCHELLE TINITIGAN, MD, University of Texas Health Science Center, San Antonio, Texas

Am Fam Physician. 2010 Nov 1 82:1075-1082.

Patient information: See related handout on cold sores, written by the authors of this article.

Nongenital herpes simplex virus type 1 is a common infection that most often involves the oral mucosa or lips . The primary oral infection may range from asymptomatic to very painful, leading to poor oral intake and dehydration. Recurrent infections cause cold sores that can affect appearance and quality of life. Although HSV-2 also can affect the oral mucosa, this is much less common and does not tend to become recurrent.

SORT: KEY RECOMMENDATIONS FOR PRACTICE

Oral acyclovir suspension is an effective treatment for children with primary herpetic gingivostomatitis.

Clinical recommendation

Oral acyclovir, valacyclovir , and famciclovir are effective for the treatment of acute recurrences of herpes labialis.

Recurrences of herpes labialis are suppressed with daily oral acyclovir or valacyclovir.

Topical acyclovir, penciclovir , and docosanol are optional treatments for recurrent herpes labialis.

A = consistent, good-quality patient-oriented evidence B = inconsistent or limited-quality patient-oriented evidence C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, go to .

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.

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How Effective Is Suppressive Therapy For Herpes Treatment

Research have proven that nonstop suppressive antiviral therapy can intensely reduce the herpes outbreaks frequency or prevent them completely and lessen the risk of spreading the disease by 50%.

For instance, an important study reveals that individuals who have more than 12 occurrences per year on average could lessen their outbreaks frequency to less than two a year following one year of nonstop suppressive therapy. The research also stated that if recurrences do happen during suppressive therapy, theyre usually shorter in duration and less severe.

Who is Suppressive Therapy Appropriate For?

Your physician may approve that suppressive antiviral therapy is good for you if:

While there is still no cure of herpes, there are certainly treatment for herpes simplex such as taking anti-viral drugs and suppressive therapy that you can opt for to get rid of your herpes outbreaks.

Education Is An Integral Part Of Herpes Treatment

Dating Advice : Dating With Herpes

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.

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What Happens If Herpes Is Left Untreated

Without treatment, sores and outbreaks usually heal on their own. Oral herpes is usually considered a mild infection, but complications may appear in people with weakened immune systems.

The risk of complications with genital herpes is also low, though these include inflammation, swelling, and pain. Passing HSV-2 to a newborn can be dangerous, however. Doctors may recommend a cesarean delivery to mothers with genital herpes, according to the .

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.

Having herpes can make it easier to get HIV, because the sores give HIV an open pathway into your body. So always use condoms to help prevent the spread of both herpes and HIV.

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One Option For Ongoing Therapy: Taking Drugs Regularly

Some people with genital herpes choose to take antiviral medication daily to reduce the number of symptom outbreaks they have. In some cases, daily therapy prevents outbreaks completely.

Numerous studies over the years have demonstrated the safety and effectiveness of all three of the approved antivirals used to treat genital herpes.

Studies have also shown that daily antiviral therapy reduces the rate of transmission from an HSV-2 infected person to an uninfected partner of the opposite sex.

Daily therapy also lowers the odds of infecting other people if you have multiple sex partners or if you are a man who has sex with men.

The drugs work both for people who have had herpes symptoms and for those whose blood tests show they have an HSV-2 infection but who have never had symptoms.

Some people choose to take antiviral drugs only as needed, for outbreaks that occur after the first one. For this to work, you need to start taking the medicine within one day of sores cropping up or during the time period that comes before some outbreaks.

During the prodrome, you may feel

  • Burning in the area where the virus first entered your body
  • Itching or tingling in that area
  • Pain in your back, buttocks, thighs, or knees

Your doctor will probably give you a prescription you can fill and keep handy for timely use, and tell you to start taking the drugs just as soon as symptoms begin.

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