Herpes
Genital herpes is a sexually transmitted disease (STD) caused by the herpes simplex viruses type 1 (HSV-1) or type 2 (HSV-2).
Most genital herpes is caused by HSV-2. Most individuals have no or minimal signs or symptoms from HSV-1 or HSV-2 infection. When signs do occur, they typically appear as one or more blisters on or around the genitals or rectum. The blisters break, leaving tender ulcers (sores) that may take two to four weeks to heal the first time they occur.
Typically, another outbreak can appear weeks or months after the first, but it almost always is less severe and shorter than the first outbreak. Although the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years.
Treatments for Herpes
Acyclovir, Famciclovir, and Valacyclovir are antiviral medicines used to treat genital herpes.
All are effective, but because Valacyclovir and Famciclovir are absorbed better by the stomach, they can be taken less often than acyclovir.
Antiviral medicines are usually taken by mouth (orally), although they are sometimes given intravenously (IV) in severe genital herpes outbreaks or herpes in newborns.
The topical form of acyclovir (Zovirax ointment) offers little benefit in the treatment of genital herpes and is not recommended.
Antiviral medicines stop the growth of the herpes simplex virus (HSV).
Antiviral medicines may be given to:
• People who are having a primary outbreak of genital herpes.
• People who have frequent (about 6 or more a year) recurrent outbreaks of genital herpes.
• People who want to decrease the length and severity of their recurrent outbreaks.
• People who want to decrease the possibility of unintentionally transmitting the virus.
• Genital herpes is more likely to be transmitted during the first year of infection, even though a person may not have symptoms of a genital herpes outbreak.
• Pregnant women who are having a primary outbreak of genital herpes.
• Women in the last 4 weeks of their pregnancy who are having frequent recurrent outbreaks.
• People who have impaired immune systems and recurrent outbreaks.
How Well It Works
- Initial outbreak
Antiviral medicines may significantly lessen the severity of an outbreak of genital herpes and reduce the time it takes an outbreak to heal.
The medicine also decreases the number of days of painful symptoms, and for some people, decreases the number of days you can spread the virus.
- Recurrent outbreaks
Antiviral medicine is most effective if it is taken when you first notice the prodromal symptoms (tingling and pain) of a recurrent genital herpes outbreak and if it is taken for the next 5 to 7 days or until symptoms go away.
Some people with frequent recurrent outbreaks (more than 6 recurrences a year) take antiviral medicine every day (suppressive therapy) to help reduce the frequency and duration of recurrent outbreaks. Antiviral medicine can reduce the number of outbreaks by 70% to 80%.
Research shows that acyclovir has been safely used long-term for as long as 6 years and valacyclovir or famciclovir for 1 year.
Research shows that an HSV-infected person in a heterosexual, single-partner (monogamous) relationship who takes valacyclovir daily in the doses used for suppressive therapy to prevent recurrent outbreaks reduces the risk of infecting his or her partner. Other antiviral medicines may also reduce transmission but further study is needed.
- Side Effects include:
• Headache, lightheadedness, or feelings of general illness (malaise)
• Nausea and vomiting
• Decreased appetite or abdominal pain
• Joint pain
• Diarrhea or constipation (rare)
• Kidney problems in people who receive large doses of intravenous acyclovir (rare).
