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He was born into a noble family in the Goa Kingdom but decided to run away and live in the Gray Terminal, eventually setting out to sea on his own. Sabo was a ten year old boy at the time of Luffy's flashback, the same age as Ace at that time. Before he entered into the Gray Terminal, he was seen with a gentle outfit with a white colored short-sleeved shirt and wearing blue colored shorts as usual. While participating in the final round at the Corrida Colosseum in Luffy's place, he wore Luffy's cape, fake beard, and viking style helmet. Later, after the round, he returned to his original outfit, which resembles his old outfit from twelve years ago: a long black jacket with a buckle on the left sleeve, with a blue shirt and vest, a frilled cravat, and a simple belt holding a pair of loosen light-blue pants with black boots (said boots are shown in greater detail in Pirate Warriors 3, to be wrapped with buckles and with cloth bracings). Sabo is devoted to his dreams to the point that he agreed with Ace that the two of them had to kill Luffy so that he could not tell anyone about their treasure, though neither Ace nor Sabo knew how to kill a person nor had any experience, implying some degree of innocence despite their profession. Despite being the son of a noble, Sabo does not act like a stereotypical noble would act, nor does he consider himself to be a noble. At age 22, Sabo has retained much of his old personality, although he appears to have adapted many mannerisms from Luffy, including his brother's tendency to mispronounce the names of others. Outlook III, Sabo's father is a stereotypical noble, treating Ace and Luffy as trash, and panicking about being contaminated when Bluejam got their blood onto him during a beating, claiming that he needed to be decontaminated.
Sabo's mother has the stereotypical personality of a Noble, and only seeks to further her family's status. While Sabo cared greatly for Luffy and Ace, he absolutely did not care for his adopted brother, Stelly, who came from a higher nobility than Sabo's family and is arrogant and a coward. At first, Sabo worried that Luffy would reveal the secret stash that he and Ace had hidden, they suggested that they would kill him. After the time skip, when Sabo meets Luffy, the latter is greatly shocked and surprised to see that Sabo is still alive and starts crying after meeting him, thinking that he had died 12 years ago. It is shown that Sabo has gained an overprotective attitude towards Luffy as he held off Admiral Fujitora and told him that should Luffy ever need help, he would be there for him, having refused to ever lose another loved one ever again. Upon his departure from Dressrosa, Sabo gave the Straw Hats a Vivre Card and entrusted Luffy's well-being into their care similar to what Ace had done. During the From the Decks of the World: The 500,000,000 Man Arc, Sabo was very proud to see Luffy's new bounty poster. Although Sabo had amnesia for half of his current life and forgot about Ace and Luffy, after reading about Ace's death in a newspaper article, Sabo regained his memories of Ace — and by extension — the rest of the memories he had lost.
He later rescued Sabo - who had his boat blown up by Jalmack - a Celestial Dragon - and saved him from the wreckage. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. 2" of the entire organization, being directly under Dragon himself in terms of command.[2] He is an adoptive brother of Luffy and Ace, and the son of Outlook III.
12 years before the present storyline, he was a childhood friend of Ace, and eventually Luffy as well, to the point where the three considered themselves to be "brothers", swearing an oath of brotherhood over sake.
He has matured greatly, with more pronounced facial symmetry and a scar he acquired over his left eye.[8] This scar was inflicted when Saint Jalmack selfishly blew up the fishing boat Sabo used to set out to sea, leaving him with serious burns and critical injuries. He is very ashamed of being a noble, and even stated that he wished that he hadn't been born as one.
This is in order to write a book containing the story of everything he would see and every place he would visit during his journey.
He has also displayed an immensely fierce protective streak towards Luffy, to the point where he disregards everything he is currently doing if he feels Luffy is in danger, including his duties in the Revolutionary Army; his tendency to hang up the phone in the middle of a call rather angers his comrades. He also desired for his son to become his heir, believing that a child must adhere to the parents' wishes, and threatened to kill Ace and Luffy if Sabo did not comply.
This was clearly seen when her son got into a fight with a noble boy of a higher status who used a weapon on him, she apologized to the family while comforting the other boy, completely ignoring her own son's injuries. However, after seeing Luffy resist Porchemy and refusing to tell the secret, they inducted him into the group and treated him like a brother. Luffy quickly embraced Sabo happy that his remaining brother was alive and well while Sabo thanked Luffy for surviving the Battle of Marineford. He also came to Luffy's aid when Jesus Burgess attempted to kill Luffy firmly telling the Blackbeard pirate that Luffy is his brother.
In fact, they were like brothers, and Sabo was willing to forsake his dreams to save Ace and Luffy from his father's wrath. This event, combined with the fact that he discovered that his brother had died all at the same time, put him into a coma for three days.[7] Two years after Ace's death, Sabo deeply regrets that he wasn't there to try and save his brother's life, and not a day went by where he didn't agonize over what Ace's final thoughts might have been. He was openly affected by Sabo's morality and sympathized with the noble child for his refusal of his heritage. Because Sabo lost his memories of Luffy and Ace after this incident, Dragon was not aware that Sabo was a sworn brother to his son. 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. He is also (via his parents) the adopted brother of Stelly - the current king of the Goa Kingdom, although Sabo has never recognized him as such.
Along with Ace and Luffy, Sabo's dream was to become a pirate so that he could set sail and achieve freedom, and made plans with his brothers to set sail at age 17. He wore a large black top hat with a pair of blue goggles wrapped around it, a blue jacket with the sleeves rolled up, a cravat and a pair of light blue cyan shorts held up by a belt with an elaborate flower-design buckle. He resembles Luffy enough to allow him to easily deceive opponents as perceptive as Diamante into thinking he was "Lucy" by simply wearing the same outfit, although Sabo is still taller than his younger brother.
He helped Ace and Luffy get along when they were fighting, thus being the nice, diplomatic one of the trio.
One of the reasons behind all this could be the "segregation" that envelopes so much of the Goa Kingdom, a thing that could easily stir a freedom-loving spirit like Sabo's to ask himself what the world was really like outside the walls of High Town, and outside the island itself. This is in stark contrast to the rest of his family, who see their status as more important than anything else and will do whatever it takes to raise their social standing or maintain their current status, as well as look down on anyone they consider to be inferior. This is largely contributed by Sabo's inability to protect Ace from death, a fact he still regrets to this very day.
He ordered Sabo to marry a princess when he grew up, which is one of the reasons he ran away. She also acted in a rather insensitive manner when Sabo was dragged back from his runaway, giving her son a somewhat rude welcome back.
To this end, Sabo was willing to assault Stelly in order to learn about the plan to burn down Gray Terminal. He also let Sabo take up his disguise as Lucy to enter the finale in the Corrida Colosseum, allowing Sabo to take claim of the Mera Mera no Mi after Luffy gave him permission. In return, Luffy was very happy to see his brother again and was pleased to see that Sabo had inherited Ace's power.
He visited Ace's grave and left three cups of sake next to Ace's gravestone in memory of their brotherhood, and pinned a newspaper article to the gravestone to indicate that Luffy is doing fine. He permitted him to join the Revolutionary Army after the boy begged them to let him stay with them in order to avoid returning to his parents. Trends in HSV Types and Genital HerpesGenital herpes can be caused by either HSV-2 or HSV-1.
Sabo rejects these values completely, and even went as far as to say that he feels ashamed of his status as a noble. This is ironic considering that Ace himself had gained a very similar protective-streak after Sabo's presumed death. Prior to his departure from Goa, Sabo sent a letter to Ace, telling him to take care of Luffy as their younger brother.
He later told Rebecca and Bartolomeo that Luffy will be the future Pirate King showing that he supports his brother's dream.
Despite his regret, Sabo still remains determined to inherit Ace's power by obtaining the Mera Mera no Mi. After Sabo joined the revolutionaries, he eventually ascended the ranks to become the Chief of Staff and the Army's second in command, underneath Dragon himself. Sabo was loyal to his friends and, in this case his two "brothers", to the point that he would give in to the demands of his father, becoming miserable and "alone" in order to save both Luffy and Ace.
This can be seen as the reason why he ran away from home and went to live in the Gray Terminal, forfeiting his noble heritage.
What is worse, Outlook had no confidence in him, despite wanting him to return, going as far as to adopt a stepson of higher status in order to have a backup heir. In the aftermath of Marineford, when Ace's death along with Luffy's heritage was revealed in the newspaper, Sabo both regained his lost memories and his brotherhood with Luffy and Ace was finally made known to the group.
In recent years, HSV-1 has become a significant cause in developed countries, including the United States.
After reawakening his memories, Sabo did not leave the Revolutionary Army to resume his dream as a free-sailing pirate, as he seems to remain convicted to the Army's causes. Since a child becomes a full-fledged noble at the age of eighteen, Sabo intended to leave the Goa Kingdom at the age of seventeen, to escape the idea of being recognized as the thing he hated the most.
Sabo obtained and ate the Mera Mera no Mi, and the first attack he used with his new abilities was Ace's signature move, Hiken. Because of Sabo regaining his memories, it can be assumed that Dragon now knows about the relationship between Sabo and his son.
He even refers to the nobles as "smelling worse than Trash Mountain, as they are people rotten to the core". Despite Sabo's grief, he took it upon himself to protect his remaining brother Luffy in Ace's stead, and vowed to never live with any regrets ever again - as he believed Ace would never have forgiven him for it. Sabo refers to Dragon as "Dragon-san" and is loyal to him and is trusted enough to lead the Revolutionary Army's investigation of Donquixote Family's weapons trade.
Like Luffy, Sabo does not take too kindly to people insulting Ace as shown when Burgess insulted and mock his deceased brother, with Sabo unleashing a brutal fire attack on him despite him never intending to kill 'the Champion' in the first place. Even after regaining his memories, Sabo did not leave the Army to resume his dream of being a free-sailing pirate, showing a firm conviction to Dragon's cause.
The risk of infection is highest during outbreak periods when there are visible sores and lesions. SymptomsWhen genital herpes symptoms do appear, they are usually worse during the first outbreak than during recurring attacks.


Herpes, Pregnancy, and Newborn InfantsHerpes can pose serious risks for a pregnant woman and her baby.
The risk is greatest for mothers with a first-time infection, because the virus can be transmitted to the infant during childbirth. Guidelines from the American Academy of Pediatrics recommend using specific diagnostic tests for women in labor to determine the risk of transmission.
Babies born to mothers infected with genital herpes are often treated with the antiviral drug acyclovir, which can help suppress the virus. Herpes viruses 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. The usual cause of oral herpes (herpes labialis), which are commonly called cold sores or fever blisters.
HSV-1 can also cause genital herpes, which is a sexually transmitted disease (STD). Herpes simplex virus 2 (HSV-2).
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. 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. 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.
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. 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.
Certain triggers can wake up the virus from its dormant state and cause it to become active again. 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. In addition, because HSV-1 can be passed in saliva, people should also avoid sharing toothbrushes or eating utensils. Transmission of Genital Herpes Genital herpes is transmitted through sexual activity. 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). Although condoms may not provide 100% protection, they are proven to significantly reduce the risk of sexual disease transmission, including herpes.
Natural condoms made from animal skin do NOT protect against HSV infection because herpes viruses can pass through them. Use a water-based lubricant.
Lubricants can help prevent friction during sex, which can irritate the skin and increase the risk for outbreaks. Only water-based lubricants (K-Y Jelly, Astroglide, AquaLube, and glycerin) should be used. However, it is best not to use condoms pre-lubricated with spermicides. Do not use spermicides for protection against herpes. Nonoxynol-9 can cause irritation around the genital areas, which makes it easier for herpes and other STDs to be transmitted. Use a dental dam or condom for oral sex. If you have any symptoms of oral herpes, it is best not to perform oral sex on a partner until any visible sores or blisters have healed. Limit the number of sexual partners. The more sexual partners you have, the greater your chances of becoming infected or infecting others. 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, often 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. Ocular herpes is usually a simple infection that clears up in a few days, but in its more serious forms, and in severe cases, it can cause blindness.
It only affects the upper layer (epithelium) of the cornea and heals with scarring. Stromal Keratitis.
Iridocyclitis is another serious complication of ocular herpes, in which the iris and the area around it become inflamed. 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.
Untreated, this condition can be extremely serious and possibly fatal. Gingivostomatiti Oral herpes can cause multiple painful ulcers on the gums and mucus membranes of the mouth, a condition called gingivostomatitis. Children with gingivostomatitis commonly develop herpetic whitlow (herpes of the fingers). Herpetic Whitlow A herpetic whitlow is an infection of the herpes virus involving the finger, often around the fingernail.


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. Women may also experience vaginal discharge. Recurrent Genital Herpes Outbreak In general, recurrences are much milder than the initial outbreak. 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 HerpesOral 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. A herpes infection may occur on the cheeks or in the nose, but facial herpes is very uncommon. Primary Oral Herpes Infection If the primary (initial) oral infection causes symptoms, they can be very painful, particularly in children. 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. The outbreak of infection is often preceded by a prodrome, an early group of symptoms that may include itchy skin, pain, or an abnormal tingling sensation at the site of infection. Recurrent outbreaks feature most of the same symptoms at the same sites as the primary attack, but they tend to be milder and briefer. 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. Oral herpes can be triggered within about 3 days of intense dental work, particularly root canal or tooth extraction. Timing of Recurrences Recurrent outbreaks may occur at intervals of days, weeks, or years. 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.
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, Campho-phenique, 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. Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with HSV-2 infection.




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