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Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Expression of concern regarding paper by Park et al, published on 25 June 2015: “Epidemiological investigation of MERS-CoV spread in a single hospital in South Korea, May to June 2015”, Euro Surveill.
It has been brought to our attention that some of the authors may not have been informed about the content of the above paper.
Citation style for this article: Hill C, McKinney E, Lowndes CM, Munro H, Murphy G, Parry JV, Gill ON, the GUM Anon Network. The objective was to investigate herpes simplex virus (HSV) epidemiology amongst HIV-positive and HIV-negative men who have sex with men (MSM) in England and Wales. Samples were drawn from the National Unlinked Anonymous Survey of Genito-Urinary Medicine Clinic Attendees (GUM Anon) [16] serum archive, which includes unlinked anonymous residual blood specimens collected for routine syphilis serology at representative sentinel sexual health clinics across England and Wales. The study included a randomised age-stratified sample of 3,968 specimens from a total of 8,463 specimens obtained from MSM attending twelve sentinel sexual health clinics (seven in London and five elsewhere across England and Wales) during 2003. The legal and ethical basis for unlinked anonymous HIV testing was established before the programme began and is consistent with the Human Tissue Act 2004 and other guidelines [24]. Sixteen percent (CI: 15%-17%) of the study population were HIV-positive according to unlinked anonymous HIV antibody testing. The prevalence of HSV-2 in this study is similar or lower than those found amongst HIV-positive and HIV-negative MSM in studies elsewhere in Europe, the Americas and Australia [8]. This study also showed that seven in 10 MSM were HSV-1-positive, a rate similar to that found in other high-risk groups in Europe [8]. We thank the clinical and lab staff who collaborate in the GUM Anon survey (institutions listed below). Disclaimer: The opinions expressed by authors contributing to Eurosurveillance do not necessarily reflect the opinions of the European Centre for Disease Prevention and Control (ECDC) or the editorial team or the institutions with which the authors are affiliated. This is usually followed by painful, small blisters that pop and leave sores that ooze or bleed. It is intended for general informational purposes only and does not address individual circumstances. Unlinked anonymous sera from 3,968 MSM attending 12 sexual health clinics in 2003 were tested for HIV, HSV-2 and HSV-1 antibodies. In the UK as elsewhere in Western Europe, there are high rates of sexually transmitted infections (STI) (other than HSV) amongst MSM, particularly HIV-positive MSM [12,13], and there have been increasing diagnoses of anogenital herpes reported by sexual health clinics [9].
For each serum limited information was available, including prevention group, prior knowledge of HIV status and diagnoses received at the visit.
All sera were tested for HSV-2 and HSV-1 antibodies using a pair of enzyme immunoassays that distinguish the type-specific antibody response against HSV-2 and HSV-1 [20]. Approval was received from local ethics committees covering each site where the GUM Anon survey was underway. This is of concern, given the increasing evidence for the role of HSV-2 in HIV progression, onward transmission and acquisition [1-3].
This is consistent with the global epidemiology: whilst there is considerable variation in HSV-2 prevalence worldwide, in general, HSV-2 prevalence is lower in Europe than in Africa and the Americas [8,11]. The role of anti-HSV therapeutics in the HIV-infected host and in controlling the HIV epidemic.
The effects of herpes simplex virus-2 on HIV-1 acquisition and transmission: a review of two overlapping epidemics.
Herpes simplex virus 2 infection increases HIV acquisition in men and women: systematic review and meta-analysis of longitudinal studies.
Age-specific prevalence of infection with herpes simplex virus types 2 and 1: a global review.
Sexually transmitted infections in Western Europe among HIV-positive men who have sex with men. Genital herpes serotesting: a study of the epidemiology and patients' knowledge and attitude among STD clinic attenders in Coventry, UK.
Antibody to herpes simplex virus type 2 as serological marker of sexual lifestyle in populations. The public health applications of unlinked anonymous seroprevalence monitoring for HIV in the United Kingdom. GACPAT HIV 1 + 2: a simple, inexpensive assay to screen for, and discriminate between, anti-HIV 1 and anti-HIV 2.
HIV incidence appears constant in men who have sex with men despite widespread use of effective antiretroviral therapy.
Monoclonal antibody blocking tests for the detection of HSV-1- and HSV-2-specific humoral responses: comparison with western blot assay. Performance of Commercially Available Enzyme Immunoassays for Detection of Antibodies against Herpes Simplex Virus Type 2 in African Populations.
A monoclonal blocking EIA for herpes simplex virus type 2 antibody: validation for seroepidemiological studies in Africa.
Human tissue and biological samples for use in research: Operational and ethical guidelines. Clinical efficacy of high-dose acyclovir in patients with human immunodeficiency virus infection: a meta-analysis of randomized individual patient data. Neither ECDC nor any person acting on behalf of ECDC is responsible for the use that might be made of the information in this journal.
HSV-1 can also cause genital herpes. Herpes simplex virus 2 (HSV-2) is the most common cause of genital herpes, but it can also cause oral herpes. Most people notice symptoms within a few weeks after they catch the virus from someone else. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health.
For HIV-negative individuals, HSV-2 infection increases the risk of HIV acquisition more than two-fold [1,3,5,6], although trials to date have failed to show an impact of HSV medication on HIV acquisition [1-3]. However, information on the prevalence of HSV amongst HIV-positive and HIV-negative MSM in the UK is not available: the infection is primarily asymptomatic or unrecognised and serological screening is not routinely performed [3,5].
They utilise type-specific murine monoclonal antibodies whose binding to the homologous HSV antigen is blocked when the specimen under test also contains the homologous antibody type.
Among HIV-positive individuals, the association of HSV-2 and HSV-1 serostatus with knowledge of HIV serostatus, recently acquired HIV infection (derived through STARHS) and other characteristics was investigated. The prevalence rates may be an underestimate of current rates amongst MSM attending sexual health clinics, as the annual number of ano-genital herpes diagnoses in sexual health clinics and the prevalence of HIV and other STI have increased since 2003 [9]. In our study, the prevalence of HSV-2 amongst MSM born in sub-Saharan Africa was not different to that amongst UK-born MSM, even after adjusting for age and other factors. Unfortunately, no culture or PCR result was available from the genital ulcers to determine the type causing the presenting ano-genital disease.
Trends in HSV Types and Genital Herpes Genital herpes can be caused by either HSV-2 or HSV-1.
The first time it happens, you may also have a fever, headache, or other flu-like feelings. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. The impact of HSV-1 on HIV is less researched, possibly as it causes genital herpes with less severe symptoms and less frequent recurrences [7] and because it is primarily acquired orally early on in childhood in most countries with a high HIV incidence [7,8]. Specimens that inhibit the binding of the monoclonal antibody by ≥50% are considered to be positive for that HSV type-specific antibody. Additional information such as ethnicity and sexual behaviour would be needed to understand how MSM born in sub-Saharan Africa attending sexual health clinics in England and Wales differ from the overall population in their region of birth. Most of those diagnosed with a first attack of ano-genital herpes who were HSV-1 seropositive only may have been infected with HSV-2 as well but had not yet seroconverted. It is of concern that one in two HIV-positive MSM and one in six HIV-negative MSM may be infected with HSV-2, given increasing evidence of its impact on HIV progression, onward transmission and acquisition. However, 50% of diagnoses of first attacks of ano-genital herpes amongst MSM in the United Kingdom (UK) are now caused by HSV-1 [5,7,9,10]. Sera from individuals with a previously undiagnosed HIV infection were further examined by the Serological Testing Algorithm for Recent HIV Seroconversion (STARHS) using the ‘detuned’ Vironostika HIV-1 microelisa test (bioMerieux).
Except where otherwise stated, all manuscripts published after 1 January 2016 will be published under the Creative Commons Attribution (CC BY) licence. First Time Reality Star Has Been Seen With the Common Infection By TheImproper Staff, December 3rd, 2012(Photo: INFDaily)Kim Kardashian, who is known for her natural beauty, returned from her trip to the Middle East with a horrid looking Herpes cold sore on her upper lip. In recent years, HSV-1 has become a significant cause in developed countries, including the United States. How You Do -- and Don’t -- Get HerpesYou get herpes by having any kind of sex -- vaginal, oral, or anal -- with someone who’s infected.
To date results have been disappointing from trials aimed at reducing HIV onward transmission and HIV acquisition using HSV antiviral medication. The mean time since seroconversion for sera testing positive for recently acquired HIV infection by the detuned test is six months [19]. You are free to share and adapt the material, but you must give appropriate credit, provide a link to the licence, and indicate if changes were made.
However, recent research in an African context demonstrates the efficacy of HSV antivirals in delaying HIV progression. Did Kanye West infect her?The Herpes virus, which causes cold sores, is infectious and can be transmitted between people, usually by kissing or mouth to body contact in other, ahem, places.This is believed to be the first time Kim has been spotted with such an ugly sore. The high prevalence of HSV-2 amongst HIV-positive MSM suggests that an increased focus on HSV control in the management of HIV amongst MSM in the United Kingdom (UK) may be warranted. The risk of infection is highest during outbreak periods when there are visible sores and lesions. Given this and existing research on the high prevalence of genitally acquired HSV-1 amongst MSM in the UK, further research is also warranted into the role of HSV-1 in the HIV epidemic in this context.
Because the virus can't live long outside your body, you can't catch it from something like a toilet seat or towel.  Worried It’s Herpes?Sometimes people mistake a pimple or ingrown hair for herpes. Symptoms When genital herpes symptoms do appear, they are usually worse during the first outbreak than during recurring attacks.
If you don’t have symptoms but think you might have herpes, your doctor can do a blood test.


What Causes It?Genital herpes usually comes from the virus called herpes simplex-2 (HSV-2).
The affliction, which causes redness, itchiness and flaking skin, is hereditary.Kim was spotted with the outbreak while arriving at Miami International Airport.
Herpes, Pregnancy, and Newborn Infants Herpes can pose serious risks for a pregnant woman and her baby. The outbreak was clearly visible in photos taken by waiting paparazzi, in what amount to a significant outbreak. The risk is greatest for mothers with a first-time infection, because the virus can be transmitted to the infant during childbirth. Kim later said she has had the problem since childhood.Kim is returning from a high-stress trip to Kuwait an Bahrain.
Guidelines from the American Academy of Pediatrics recommend using specific diagnostic tests for women in labor to determine the risk of transmission.
She was there to dedicate the opening of a new chain of milkshake shops, but her appearance in both countries drew protests. Babies born to mothers infected with genital herpes are treated with the antiviral drug acyclovir, which can help suppress the virus. How to Prevent an OutbreakSome people only take their medications if they feel the itching and tingling that means an outbreak is coming on -- or when sores show up -- to stop it from getting worse.
They include human herpes virus 8 (the cause of Kaposi sarcoma) and varicella-zoster virus (also known as herpes zoster, the virus responsible for shingles and chickenpox). The word "herpes" comes from the Greek word "herpein," meaning "to creep." This refers to the unique characteristic pattern of all herpes viruses to creep along local nerve pathways to the nerve clusters at the end, where they remain in an inactive (dormant) state for variable periods of time. Most people have them on and off for several years,  but they get milder and happen less often over time.
How to Avoid HerpesAs long as you're sexually active, there's a chance you could get herpes. HSV-1 can also cause genital herpes, which is a sexually transmitted disease (STD). Herpes simplex virus 2 (HSV-2) is the usual cause of genital herpes, but it can also cause oral herpes. You'll make it a lot less likely if you use a latex or polyurethane condom or dental dam every time, for every activity.
I have had cold sores since I was a kid and it would literally take days off of my life – I would basically hide for a week and I am still super super conscious about transmission. Until recently, the general rule was to assume that HSV-1 caused oral herpes and HSV-2 caused genital herpes.
It is now clear, however, that either type of herpes virus can be found in the genital or oral areas (or other sites). In fact, HSV-1 is now responsible for more than half of all new cases of genital herpes in developed countries. The Disease ProcessHerpes is transmitted through close skin-to-skin contact.
What Triggers an Outbreak?The herpes virus stays in your body forever, even if you have no symptoms.
To infect people, the herpes simplex viruses (both HSV-1 and HSV-2) must get into the body through tiny injuries in the skin or through a mucous membrane, such as inside the mouth or on the genital or anal areas. You may have an outbreak when you're sick, after you’ve been out in the sun, or when you’re stressed out or tired. The risk for infection is highest with direct contact of blisters or sores during an outbreak. But the infection can also develop from contact with an infected partner who does not have visible sores or other symptoms. Once the virus has contact with the mucous membranes or skin wounds, it enters the nuclei of skin tissue cells and begins to replicate.
Sex and HerpesYou still can have sex if you have genital herpes, but you must tell your partner you have the virus. The virus is then transported from the nerve endings of the skin to clusters of nerve cells (ganglia) where it remains inactive (latent) for some period of time.
However, at some point, the virus wakes up and travels along nerve pathways to the surface the skin where it begins to multiply again.
During this time, the virus can infect other people if it is passed along in body fluids or secretions. Problems With HerpesPeople often don’t have serious problems from herpes, but there's a chance of them. Viral shedding may be accompanied by noticeable symptoms (outbreak) but it can also occur without causing symptoms (asymptomatic shedding). In either case, a person is infectious during periods of viral shedding. Symptoms may appear as multiple small red bumps or patches that develop blisters. Herpes and PregnancyIf you’re pregnant and have herpes, your doctor may suggest that you have your baby by C-section.
Certain triggers can wake up the virus from its dormant state and cause it to become active again. During vaginal birth, the herpes virus could spread to your baby, especially if your first outbreak happens around the delivery time. In general, recurrent episodes of herpes cause less severe symptoms than the primary outbreak.
HSV-1 is the most prevalent form of herpes simplex virus, and infection is most likely to occur during preschool years. The American Sexual Health Association recommends you pick a time when you won't be interrupted, plan what you want to say ahead of time, and practice what you'll say so you feel confident. People can get HSV-2 through genital contact or HSV-1 through mouth-to-genital contact with an infected partner.
People with active symptoms of genital herpes are at very high risk for transmitting the infection.
Unfortunately, most cases of genital herpes infections occur when the virus is shedding but producing no symptoms.
Most people either have no symptoms or do not recognize them when they appear. In the past, genital herpes was mostly caused by HSV-2, but HSV-1 genital infection is increasing. There is also evidence that children today are less likely to get cold sores and become exposed to HSV-1 during childhood. Centers for Disease Control and Prevention (CDC), about 1 in 6 Americans ages 14 to 49 years have genital herpes.
While HSV-2 remains the main cause of genital herpes, HSV-1 has significantly increased as a cause, most likely because of oral-genital sex. African-American women are at particularly high risk. People with compromised immune systems, such as those who have HIV, are at very high risk for genital herpes. Drugs that suppress the immune system, and organ transplantation, can also weaken the immune system and increase the risk for contracting genital herpes. It is almost impossible to defend against the transmission of oral herpes, because it can be transmitted by very casual contact, including kissing. Still, you can help reduce the risk of transmitting oral herpes by not sharing objects that touch the mouth, such as eating and drinking utensils, toothbrushes, and towels. It is best to refrain from any type of sex (vaginal, anal, or oral) during periods of active outbreak. However, herpes can also be transmitted when symptoms are not present (asymptomatic shedding). Only water-based lubricants (K-Y Jelly, Astroglide, AquaLube, and glycerin) should be used. It is very unlikely to transmit or contract genital herpes from a toilet seat or bath towel. Studies suggest that male circumcision may help reduce the risk of HSV-2, as well as human papillomavirus (HPV) and HIV infections. However, herpes can cause significant and widespread complications in people who don't have a fully functioning immune system. The CDC recommends that all people diagnosed with herpes simplex virus 2 (HSV-2) get tested for HIV. Most people with HIV are co-infected with HSV-2 and are particularly vulnerable to its complications. HSV-2 infection increases HIV levels in the genital tract, which makes it easier for the HIV virus to be spread to sexual partners. Herpes and PregnancyPregnant women who have genital herpes due to either HSV-2 or HSV-1 have an increased risk for miscarriage, premature labor, inhibited fetal growth, or transmission of the herpes infection to the infant in the uterus or at the time of delivery. Herpes in newborn babies (herpes neonatalis) can be a very serious condition. Fortunately, neonatal herpes is rare. Although about 25 to 30% of pregnant women have genital herpes, less than 0.1% of babies are born with neonatal herpes. The baby is at greatest risk during a vaginal delivery, especially if the mother has an asymptomatic infection that was first introduced late in the pregnancy. The risk for transmission also increases if infants with infected mothers are born prematurely, there is invasive monitoring, or instruments are used during vaginal delivery. Transmission can occur if the amniotic membrane of an infected woman ruptures prematurely, or as the infant passes through an infected birth canal. This risk is increased if the woman is having or has recently had an active herpes outbreak in the genital area. Very rarely, the virus is transmitted across the placenta, a form of the infection known as congenital herpes.
Also rarely, newborns may contract herpes during the first weeks of life from being kissed by someone with a herpes cold sore. Infants may get congenital herpes from a mother with an active herpes infection at the time of birth. Aggressive treatment with antiviral medication is required. Most infected pregnant women do not have a history of symptoms, so herpes infection is often not suspected or detected at the time of delivery.
Fortunately, if a woman does have genital lesions, rapid diagnostic blood tests can quickly determine her chances of transmitting the virus to her baby during delivery. Some women with new or recurrent herpes may also be prescribed antiviral medication during pregnancy.
A woman with herpes can usually safely breastfeed her baby, as long as she does not have a lesion on her breast or nipple.
Neonatal herpes can spread to the brain and central nervous system, causing encephalitis and meningitis. Herpes can also spread to internal organs, such as the liver and lungs. Infants infected with herpes are treated with acyclovir, an antiviral drug.
They usually receive several weeks of intravenous acyclovir treatment, followed by several months of oral acyclovir.
It is important to treat babies quickly, before the infection spreads to the brain and other organs. Fortunately, rapid diagnostic tests and treatment with acyclovir have significantly improved survival rates and reduced complication rates. Nearly all who recover have some impairment, ranging from very mild neurological changes to paralysis.


Like encephalitis, meningitis symptoms include headache, fever, stiff neck, vomiting, and sensitivity to light.
Fortunately, herpes meningitis usually resolves after about a week without complications, although symptoms can recur. Herpes Eye ComplicationsOcular herpes is a recurrent infection that affects the eyes. Herpes Skin ComplicationsEczema Herpeticum: A rare form of herpes infection called eczema herpeticum, also known as Kaposi varicelliform eruption, can affect people with skin disorders and those with a weakened immune system.
In children, this is often caused by thumb sucking or finger sucking while they have a cold sore. It can also occur in adult health care workers, such as dentists, because of increased exposure to the herpes virus.
The use of latex or polyurethane gloves prevents herpes whitlow in health care workers. SymptomsHerpes symptoms vary depending on whether the outbreak is initial or recurrent.
The primary outbreak is usually worse than recurrent outbreaks, with more severe and prolonged symptoms. In fact, studies indicate that 10 to 25% of people infected with HSV-2 are unaware that they have genital herpes. The first signs are a tingling sensation in the affected areas (genitalia, buttocks, and thighs) and groups of small red bumps that develop into blisters. The sores may sometimes itch, but itching decreases as they heal. About 40% of men and 70% of women develop other symptoms during initial outbreaks of genital herpes, such as flu-like discomfort, headache, muscle aches, and fever. Some women may have difficulty urinating and may, occasionally, require a urinary catheter.
The virus sheds for a much shorter period of time (about 3 days) compared to an initial outbreak of 3 weeks.
Women may have only minor itching, and the symptoms may be even milder in men. On average, people have about four recurrences during the first year, although this varies widely.
There are some differences in frequency of recurrence depending on whether HSV-2 or HSV-1 caused genital herpes. HSV-2 genital infection is more likely to cause recurrences than HSV-1. Symptoms of Oral Herpes Oral herpes (herpes labialis) is most often caused by HSV-1, but it can also be caused by HSV-2.
It usually affects the lips and, in some primary attacks, the mucus membranes in the mouth. The sores last 10 to 14 days and can be very uncomfortable. Blisters that may be preceded or accompanied by sore throat, fever, swollen glands, and painful swallowing.
Recurrent Oral Herpes Infection: A recurrent oral herpes infection is much milder than the primary outbreak. It usually manifests as a single sore, commonly called a cold sore or fever blister (because it may arise during a bout of cold or flu). The sore usually shows up on the outer edge of the lips and rarely affects the gums or throat. Recurrences of genital herpes are more likely with HSV-2 infection than with HSV-1 infection. Occasionally, the symptoms may not resemble those of the primary episode, but appear as fissures and scrapes in the skin or as general inflammation around the affected area.
They include sunlight, wind, fever, physical injury, surgery, menstruation, suppression of the immune system, and emotional stress. For most people, outbreaks recur with more frequency during the first year after an initial attack. The good news is that in most healthy people, recurring infections tend to become progressively less frequent, and less severe, over time. However, other conditions can resemble herpes, and doctors cannot base a herpes diagnosis on visual inspection alone. These tests include: Virologic tests (viral culture of the lesion) Serologic tests (blood tests that detect antibodies) The CDC recommends that both virologic and serologic tests be used for diagnosing genital herpes.
People diagnosed with genital herpes should also be tested for other sexually transmitted diseases. At this time, experts do not recommend screening for HSV-1 or HSV-2 in the general population. Genital herpes can be caused by either HSV-1 or HSV-2. It is important to determine which virus is involved, as the type of herpes infection influences prognosis and treatment recommendations. Recurrences of genital herpes, and viral shedding without overt symptoms, are much less frequent with HSV-1 infection than with HSV-2. False-negative (testing negative when herpes infection is actually present) or false-positive (testing positive when herpes infection is not actually present) results can occur.
Your health care provider may recommend that you have a test repeated. Virologic TestsViral culture tests are made by taking a fluid sample, or culture, from the lesions as early as possible, ideally within the first 48 hours of the outbreak. PCR tests are much faster and more accurate than viral cultures, and the CDC recommends PCR for detecting herpes in spinal fluid when diagnosing herpes encephalitis. PCR can make many copies of the virus' DNA, so that even small amounts of DNA in the sample can be detected.
However, many labs now use PCR for herpes testing because it is highly accurate. An older type of virologic testing, the Tzanck smear test, uses scrapings from herpes lesions.
The scrapings are stained and examined under a microscope for the presence of giant cells with many nuclei or distinctive particles that carry the virus (called inclusion bodies). The Tzanck test is not reliable for providing a conclusive diagnosis of herpes infection and is not recommended by the CDC. Serologic TestsSerologic (blood) tests can identify antibodies that are specific for either HSV-1 or HSV-2. When the herpes virus infects you, your body's immune system produces specific antibodies to fight off the infection.
If a blood test detects antibodies to herpes, it is evidence that you have been infected with the virus, even if the virus is in a non-active (dormant) state. The presence of antibodies to herpes also indicates that you are a carrier of the virus and might transmit it to others. Serologic tests can be especially useful for people who do not have active symptoms, but who have other risk factors for herpes (such as other STDs, multiple sex partners, or a monogamous partner who has genital herpes).
Although glycoprotein (gG) type-specific tests have been available for many years, many of the older nontype-specific tests that cannot distinguish HSV-1 from HSV-2 are still on the market.
Canker sores frequently crop up singly or in groups on the inside of the mouth, or on or underneath the tongue. They usually heal within 2 weeks without treatment. Canker sores (Aphthous ulcers) are very common. The drugs are used initially to treat a first attack of herpes, and then afterward to either treat recurrent outbreaks (episodic therapy) or reduce frequency of recurrences (suppressive therapy). Drugs can, however, reduce the severity of symptoms, improve healing times, and prevent recurrences. If people experience very severe disease or complications, they need to be hospitalized and receive an antiviral drug intravenously.
Your health care provider will prescribe one of the three antiviral medications, which you will take for 7 to 10 days. You should begin the medication as soon as you notice any signs or symptoms of herpes, preferably during the prodrome stage that precedes the outbreak of lesions. If taken during prodrome, episodic therapy may help prevent an outbreak from occurring or reduce its severity.
Valacyclovir is taken once a day. Suppressive treatment can reduce the frequency of outbreak recurrences by 70 to 80%. It is generally recommended for people who have frequent recurrences (6 or more outbreaks per year).
Because herpes recurrences often diminish over time, you should discuss annually with your health care provider whether you should stay with drug therapy or discontinue it. While taking any suppressive therapy for genital herpes, it is still important to regularly use latex condoms and to avoid any sexual activity during recurrences. A new form of acyclovir (Sitavig) is administered orally as an adhesive tablet; it is applied to the gum region of the mouth, where it dissolves during the course of the day. In addition, acyclovir is available in topical form, as is the related drug penciclovir (Denavir). Topical TreatmentsThese ointments or creams can help shorten healing time and duration of symptoms.
However, none are truly effective at eliminating outbreaks. Penciclovir (Denavir) heals HSV-1 sores on average about half a day faster than without treatment, stops viral shedding, and reduces the duration of pain.
Ideally, you should apply the cream within the first hour of symptoms, although the medication can still help if applied later.
Apply the cream 5 times a day, beginning at the first sign of tingling or pain. Over-the-counter topical ointments may provide modest relief.
They include Anbesol gel, Blistex lip ointment, Camphophenique, Herpecin-L, Viractin, and Zilactin. Some contain a topical anesthetic such as benzocaine, tetracaine, or phenol. Lip balm that contains sunblock, or sunscreen applied around the lips may help prevent sun-triggered outbreaks. Herbs and SupplementsGenerally, manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products.
Just like a drug, herbs and supplements can affect the body's chemistry, and therefore have the potential to produce side effects that may be harmful. There have been several reported cases of serious and even lethal side effects from herbal products.
Always check with your provider before using any herbal remedies or dietary supplements. Many herbal and dietary supplement products claim to help fight herpes infection by boosting the immune system. There has been little research on these products, and little evidence to show that they really work. Epidemiology, clinical presentation, and antibody response to primary infection with herpes simplex virus type 1 and type 2 in young women. Seroprevalence of herpes simplex virus type 2 among persons aged 14 - 49 years -- United States, 2005-2008. Guidance on management of asymptomatic neonates born to women with active genital herpes lesions. Epub 2013 Jan 28. Martin ET, Krantz E, Gottlieb SL, Magaret AS, Langenberg A, Stanberry L, et al. Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with HSV-2 infection.



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