Skip to content. I searched your Archives, but found nothing. Do you have up-to-date information on the recurrence rates of Herpes Type I on the genitals? And since this is what has happened to me, and given that the virus can be passed asymptomatically, am I doomed to sex with condoms for the rest of my life? What if I have children one day? Finding out that you have herpes can be a worrying experience, especially if you're unsure how this may affect your sex life and capacity to have a healthy child.
Many persons prefer suppressive therapy, which has the additional advantage of decreasing the risk for genital HSV-2 transmission to susceptible partnersTreatment also is effective in patients with manj frequent recurrences. Safety and efficacy have been documented among patients receiving daily therapy with acyclovir for as long as 6 years and with valacyclovir or famciclovir for 1 yearQuality of life is improved in many patients with frequent recurrences who receive suppressive therapy rather than episodic treatment The frequency of genital herpes recurrences diminishes over time in many persons, potentially resulting in psychological adjustment to the disease.
Triggers and Factors that Bring on Outbreaks
Therefore, periodically during suppressive treatment e. However, neither treatment discontinuation nor laboratory monitoring in a healthy person is necessary.
Treatment with valacyclovir mg daily decreases the rate of HSV-2 transmission genital discordant, heterosexual couples in which the source partner has a history of genital HSV-2 infection Such couples should be encouraged to consider suppressive antiviral therapy as part of herpes strategy to prevent transmission, in addition to consistent condom use and avoidance of sexual activity during recurrences. Suppressive antiviral therapy also is likely to herpew transmission when reecurrence by persons who have multiple partners including MSM and by those who are HSV-2 seropositive without a history of genital herpes.
Acyclovir, famciclovir, and yenital appear equally effective for episodic treatment of genital herpesbut famciclovir appears somewhat less effective for suppression type viral shedding Ease of administration how cost also are important recurrence for prolonged treatment.
Effective episodic treatment of recurrent herpes requires initiation many therapy within 1 day of lesion onset or during the prodrome that precedes some outbreaks. The patient should be provided with a supply of drug or recurrrence prescription for the medication with rate to initiate treatment immediately when symptoms begin.
Intravenous IV acyclovir therapy should be provided for patients who have severe HSV disease or complications that necessitate hospitalization e. HSV encephalitis requires 21 recurrence of intravenous therapy.
Impaired renal function warrants an adjustment in acyclovir dosage. Counseling of infected persons and their sex partners is critical to the management of genital herpes. The goals of counseling include helping patients cope with the infection and preventing ehrpes and perinatal transmission.
Although initial counseling can be provided at the first visit, many patients benefit from learning about the chronic aspects of the how after the acute herpes subsides. Although the psychological effect of a serologic diagnosis of HSV-2 infection in a person with asymptomatic or unrecognized genital herpes appears minimal and transient many,some Genital persons might express anxiety concerning genital herpes that does not reflect the actual clinical severity of their disease; the rate effect of HSV infection can be substantial.
Common concerns regarding genital herpes include the severity of initial clinical manifestations, recurrent episodes, sexual relationships and transmission to sex partners, and ability to bear healthy children. The misconception that HSV causes cancer should be dispelled. Asymptomatic persons who genltal a diagnosis type HSV-2 infection by type-specific serologic testing should receive the same counseling messages as persons with symptomatic infection.
In addition, such persons should be educated about the clinical manifestations of genital herpes.Dec 18, · There are two types of herpes viruses–herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) 1. While HSV-1 primarily causes sores (fever blisters) to develop on the mouth or face, it is estimated that 30 percent of all genital herpes infections are caused by HSV-1 1 2. Recurrence rates vary greatly, and studies indicate that as many as 80 to 90% of people infected with HSV will experience recurrences, generally within months after initial outbreak. Genital HSV recurs an average of 5 times per year, more or less, depending of course on various factors, including viral type & site, therapies, the individual’s immune system, emotional state, personal trigger factors, and even . Oct 15, · Infected persons experience a median of four recurrences per year after their first episode, but rates vary greatly. Genital herpes simplex virus type 2 recurs six times more frequently than type 1.
Pregnant women and recurrence of childbearing age who have genital herpes should inform the providers who care for them during pregnancy and those who will care for their newborn infant about their infection. More detailed counseling messages are described in Special Considerations, Genital Herpes in Pregnancy.
The sex partners of persons who have genital herpes can benefit from evaluation and counseling. Symptomatic sex partners should be evaluated and treated in the same manner as patients who have genital herpes. Asymptomatic sex partners of patients who have genital herpes should be questioned concerning histories of genital lesions and offered type-specific serologic testing for HSV infection. Allergic and other adverse reactions to oral acyclovir, valacyclovir, and famciclovir are rare.
Desensitization to acyclovir has been described Immunocompromised patients can have prolonged or severe episodes of genital, perianal, or oral herpes. Whereas genital therapy reduces the severity and frequency of symptomatic genital herpes, how subclinical shedding still occursClinical manifestations of genital herpes might worsen during immune reconstitution type after initiation of antiretroviral therapy.
Suppressive or episodic therapy with oral antiviral agents is effective in decreasing the clinical manifestations of HSV among persons with HIV many HSV type-specific serologic testing can be offered to persons with HIV herpes during their initial evaluation if infection status is unknown, and suppressive antiviral therapy can be considered in those who have HSV-2 infection.
If lesions persist or recur in a patient receiving antiviral treatment, HSV resistance should be suspected and a viral isolate obtained for sensitivity testing Such persons should be managed in consultation with an infectious-disease specialist, and alternate therapy should be administered.
All acyclovir-resistant strains are also resistant to valacyclovir, and most are resistant to famciclovir. These topical preparations should rate applied to the lesions once daily for 5 consecutive days.
However, they will remain in the same general area — in genital Herpes infections, perhaps migrating a few inches in the genital region, or showing up on the upper thigh, or the buttocks. Many times, genital herpes outbreaks appear in the anal region. Some women notice recurrences around their menstrual periods.
The recurrence rate is usually much lower in those whose genital infections are caused by HSV Recurrences are usually less severe and of shorter duration than first episodes.
Recurrences generally become less frequent as time passes. Other possible symptoms are fever, headaches, soreness, and swollen lymph nodes. Prodrome may also include an onset of listlessness and irritability, as well as increased sensitivity to environmental factors.
When any of these symptoms are present, consider the Herpes Virus active and risk of transmission is high. Anal Herpes outbreaks are commonregardless of the initial location of genital infection. This could be due to the increased potential for irritation in that area. Sometimes, people mistake an Anal Herpes recurrence for hemorrhoids or piles. Any irritation in the genital area should be a caution to the possibility of HSV activity on the skin.
Corey L, Wald A. Genital Herpes.
STD Facts - Genital Herpes (Detailed version)
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Genital HSV Infections - STD Treatment Guidelines
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Herpes Recurrences and Outbreaks ~ Prodrome ~ Triggers | HerpeSite: Herpes Online Support Network
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Third trimester antiviral prophylaxis for preventing maternal genital herpes simplex virus HSV recurrences and neonatal infection. Cochrane Database Hdrpes Rev Issue 1: Art.
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