Research has gone into vaccines for both prevention and treatment of herpes infections. Unsuccessful clinical trials have been conducted for some glycoprotein subunit vaccines. As of 2017, the future pipeline includes several promising replication-incompetent vaccine proposals while two replication-competent (live-attenuated) HSV vaccine are undergoing human testing.
Herpes type 2 is one of two types of HSV (Herpes Simplex Virus). The virus is also known as HSV-2 and differs slightly from HSV-1. It is also called genital herpes or herpes genitalis, which is considered a harmless viral infection. Herpes genitalis is usually considered a sexually transmitted disease. However, it is not listed among notifiable diseases regulated under the Public Health Act.
Genital herpes is passed on by skin-to-skin contact during vaginal, oral or anal sex, or by sharing sex toys. You can get genital herpes even if there are no visible sores or blisters, and once you have the virus, there is no cure. 'Herpes is more likely to be passed on just before, during or straight after an outbreak, as herpes blisters and sores are highly infectious,' says O’Sullivan.
Herpes antiviral therapy began in the early 1960s with the experimental use of medications that interfered with viral replication called deoxyribonucleic acid (DNA) inhibitors. The original use was against normally fatal or debilitating illnesses such as adult encephalitis, keratitis, in immunocompromised (transplant) patients, or disseminated herpes zoster. The original compounds used were 5-iodo-2'-deoxyuridine, AKA idoxuridine, IUdR, or(IDU) and 1-β-D-arabinofuranosylcytosine or ara-C, later marketed under the name cytosar or cytarabine. The usage expanded to include topical treatment of herpes simplex, zoster, and varicella. Some trials combined different antivirals with differing results. The introduction of 9-β-D-arabinofuranosyladenine, (ara-A or vidarabine), considerably less toxic than ara-C, in the mid-1970s, heralded the way for the beginning of regular neonatal antiviral treatment. Vidarabine was the first systemically administered antiviral medication with activity against HSV for which therapeutic efficacy outweighed toxicity for the management of life-threatening HSV disease. Intravenous vidarabine was licensed for use by the U.S. Food and Drug Administration in 1977. Other experimental antivirals of that period included: heparin, trifluorothymidine (TFT), Ribivarin, interferon, Virazole, and 5-methoxymethyl-2'-deoxyuridine (MMUdR). The introduction of 9-(2-hydroxyethoxymethyl)guanine, AKA aciclovir, in the late 1970s raised antiviral treatment another notch and led to vidarabine vs. aciclovir trials in the late 1980s. The lower toxicity and ease of administration over vidarabine has led to aciclovir becoming the drug of choice for herpes treatment after it was licensed by the FDA in 1998. Another advantage in the treatment of neonatal herpes included greater reductions in mortality and morbidity with increased dosages, which did not occur when compared with increased dosages of vidarabine. However, aciclovir seems to inhibit antibody response, and newborns on aciclovir antiviral treatment experienced a slower rise in antibody titer than those on vidarabine.
According to Gina*, 21, “A herpes diagnosis is very shaking and it gives you the opportunity to look inward and really find what you love about yourself.” Gina says she has even better self-esteem than prior to finding out she had HSV. She explains, “You learn not to lower your standards, because you start to pick out who it is worth disclosing to and who isn't.”
Primary Infection: This is the first stage wherein the contagion reproduces upon entering from the mucous membrane or skin. Typical symptom is the appearance of oral lesions which may not be present initially resulting in an asymptotic infection. In this case due to lack of symptoms one will be unaware of the presence of an infection. The sores usually takes 21 days to form and become visible, then the blisters will persist up to 10 days before beginning to heal.
When a herpes outbreak occurs, you can expect cold sores to take about 10–14 days to heal on average. During this time period, the virus is considered to be active, and you should be very careful to avoid direct contact between a sore and someone else. If after trying the natural remedies for herpes described above you still experience frequent recurrences, talk to your doctor for how to get rid of herpes symptoms. Sometimes immunity is suppressed due to another infection or virus, or even as a side effect of taking some medications, so be sure to rule these causes out.
With the first outbreak of herpes virus infection, an individual may also experience nonspecific flu-like symptoms like fever, swollen lymph nodes, headache, and muscle aches. It is also possible to have herpes virus infection without having any symptoms or signs, or having signs and symptoms that are so mild that the infection is mistaken for another condition.
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As of 2017, there is not currently a herpes vaccine available to prevent HSV-1 or HSV-2. (There is a vaccine available for another virus, herpes zoster; however, despite the similar name, it actually refers to the shingles virus. And, in fact, shingles occurs due to the reactivation of yet another virus, varicella zoster, which causes chicken pox.)
These drugs may stop viral replication in the skin but do not eliminate HSV from the body or prevent later outbreaks (HSV reactivation). These drugs are used more frequently with HSV-2 infections. Most investigators suggest consulting an infectious-disease expert when HSV-infected people need hospitalization. Research findings suggest laser treatments may speed healing and lengthen the time before any sores reappear.
Herpes sores follow a similar cyclical pattern and appear first like pimples that turn into small vesicles. Then, the skin becomes crusty, and eventually a scab is formed. It can take up to several weeks for the lesions to heal, during which time there may be one outbreak followed by another. Certain risk factors may increase the likelihood of an outbreak, such as: asthma medication, lack of sleep, stress, decreased immunity and ultraviolet rays.
The annual incidence in Canada of genital herpes due to HSV-1 and HSV-2 infection is not known (for a review of HSV-1/HSV-2 prevalence and incidence studies worldwide, see Smith and Robinson 2002). As many as one in seven Canadians aged 14 to 59 may be infected with herpes simplex type 2 virus and more than 90 per cent of them may be unaware of their status, a new study suggests. In the United States, it is estimated that about 1,640,000 HSV-2 seroconversions occur yearly (730,000 men and 910,000 women, or 8.4 per 1,000 persons).
The HSV viruses multiply in the human cell by overtaking and utilizing most of the human cells functions. One of the HSV steps in multiplication is to take control of the human cell's nucleus and alter its structure. The altered nucleus (enlarged and lobulated or multinucleated) is what actually is used to help diagnose herpes simplex infections by microscopic examination. The reason sores appear is because as they mature the many HSV particles rupture the human cell's membrane as they break out of the cell.
Herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. The blisters break and leave painful sores that may take a week or more to heal. These symptoms are sometimes called “having an outbreak.” The first time someone has an outbreak they may also have flu-like symptoms such as fever, body aches, or swollen glands.
No method eradicates herpes virus from the body, but antiviral medications can reduce the frequency, duration, and severity of outbreaks. Analgesics such as ibuprofen and paracetamol (acetaminophen) can reduce pain and fever. Topical anesthetic treatments such as prilocaine, lidocaine, benzocaine, or tetracaine can also relieve itching and pain.
Herpes infection of the genital tract is a sexually transmitted infection (sexually transmitted disease or STD). Like in the mouth area, herpes symptoms and signs include a painful, blistering rash around or on the genital or rectal areas. These lesions open and result in painful sores that can take two to four weeks to heal. The sores can sometimes cause painful urination. Recurrent outbreaks are typical, and the time between outbreaks varies among affected people and even within the same individual. Prior to an outbreak, a tingling, burning, or itching sensation may be present on the area of involved skin.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.