Treating HSV-1: CDC’s Guidance on Genital Herpes Treatment
How can you treat HSV-1 infection? What are the latest CDC recommendations for managing genital herpes? Get the facts.
Understanding HSV-1 Infection and Genital Herpes
Herpes simplex virus type 1 (HSV-1) is a common viral infection that primarily causes oral herpes, resulting in cold sores or fever blisters. However, HSV-1 can also lead to genital herpes in some cases. Genital herpes is a sexually transmitted infection (STI) that can cause painful blisters and sores around the genitals, rectum, and surrounding areas.
CDC Recommendations for Treating HSV-1 Genital Herpes
The Centers for Disease Control and Prevention (CDC) provides comprehensive guidance on the treatment of genital herpes caused by HSV-1 infection. Here are the key points from their recommendations:
Antiviral Medications
The CDC recommends the use of antiviral medications as the primary treatment for genital herpes caused by HSV-1. These medications can help reduce the severity and duration of outbreaks, as well as lower the risk of transmitting the virus to sexual partners.
The three main antiviral medications approved for the treatment of genital herpes are:
- Acyclovir
- Valacyclovir
- Famciclovir
These medications can be prescribed for both episodic (outbreak-specific) and suppressive (long-term) therapy, depending on the individual’s needs and the severity of their condition.
Episodic Treatment
For individuals experiencing an active outbreak of genital herpes, the CDC recommends episodic treatment with antiviral medications. This involves taking the medication at the first sign of an outbreak to help reduce the duration and severity of the symptoms.
The recommended dosage for episodic treatment is:
- Acyclovir: 400 mg three times a day for 5-10 days
- Valacyclovir: 1 gram twice daily for 5-10 days
- Famciclovir: 250 mg three times a day for 5-10 days
Suppressive Therapy
For individuals with frequent or severe outbreaks of genital herpes, the CDC recommends considering suppressive therapy with antiviral medications. This involves taking the medication daily to help prevent or reduce the frequency of future outbreaks.
The recommended dosages for suppressive therapy are:
- Acyclovir: 400-800 mg twice daily
- Valacyclovir: 500-1000 mg once daily
- Famciclovir: 250 mg twice daily
Managing Genital Herpes Outbreaks
In addition to antiviral medication, the CDC also recommends the following strategies for managing genital herpes outbreaks:
Pain Management
Over-the-counter pain medications, such as acetaminophen or ibuprofen, can help alleviate the pain and discomfort associated with genital herpes outbreaks. Topical anesthetic creams or gels may also provide relief.
Sitz Baths
Soaking the genital area in warm (not hot) water can help soothe pain and promote healing during an outbreak.
Avoiding Sexual Activity
Individuals with an active genital herpes outbreak should abstain from sexual activity to prevent the transmission of the virus to their partners.
Preventing the Spread of HSV-1 Genital Herpes
To reduce the risk of transmitting HSV-1 genital herpes to sexual partners, the CDC recommends the following preventive measures:
Disclosure and Communication
Individuals with genital herpes should inform their sexual partners about their condition and discuss ways to reduce the risk of transmission, such as using condoms and avoiding sexual activity during outbreaks.
Asymptomatic Viral Shedding
Even in the absence of visible symptoms, individuals with genital herpes can still shed the virus and potentially infect their partners. Using antiviral suppressive therapy can help reduce the risk of asymptomatic viral shedding.
Seeking Medical Care
Individuals with suspected genital herpes should seek medical attention for proper diagnosis and treatment. A healthcare provider can perform diagnostic tests, such as a viral culture or PCR test, to confirm the presence of HSV-1 and rule out other possible causes of the symptoms.
Prompt and effective treatment, combined with preventive measures, can help individuals with HSV-1 genital herpes manage their condition and reduce the risk of transmission to their partners.
Herpes simplex: Diagnosis and treatment
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Herpes Simplex (HSV-1 & HSV-2) Virus: Symptoms, Diagnosis, Treatment
Written by WebMD Editorial Contributors
- What Causes Herpes Infections and Outbreaks?
- What Are the Symptoms of Herpes Simplex?
- How Is Herpes Simplex Diagnosed?
- How Is Herpes Simplex Treated?
- How Painful Is Herpes Simplex?
- Can Herpes Be Cured?
- More
Herpes simplex viruses — more commonly known as herpes — are categorized into two types: herpes type 1 (HSV-1, or oral herpes) and herpes type 2 (HSV-2, or genital herpes). Most commonly, herpes type 1 causes sores around the mouth and lips (sometimes called fever blisters or cold sores). HSV-1 can cause genital herpes, but most cases of genital herpes are caused by herpes type 2.
In HSV-2, the infected person may have sores around the genitals or rectum. Although HSV-2 sores may occur in other locations, these sores usually are found below the waist.
Herpes simplex type 1, which is transmitted through oral secretions or sores on the skin, can be spread through kissing or sharing objects such as toothbrushes or eating utensils. In general, a person can only get herpes type 2 infection during sexual contact with someone who has a genital HSV-2 infection. It is important to know that both HSV-1 and HSV-2 can be spread even if sores are not present.
Pregnant women with genital herpes should talk to their doctor, as genital herpes can be passed on to the baby during childbirth.
For many people with the herpes virus, which can go through periods of being dormant, attacks (or outbreaks) can be brought on by the following conditions:
- General illness (from mild illnesses to serious conditions)
- Fatigue
- Physical or emotional stress
- Immunosuppression due to AIDS or such medications as chemotherapy or steroids
- Trauma to the affected area, including sexual activity
- Menstruation
Symptoms of herpes simplex virus typically appear as a blister or as multiple blisters on or around affected areas — usually the mouth, genitals, or rectum.
The blisters break, leaving tender sores.
Often, the appearance of herpes simplex virus is typical and no testing is needed to confirm the diagnosis. If a health care provider is uncertain, herpes simplex can be diagnosed with lab tests, including DNA — or PCR — tests and virus cultures.
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.
Some people experience very mild genital herpes symptoms or no symptoms at all. Frequently, people infected with the virus don’t even know they have it. However, when it causes symptoms, it can be described as extremely painful. This is especially true for the first outbreak, which is often the worst. Outbreaks are described as aches or pains in or around the genital area or burning, pain, or difficulty urinating.
Some people experience discharge from the vagina or penis.
Oral herpes lesions (cold sores) usually cause tingling and burning just prior to the breakout of the blisters. The blisters themselves can also be painful.
There is no cure for herpes simplex. Once a person has the virus, it remains in the body. The virus lies inactive in the nerve cells until something triggers it to become active again.
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Herpes simplex – symptoms and diagnosis, prices for the treatment of herpes simplex in Moscow at the Hadassah clinic
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Herpes simplex (herpes virus type 1,2) is an infectious disease that manifests itself mainly in the appearance of blisters on the skin or mucous membranes.
Symptoms occur mainly in the lips, eyelids or genitals. Herpes affects more women than men. Herpes simplex type 1 is the main cause of
blisters characteristic of this disease in the lips. Herpes simplex type 2 blisters appear mainly in the genital area. The disease of herpes simplex most often does not lead to death. It can be life-threatening for infants (if the virus enters the brain and causes encephalitis) and for patients with weakened immune systems.
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Symptoms of a herpes infection
HSV-1 manifests itself as transparent and fluid-filled blisters. Herpes simplex virus type 1 rarely causes pimples on the genitals – mostly on the face. When initially infected with the virus, acne appears only in about 10% of patients 2-20 days after contact with an infectious person. There may be several wounds or one. Before the appearance of acne, there are such precursors as itching and burning of the skin.
A pimple may burst when struck or scratched and release fluid.
After the wound heals, a crust remains on it, which dries up and leaves. The duration until recovery is about 10 days. At the end of the recovery, the skin usually recovers completely.
Even after the initial wound has healed, the virus remains in the body. It penetrates the nerve cells and remains in them in an inactive state until the right conditions arise. Any “awakening” can cause bubbles to appear in or near the same spot.
Primary infection with herpes simplex virus type 2 usually manifests as blisters on the surface of the genitals, buttocks, or cervix 2-20 days after exposure to a carrier of the virus. Herpes simplex virus type 2 can cause symptoms to appear elsewhere, but it usually attacks below the waist. A second outbreak of the virus can cause the symptoms of a herpes infection, such as itching, painful pimples, fever, muscle pain, and burning when urinating.
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Causes of herpes simplex
The herpes virus is transmitted by direct contact of infected skin with the skin of a healthy person, in the mouth or genital area. The penetration of the virus is possible only through a skin defect (wound or scratch), mainly in the area of the penis and vulva, rectum and cervix.
In most cases, herpes simplex type 1 infection occurs in childhood through close contact with peers or family members who are carriers of the virus. The infection can be transmitted with a kiss, through ordinary cutlery or lipstick.
Herpes type 2 infection usually occurs through sexual contact with a carrier of the virus.
The virus is present in 20% of sexually active people. As far as we know, this form of infectious disease (genital herpes type 2) cannot be contracted through contact with objects such as a toilet seat, toilet paper or towel. This is because the herpes virus is very sensitive to environmental conditions and does not survive outside the body.
Among the predisposing factors activating the “dormant” virus in the body, it should be noted:
- colds;
- fever;
- prolonged sun exposure;
- menstrual cycle;
- severe emotional stress;
- injury to the skin or mucosa.
With both types of herpes simplex, the recurrence rate can vary. Pimples can spread to different parts of the body due to constant scratching.
Methods for diagnosing herpes virus 1.2 type
Herpes is relatively easy to diagnose. Usually, the diagnosis of herpes type 1.2 is necessary for patients suffering from impaired immune function, those undergoing chemotherapy and patients with AIDS.
The following diagnostic measures are recommended:
Laboratory tests
include microscopic and other tests of blood or fluid from the pimple to detect antibodies against the virus; some tests are valid only in the initial stages of the disease
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Treatments for herpes simplex
Existing technologies do not allow to clear the hereditary material of the virus from the DNA of nerve cells, and the displacement of the ganglia will cause much more acute side effects (for example, paralysis of the lips). That is why today the disease is incurable.
Treatment for herpes simplex is directed at controlling the symptoms and preventing complications. Antiviral drugs used to treat rashes are prescribed (Acyclovir, Gerpevir, etc.)
After stopping the acute process, a herpes vaccine is recommended, which allows achieving a stable remission. Among the physiotherapeutic methods of treatment, infrared and UV radiation, OCU therapy and laser therapy should be distinguished.
Treatment of herpes simplex in the Hadassah clinic
For the treatment of herpes types 1 and 2, please contact the Hadassah clinic in Moscow. We have doctors with extensive practical experience, we have modern equipment that simplifies the diagnosis.
Text checked by an expert doctor
Shilov
Dmitry Yurievich
Allergist-immunologist, Ph.D.
Work experience: 17 years
Published: 07/11/2023
The information provided on the site is for reference only and cannot serve as a basis for making a diagnosis or prescribing treatment. Internal consultation of the expert is necessary.
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| Allergological studies (skin scarification or prick testing), test control and histamine | 660 RUB | |
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Treatment of herpes simplex virus type 1 and 2 in Kyiv – consultation price from 650 UAH
Herpes simplex virus (HSV) – is considered the most common disease among viral infections.
According to unconfirmed reports, up to 90% of people from all over the planet are infected with HSV.
Prices for the treatment of herpes virus type 1 and 2
| Appointment with a neurologist (consultation, examination) | 650 ₴ | ||||||
| Repeated appointment with a neurologist (consultation, examination) | 550 ₴ | ||||||
| General detailed blood test (22 analyzer parameters, ESR, leukocyte formula) – execution time 1 day. | 200 ₴ | ||||||
| PCR. Determination of DNA of the herpes virus (HSV 1.2) (scraping, quantitatively) – execution time 1 day. | 300 ₴ | ||||||
PCR. – execution time 1 day. | 300 ₴ | ||||||
Antibodies of IgM to herpes virus type 1 HSV – execution time 3 days. | 220 ₴ | ||||||
Antibodies of IgM to herpes virus type 2 HSV – execution time 3 days. | 220 ₴ | ||||||
Avidity of IgG antibodies to herpes virus type 2 – execution time 5 days. | 300 ₴ | ||||||
PCR. Determination of the DNA of the herpes virus type 6 (HSV type 6) (Blood, cerebrospinal fluid. Qualitative determination.) – execution time 3 days. | 280 ₴ | ||||||
Antibodies Ig G to herpes virus type 6 HSV – execution time 4 days. | 300 ₴ | ||||||
Complex “Herpes virus infection of antibodies Ig G” (VCA, CMV, HSV 1, HSV 2) – execution time 2 days. | 800 ₴ | ||||||
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Determination of DNA of the herpes virus (HSV 1 and HSV 2). Real-time detection and typing
Herpes simplex virus (HSV) – is considered the most common disease among viral infections. According to unconfirmed reports, HSV infected up to 90% of people from all over the planet. Usually, the virus proceeds without pronounced symptomatology, since in the process of infection entering the body, a person begins to “create” antibodies that prevent the herpes virus from actively multiplying. Almost all adults have specific antibodies to the herpes simplex virus.
100% to identify the type of HSV, guided only by the affected area, is not possible. According to various sources, 10-30 percent of the inhabitants of different countries who were examined had various types of mixed viral lesions of HSV types 1 and 2.
The reason for this is that the herpes virus is very common among oral and genital contacts, in which type 1 HSV can “move” from the lips of one person to the partner’s genitals, or, conversely, the virus from the genitals can move to the mucous membranes of the oral cavity.
Herpes type 1
Herpes infection type 1 is a pathology of an agent that provokes a rash on the skin, small blisters, also called “colds”. The causative agent Herpes belongs to the Herpesviridae family. Many of us have encountered this disease, it is quite common today and is the least dangerous of all types of herpes. HSV-1 can only be contracted from a sick person, in whose body the virus itself is present in a latent state, or from an already sick person. How is herpes infection type 1 transmitted? HSV-1 can be contracted as follows:
- Direct contact between the healthy and the sick.
- Airborne route.
- Through personal care products.
To a child from the mother during gestation and delivery.
The virus is transmitted through the placenta, penetrating the uterine organ, or directly through the contact of the integument of the child with the birth canal of the woman in labor.
The virus enters the body through the mucous membranes with overcoming protection. After that, it enters the nerve cells, where it begins to multiply rapidly, and its particles are introduced into human genes. During this period, immunity is activated, so HSV particles go into the nerve ganglia, saving themselves, and waiting for the moment when human immunity weakens.
At this time, the virus begins to multiply again, the symptoms of the disease appear, and the herpes infection becomes more active among people. In other words, there is a difference between a primary herpes infection, which develops when HSV enters the body for the first time, and a secondary one, in which the disease develops at the time of immune problems, and the persistent virus begins to multiply rapidly. So, in most cases, the disease is caused by the herpes virus that is already present in the human body.
The development of pathology often includes 4 stages, which are characterized by their own symptoms. Signs of type 1 herpes infection include the following negative manifestations:
- The patient feels tingling. In the area on the body where HSV will develop in the near future, a pain syndrome appears, begins to pinch, tingle, severe itching and redness develop.
- An inflammatory process begins when a small bubble appears that hurts. It is filled with a clear liquid and eventually begins to grow in size.
- Sores appear when the shell of the vesicle is damaged, a liquid flows out of it, in which there are a large number of viral particles. At this time, the person is most contagious and an ulcer can be seen at the site of the bubble.
- Scab formation develops.
During this period, a crust forms under the ulcer. If you break its surface, then blood will flow and pain will appear. Subsequently, the ulcer will pass without a trace.
The rash on the skin completely disappears in one to two weeks. It is important to carry out symptomatic treatment, which will be prescribed by an experienced doctor. If left untreated, the manifestations will also pass, but this will drag on for a long time.
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Treatment of herpes simplex type 1
If the infection with the virus is primary, then it may be necessary to visit an infectious disease specialist, and with subsequent manifestations of a chronic infection, negative manifestations of the disease can be prevented by using medicines created on the basis of acyclovir.
If a person has time to smear the sore spot with ointment, when the pathology is only at the first stage, then it is possible to avoid the development of the following symptoms of the pathology. If the disease is difficult, then the doctor may prescribe antiviral drugs in tablet form. If a person often encounters a recurrence of a herpes infection, then you should think about strengthening the immune system.
After consulting a doctor, you can use various kinds of immunomodulators. But, any drug can be used only as prescribed by the attending infectious disease specialist.
Herpes simplex virus type 2
Herpes simplex type 2 infection is also very common. Moreover, the incidence caused by the HSV-2 virus is increasing year by year, and this seriously worries the World Health Organization (WHO), since HSV belongs to TORCH infections – pathologies that cause severe developmental anomalies in a child in the womb. HPV-2, unlike HPV-1, is usually transmitted sexually.
Therefore, infection often occurs with the onset of sexual activity, usually adolescents get sick. Just like other types of HSV, the second type virus once entered the human body, remains there forever.
If a person’s immune system is all right, he may not even notice that an infection has occurred, and with a decrease in immunity, a relapse of the disease will occur. It is not uncommon for a primary herpetic infection to develop. This happens, as a rule, a few days after infection (the incubation period can last up to 21 days). HSV-2 is rarely diagnosed in children, they are more likely to be infected with HSV-1 with damage to the lips, oral mucosa and pharynx. However, infection of the baby with HSV-2 cannot be ruled out, especially if he sleeps in the same bed with an adult with HSV-2.
HSV-2 in a child can also occur when infected from a patient with labial herpes, if it is provoked not by HSV-1, but by HSV-2.
Symptoms of herpes type 2
Primary herpes infection caused by HSV type 2 is more severe and longer than subsequent relapses.
The disease can begin with a slight increase in body temperature, general weakness, pain in the head. Against this background, red lesions appear on the mucous membranes and skin of the genital organs, as well as on the perineum and inner thighs, and swelling develops.
Within a few hours or days, the development of edema increases, and then rashes appear at the site of the lesion in the form of a group of small bubbles that can join together to form large bubbles. The bubbles burst pretty quickly, turning into erosions and ulcers that hurt a lot. On the skin, small ulcers are covered with crusts after a few days, after falling off, which usually do not leave any traces on the skin. But sometimes, dark or colorless spots may remain, which disappear after 2-3 weeks.
There are no crusts on the mucosa, but here, as a rule, no traces remain. The acute period lasts 14-21 days. Relapses of genital herpes usually occur within 12 months after infection, then they gradually become less frequent and prolonged.
The relapse is not as severe as the primary herpes and lasts about a week and a half.
Why is genital herpes dangerous? If herpes recurs very often and is not treated, the infection can spread to the internal genital organs and provoke inflammation. Inflammation, in turn, can lead to sexual dysfunction in men / women. Primary herpes is especially dangerous, the prevalence of which is high for pregnant women. When HSV-2 enters the body of a woman in a position that does not have antibodies to this infectious agent, the herpes virus can infect a child, causing his death in the early stages and severe developmental anomalies at later stages.
Relapses of herpes in a woman who acquired the infection before conception, and she had time to develop immunity to HSV-2, are less dangerous – usually, immunity does not allow the virus to enter the fetus. However, one way or another, there is a danger of infection of the fetus during delivery during its passage through the birth canal.
In this case, the infection in the baby is very difficult.
Treatment of herpes virus type 2
How to treat herpes infection type 2? Antiviral drugs are used to treat this pathology. In particular, it is important to prescribe adequate and timely therapy for primary herpes. Timely prescribed therapeutic measures can suppress the manifestation of the disease for a long time.
Genital herpes causes HSV-2, the therapy of this pathology is carried out mainly with the help of systemic antiviral drugs. The dosage and course of application of any antiviral medication is determined by the doctor on an individual basis. Immunomodulators of the general effect are also prescribed, mainly based on interferons.
Topical treatment is often prescribed in the complex – in the form of creams, ointments and gels with antiviral and immune-modulating effects. HSV-2 provokes a sexual infection, which can affect and cause severe consequences during the period of bearing a child.
Diagnosis of HSV types 1 and 2
Diagnosis of the virus consists in the determination of antibodies to HSV-1 and HSV-2 – LgG and LgM. For diagnosis, you need to pass a general and biochemical blood test. According to statistics, most people on the planet have antibodies to herpes. But the study of TITR antibodies, over a period of time, gives much more information about the presence of herpes in the human body.
LgM antibodies to HSV persist in the blood for approximately 30-60 days, while LgG antibodies last a lifetime. So LgM antibodies tell the doctor about the primary infection. If the LgM titers at the time of the test do not exceed the norm, but the LgG antibodies are elevated, this indicates a chronic form of herpes in the body.
LgM markers increase only during the acute phase of the pathology. The presence of LgG antibodies in the blood indicates that a person is a carrier of the virus.
Treatment of HSV types 1 and 2
The treatment of herpes has the following features:
- It is impossible to completely kill the virus.
