What are the best treatments for herpes simplex 1. How do antiviral medications work against HSV infections. What is the difference between episodic and suppressive therapy for herpes. How effective are topical treatments for oral herpes outbreaks. What are the FDA-approved medications for genital herpes.

Understanding Herpes Simplex Virus (HSV) Infections

Herpes simplex virus (HSV) infections are common viral conditions that affect millions of people worldwide. There are two main types of HSV: HSV-1, which typically causes oral herpes, and HSV-2, which is usually associated with genital herpes. However, both types can infect either area. While there is no cure for herpes, various treatment options are available to manage symptoms, reduce outbreak frequency, and minimize transmission risk.

FDA-Approved Antiviral Medications for Herpes Treatment

The cornerstone of herpes treatment involves antiviral medications. Three primary antiviral drugs have been approved by the FDA for treating genital herpes:

• Acyclovir
• Valacyclovir
• Famciclovir

These medications work by interfering with the virus’s ability to replicate, thereby reducing the severity and duration of outbreaks. Each drug has its unique properties and dosing regimens, which we’ll explore in more detail.

Acyclovir: The Pioneer in Herpes Treatment

Acyclovir has been a mainstay in herpes treatment since the 1980s. Initially available as a topical ointment, it later became available in pill form. Its long-standing use has demonstrated an impressive safety profile, with some patients using it continuously for up to a decade without significant adverse effects.

Valacyclovir: Enhanced Absorption and Convenience

Valacyclovir is a newer antiviral medication that uses acyclovir as its active ingredient. Its key advantage lies in its improved absorption by the body, allowing for less frequent dosing compared to acyclovir. This enhanced efficiency translates to greater convenience for patients, potentially improving treatment adherence.

Famciclovir: Long-lasting Antiviral Action

Famciclovir utilizes penciclovir as its active component to halt HSV replication. Like valacyclovir, it boasts excellent absorption and persistence in the body, enabling less frequent dosing schedules. This characteristic makes it an attractive option for those seeking a balance between efficacy and convenience.

Treatment Approaches: Episodic vs. Suppressive Therapy

When it comes to managing herpes outbreaks, healthcare providers typically recommend one of two treatment approaches: episodic therapy or suppressive therapy. Each strategy has its merits and is tailored to the individual’s needs and outbreak patterns.

Episodic Therapy: Targeting Individual Outbreaks

Episodic therapy involves taking antiviral medication at the first sign of an outbreak or during the prodromal phase (the period just before visible symptoms appear). This approach aims to shorten the duration of symptoms and potentially prevent a full-blown outbreak.

How effective is episodic therapy? While results can vary among individuals, studies have shown that all three FDA-approved antivirals can significantly reduce the time a person experiences herpes symptoms. On average, episodic therapy can cut the length of an outbreak by one to two days.

The key to maximizing the benefits of episodic therapy lies in early intervention. Starting treatment at the very first sign of prodrome offers the best chance of mitigating outbreak severity. However, if lesions are already present, the effectiveness of episodic therapy may be limited.

Suppressive Therapy: Preventing Outbreaks

Suppressive therapy involves taking antiviral medication daily to prevent or reduce the frequency of herpes outbreaks. This approach is particularly beneficial for individuals who experience frequent recurrences (six or more per year).

How effective is suppressive therapy in reducing outbreaks? Studies have demonstrated that suppressive therapy can reduce the number of outbreaks by at least 75% while the medication is being taken consistently. For some individuals, daily antiviral use can even prevent outbreaks altogether.

Beyond reducing visible symptoms, suppressive therapy has shown promise in addressing asymptomatic viral shedding. Research has indicated that women on suppressive acyclovir therapy experienced a 94% reduction in subclinical shedding. Similar studies with famciclovir and valacyclovir have yielded comparable results in both men and women.

Treating Oral Herpes: Options and Efficacy

While the antiviral medications discussed earlier were primarily developed for genital herpes, they are often prescribed for managing frequent or severe oral herpes outbreaks as well. Recent research has shed light on the effectiveness of these treatments for oral HSV infections.

Valacyclovir for Oral Herpes: A One-Day Treatment Option

A recent study explored the efficacy of valacyclovir in treating oral herpes using a one-day treatment regimen. The protocol involved taking 2 grams of valacyclovir at the first sign of a cold sore, followed by another 2-gram dose approximately 12 hours later. This short-course treatment showed promising results in expediting the healing process and reducing symptom severity.

Topical Treatments for Oral Herpes

In addition to oral medications, two prescription topical antiviral treatments are available for oral herpes:

• Acyclovir ointment
• Penciclovir cream

These topical antivirals work directly on the lesions to accelerate healing and reduce viral activity. They can be applied at the first sign of an outbreak or during the prodromal phase for optimal results.

Are over-the-counter treatments effective for oral herpes? While various OTC options are available, it’s important to note that most are not antiviral compounds like acyclovir and penciclovir. Many OTC treatments contain ingredients that provide temporary relief by numbing the affected area, but they do not directly combat the virus or significantly alter the course of an outbreak.

Optimizing Herpes Treatment: Factors to Consider

When determining the most appropriate treatment approach for herpes, several factors come into play. Healthcare providers consider the frequency and severity of outbreaks, the individual’s overall health, potential side effects, and the patient’s preferences regarding daily medication versus as-needed treatment.

Personalized Treatment Plans

The optimal treatment plan for herpes is highly individualized. Some people may find that the benefits of episodic therapy for recurrent episodes are minimal compared to its use during a primary outbreak. Others might prefer the peace of mind that comes with daily suppressive therapy, especially if they have frequent outbreaks or are concerned about transmitting the virus to partners.

Importance of Early Intervention

Regardless of the chosen treatment approach, early intervention is crucial for maximizing the benefits of antiviral therapy. Recognizing the early signs of an outbreak and promptly initiating treatment can significantly impact the course and severity of symptoms.

Beyond Medication: Holistic Management of Herpes

While antiviral medications form the backbone of herpes treatment, a comprehensive management approach often yields the best results. This holistic strategy may include:

• Stress reduction techniques
• Dietary modifications
• Adequate rest and sleep
• Strengthening the immune system
• Avoiding known triggers

By combining medical treatment with lifestyle adjustments, many individuals find they can effectively manage their herpes symptoms and improve their overall quality of life.

Advances in Herpes Research: Future Treatment Possibilities

The field of herpes research is continually evolving, with scientists exploring new treatment modalities and potential cures. Some areas of ongoing research include:

• Gene editing techniques to eliminate the virus from infected cells
• Therapeutic vaccines to boost the immune response against HSV
• Novel antiviral compounds with improved efficacy and fewer side effects
• Combination therapies that target different aspects of the viral life cycle

While these potential advancements offer hope for improved herpes management in the future, current treatment options remain effective for many individuals in controlling symptoms and reducing transmission risk.

In conclusion, the treatment landscape for herpes simplex 1 and 2 infections has come a long way since the introduction of acyclovir in the 1980s. Today, patients have access to a range of antiviral medications and treatment strategies that can effectively manage symptoms and reduce outbreak frequency. By working closely with healthcare providers and staying informed about the latest developments in herpes treatment, individuals can find the most appropriate and effective management plan for their unique situation.

Treatment Options for Herpes Infections

Treatment for Genital Herpes

There are three antiviral medications that are FDA-approved for the treatment of genital herpes:

• Acyclovir: The oldest antiviral medication for herpes is acyclovir. It has been available since 1982 in a topical form (as an ointment) and sold since 1985 in pill form. Acyclovir has been shown to be safe in persons who have used it continuously (every day) for as long as 10 years.
• Valacyclovir: A newer drug, valacyclovir, actually uses acyclovir as its active ingredient. This medication delivers acyclovir more efficiently so that the body absorbs much of the drug, which has the advantage of taking the medication fewer times during the day.
• Famciclovir: Famciclovir uses penciclovir as its active ingredient to stop HSV from replicating. Like valacyclovir, it is well absorbed, persists for a longer time in the body, and can be taken less frequently than acyclovir.

Antiviral medication is commonly prescribed for patients having a first episode of genital herpes, but they can be used for recurrent episodes as well. There are two kinds of treatment regimens: episodic therapy and suppressive therapy.

Episodic Therapy

In this approach, a person begins taking medication at the first sign of an outbreak (or ideally at first signs of prodrome) and continues taking medication for several days, in order to speed healing or even prevent an outbreak from fully occurring. All three of the antiviral treatments mentioned above have been proven to help shorten the amount of time that a person may experience symptoms of herpes. However, keep in mind that results may vary from person to person.

Many people feel the advantages of using medication for recurrent episodes are marginal compared with use in a primary episode. But for others, episodic therapy offers a useful way to manage outbreaks by cutting the length of an outbreak by a day or two, on average. The benefits may be greater for those whose outbreaks tend to last longer.

Also, episodic therapy has its best results when treatment begins at the very first sign of prodrome. If lesions are already present, therapy may offer little benefit. Because the medications differ in their absorption rate and duration of effectiveness, dosages vary with episodic therapy treatment ranging from one to five pills every day for three to five days during an outbreak.

Suppressive Therapy

People with genital herpes who want to eliminate (suppress) outbreaks can take antiviral medication daily to hold HSV in check so that it’s less likely to flare up and cause symptoms. For individuals who have frequent recurrences (six or more per year), studies have shown that suppressive therapy can reduce the number of outbreaks by at least 75% while the medication is being taken. Also, for some, taking an antiviral on a daily basis can prevent outbreaks altogether.

While antivirals can be successful in controlling herpes symptoms, researchers also have turned their attention to the important issue of antiviral therapy and asymptomatic shedding. Does suppressive therapy lower the risk of unrecognized herpes reactivation as well as curb recognized outbreaks? One study addressing this question found that women on suppressive acyclovir (400 mg, twice daily) had a 94% reduction in subclinical shedding while taking daily therapy. This type of study has also been done with famciclovir and valacyclovir, with similar reductions seen in both men and women.

Suppressive therapy has been studied in thousands of patients and it appears to be both safe and effective. Because the medications differ in their absorption rate and duration of effectiveness, dosages vary with suppressive therapy treatment ranging from one to two pills every day.

Treatment for Oral Herpes

The antiviral medications available in pill form (acyclovir, valacyclovir, famciclovir) 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 (OTC), 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.

Alternative Therapies

Over-the-counter creams and/or ointments are not recommended for genital herpes, since they can interfere with the healing process in a number of ways, causing genital outbreaks to last longer. Keeping the area clean and as dry as possible and allowing the area to get air can help to speed the healing process.

Many people find that outbreaks tend to lessen in severity and frequency with time. What triggers an outbreak is highly individual, but with time, many people learn to recognize, and sometimes avoid, factors that seem to reactivate HSV in their own bodies. For example, illness, poor diet, emotional or physical stress, friction in the genital area, prolonged exposure to ultraviolet light (commonly for oral herpes, such as a beach trip or skiing weekend), surgical trauma, or steroidal medication (such as asthma treatment) may trigger a herpes outbreak.

The frequency of outbreaks can often be managed through effective stress management, and getting adequate rest, nutrition, and exercise.

People often ask about an amino acid by the name of lysine (L-lysine), because of Internet claims or claims from other people that it helps control outbreaks. While some studies have suggested that lysine supplements can reduce the frequency of recurrences or healing time, other trials have been unable to replicate those results. Therefore, there is not sufficient information to discern how effective it may be, in addition to what the effective dosages or frequency of L-lysine may be.

Lysine can be found with other nutrients and supplements at your local grocery or drug store, but people should only take the recommended dosage if it is taken and always check with their health care provider first before starting any new medication or supplement. Megadoses of lysine may throw other amino acids out of balance and interfere with the absorption of other nutrients such as vitamins and minerals.

In regard to possible foods to avoid, some people feel that foods that contain high amounts of the amino acid arginine may cause herpes outbreaks. Arginine is found in numerous foods that are eaten on a regular basis, so we don’t encourage not eating foods simply because they contain arginine. However, an individual may want to consider adjusting their diet if they are having frequent outbreaks and believes food is a contributing factor. Again, while some individuals believe arginine can trigger outbreaks, there is no clinical evidence to support these claims.

Herpes simplex: Diagnosis and treatment

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Treatment of herpes in Moscow – Prices in the infectious diseases clinic – Methods of treatment of herpes infection

The frequency of virus reactivation is due to the ability of herpetic infections to remain in the human body for a long time in a latent state and enter the active phase under certain factors: an adjacent disease, weakened immunity, hypothermia, regular physical exertion, disproportionate to your state of health, etc.

Do not underestimate small herpetic rashes on the lips or skin. Usually, the symptoms disappear after the use of special ointments, but in order to cure the disease, it is recommended that after the appearance of a rash, you should consult an infectious disease specialist and be tested for herpes in order to differentiate the type of pathogen and exclude severe manifestations of the infectious process.

Herpes virus treatment methods

The main method of treatment of herpesvirus infections in adults and children is antiviral therapy. It is not effective if the virus exists in a latent (hidden) form in the CNS. The drugs for the treatment of herpes include acyclovir and its derivatives. The drug inhibits the synthesis of viral DNA and prevents the development of the infectious process. Topical application of acyclovir preparations is widely used for infections with the herpes simplex virus (HSV) in the case of labial manifestations (herpes on the lips, face, body, oral mucosa, shoulders, back).

With a favorable course of chickenpox, as a rule, specific therapy is not required. In addition, thanks to the development of an effective vaccine against this disease, the number of infected people is much less. An exception when antiviral therapy may be needed are complications of chickenpox, in particular, encephalitis. In this case, in addition to directly acyclovir, valaciclovir, famiciclovir or interferon preparations can be prescribed.

Infectious mononucleosis caused by herpesvirus type 4 infection (Epstein-Barr virus) suggests symptomatic treatment. Ganiciclovir has been successfully used for severe forms of cytomegalovirus.

The best treatment for herpes in men and women is a doctor-thought-out drug regimen based on the study of the symptoms of the disease, the results of the differential diagnosis of herpes infection and the patient’s immune status. You will get all this by contacting the H-Clinic Infection Clinic.

Prices for complex treatment of herpes in Moscow

The H-Clinic employs experts who specialize in infectious diseases. We regularly monitor new ways of treating herpes and apply in practice only methods of evidence-based medicine, which we select taking into account the characteristics of the patient’s health. Modern drugs can cope with the disease, improve the quality of life of the patient. But the main thing is that a timely course of treatment for acute or chronic herpes, control of relapses, especially during pregnancy and in the case of a positive HIV status, helps prevent the transmission of the virus, the development of severe complications and infection of the fetus during childbirth.

The terms of treatment of herpes with shallow lesions of the mucous membranes and skin, on average, are 5-7 days. Severe forms of the disease and internal herpes affecting the nervous system may require a longer period of therapy.

You can quickly cope with a herpes infection only under the supervision of a qualified doctor, following the recommendations and taking the prescribed drugs according to the scheme. Upon completion of the course of therapy, the presence of the virus in the patient’s body is monitored.

To clarify the cost of herpes treatment and sign up for an initial consultation with an infectious disease specialist, please call +7 (495) 191-11-40

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Doctors 10

Konnov Danila Sergeevich

Head of the infectious diseases department of the clinic, infectious diseases doctor, candidate of medical sciences

Shakhgildyan Vasily Iosifovich

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Read about herpes viruses

Herpes vaccine

Herpes simplex virus type 1 and 2 infection is extremely common widespread on the planet. WHO estimates that 3.7 billion people under 50 years of age (67% of the total population) have herpesvirus type 1 infection, and 417 million (11%) aged 15-49 years are infected with herpesvirus type 2. Herpesvirus type 1 is transmitted mainly through oral contact, type 2 is more often transmitted sexually.

Genital herpes: how to recognize and where to treat

Genital herpes is a chronic viral infection that can be caused by herpes simplex viruses type I and II. Previously, it was believed that this infectious disease is caused only by the second type of virus, and the “cold” on the lips is the antics of the type 1 virus, but oral sex has changed our lives.

What, how and when appears on the skin – what to do about it?

The skin and mucous membranes are a whole vast world in which the unimaginable can happen.

Chickenpox

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Epstein-Barr virus infection: myths and reality

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Infections from oral sex

Many people believe that oral sex is much safer in terms of transmitting infections, but this is not the case.

How to remove herpes from the body forever. Rapid treatment of herpes

Date of publication: 06/08/2021

THERE ARE CONTRAINDICATIONS. SPECIALIST CONSULTATION IS REQUIREDFor immunityAntipyretic for adultsAnti-inflammatory dropsImmunity strengthening

0

• Causes of herpes and first symptoms
• Medicines for herpes
• Scientists in search of an effective remedy against herpes

Herpes, or herpes infection, is a disease caused by viruses of the Herpesviridae family. Science knows eight species, among which the most common Herpes simplex simple type: herpes simplex virus type 1 (HSV-1, oral) and herpes simplex virus (HSV-2, genital).

The first – affects the lips and oral cavity, the second – the genitals and anus, which determines the methods of infection. HSV-1 is transmitted by airborne droplets, through kissing, personal hygiene or household items, HSV-2 through sexual contact, during childbirth or breastfeeding.

Once in the body, the virus remains in it forever. Therefore, it is impossible to get rid of herpes, but it is quite possible to prevent the progression of the disease if you follow certain hygiene rules, change your eating habits and use certain medications.

The causes of herpes and the first symptoms

The virus enters the body through the mucous membranes and respiratory tract to hide inside the host cell and become completely inaccessible to immune cells. Therefore, the latter are not able to fulfill their main function – to destroy the pathogen.

The disease may not manifest itself. Symptoms may occur due to the following factors:

• Weakened immunity after past illnesses, stress, sleep disturbances and physical exertion
• Hypothermia or overheating of the body, prolonged exposure to the wind
• Against the background of cold infections
• Injuries, surgical interventions
• The use of medicinal or cosmetic products based on steroid hormones.
• Hypovitaminosis, regardless of the season

Due to these factors, skin reactions characteristic of the disease appear on the face or genitals, which progress in the following order:

1. The affected area of ​​the skin becomes swollen and painful.
2. There is itching, burning, tingling.
3. Within 1-2 days, a dense infiltrate appears in this place, which turns into a bubble with a clear liquid (not one, but several rashes are possible).
4. A sore with a yellowish film forms in place of the ruptured vesicle, which gradually dries up.
5. The wound heals when the virus is deactivated.

The defeat of the oral cavity is accompanied by pain, which disappears appetite and thirst. Often, the temperature may rise, body aches or headaches may appear. Genital herpes, in addition to the listed symptoms, causes painful or difficult urination.

Relapses of HSV, which occur no more than 4-5 times a year, should not be of particular concern. But if more often, it is necessary to conduct a comprehensive examination, including PCR diagnostics. This will help to select the appropriate treatment and prevent the complication of the infection, which can lead to chronic fatigue, provoke oncological, nervous and immune diseases, cause decreased vision, the appearance of thorns and blindness. HSV-2 is the cause of infertility, miscarriage, fetal defects, stillbirth.

Medicines for herpes

In case of infection on the lips and body, complex therapy is used, which includes:

• Antiviral drugs that deactivate the virus, such as Acyclovir and its analogue Zovirax.
• Anti-inflammatory, analgesic and antipyretic to relieve pain and reduce fever (if needed).
• Immunostimulants aimed at activating the body’s defenses.
• Vitamin complexes.
• Special diet enriched with proteins, dairy products, vegetables, fruits and herbs.
• Drink plenty of water: herbal teas, fruit drinks, non-carbonated drinking water.

When answering the question of how to remove herpes from the body forever, many doctors agree that: intestines and weaken the immune system.

Scientists in search of an effective remedy against herpes

The herpes simplex virus (HSV) is recognized not only as a medical but also as a social problem, because according to WHO statistics, about 4 billion people under the age of 50 are active carriers of the virus. Therefore, scientists are faced with the task of finding a remedy that can defeat a herpes infection.

Dutch specialists from the Medical Institute of Utrecht University, working on the problem, came to the conclusion that herpes can be completely removed from the body with the help of genes, if the DNA chain of the virus is edited by breaks. Studies conducted on human and monkey cells showed that breaking the chain once, HSV activity is reduced by 50%, and if two, it disappears by 95% from the cells.

In parallel, this theory was confirmed by American scientists from the Department of Vaccines and Infectious Diseases at the Fred Hutchinson Center. They cut the DNA of the virus with two sets of genetic scissors (meganucleases), and proved that the DNA of the virus is regenerated using one pair. But having made an impact with two sets at the same time, the cell disintegrates, and the content of “sleeping” herpes in the body decreases to 8%, and such indicators persist for a month.