? Herpes simplex virus
Microscopy image of a Herpes simplex virus.
Virus classification
Group: Group I (dsDNA) Family: Herpesviridae Subfamily: Alphaherpesvirinae Genus: Simplexvirus Species: Herpes simplex virus 1 (HSV-1) Species: Herpes simplex virus 2 (HSV-2)

The herpes simplex virus (HSV) (also known as Cold Sore, Night Fever, or Fever Blister) is a virus that manifests itself in two common viral infections, each marked by painful, watery blisters in the skin or mucous membranes (such as the mouth or lips) or on the genitals. The disease is contagious, particularly during an outbreak, and is incurable with present technology. Research has currently shown that a person can still be contagious (actively shedding virus) up to 7-10 days after the blister has healed.^{[citation needed]} During this time, the asymptomatic person should be extremely careful (washing hands frequently; not touch the blister area, etc.) since transmission is still possible. An infection on the lips is commonly known as a "cold sore" or "fever blister," though this should not be confused with a canker sore, which appears inside the mouth and is not caused by the herpes simplex virus. Image File history File links Herpes_simpex_virus. ... Viruses can be classified in several ways, such as by their geometry, by whether they have envelopes, by the identity of the host organism they can infect, by mode of transmission, or by the type of disease they cause. ... A DNA virus is a virus that has DNA as its genetic material and does not use an RNA intermediate during replication. ... Genera Subfamily Alphaherpesvirinae    Simplexvirus    Varicellovirus    Mardivirus    Iltovirus Subfamily Betaherpesvirinae    Cytomegalovirus    Muromegalovirus    Roseolovirus Subfamily Gammaherpesvirinae    Lymphocryptovirus    Rhadinovirus Unassigned    Ictalurivirus The Herpesviridae is a family of DNA viruses that cause diseases in humans and animals. ... Scientific name describing the subfamily of herpesviruses known as alphaherpesviruses. ... Groups I: dsDNA viruses II: ssDNA viruses III: dsRNA viruses IV: (+)ssRNA viruses V: (-)ssRNA viruses VI: ssRNA-RT viruses VII: dsDNA-RT viruses A virus (Latin, poison) is a submicroscopic particle that can infect the cells of a biological organism. ... Groups I: dsDNA viruses II: ssDNA viruses III: dsRNA viruses IV: (+)ssRNA viruses V: (-)ssRNA viruses VI: ssRNA-RT viruses VII: dsDNA-RT viruses A virus (Latin, poison) is a submicroscopic particle that can infect the cells of a biological organism. ... Over two thirds of the earths surface is covered with water, 97. ... A blister caused by 2nd degree burns A blister or bulla is a defense mechanism of the human body. ... A sex organ, or primary sexual characteristic, narrowly defined, is any of those parts of the body (which are not always bodily organs according to the strict definition) which are involved in sexual reproduction and constitute the reproductive system in an complex organism; namely: Male: penis (notably the glans penis... A disease is any abnormal condition of the body or mind that causes discomfort, dysfunction, or distress to the person affected or those in contact with the person. ... A mouth ulcer or canker sore is a painful open sore inside the mouth caused by a break in the mucous membrane. ...

HSV-1 and HSV-2

HSV disease

The ways in which herpes infections manifest themselves vary tremendously among individuals. The following are general descriptions of the courses outbreaks may take in the oral and genital regions.

Orofacial infection (Generally HSV 1)

Infectious fluid-filled blister on lower lip (herpes labialis).

Image from patient. The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Wikipedia does not have an article with this exact name. ... Wikipedia does not have an article with this exact name. ...

1. Prodromal symptoms
2. Skin appears irritated
3. Sore or cluster of fluid-filled blisters appear
4. Lesion begins to heal, usually without scarring

The term symptom (from the Greek syn = con/plus and pipto = fall, together meaning co-exist) has two similar meanings in the context of physical and mental health: A symptom may loosely be said to be a physical condition which shows that one has a particular illness or disorder (see... A blister caused by 2nd degree burns A blister or bulla is a defense mechanism of the human body. ...

Genital infection (Generally HSV 2)

1. Prodromal symptoms
2. Sore appears
3. Lesion begins to heal, usually without scarring

In men, the lesions may occur on the shaft of the penis, in the genital region, on the inner thigh, buttocks, or anus. In women, lesions may occur on or near the pubis, labia, clitoris, vulva, buttocks, or anus. This may require a very careful examination e.g. during delivery, examination by use of a flashlight may be necessary. The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ...

The appearance of herpes lesions and the experience of outbreaks in these areas varies tremendously among individuals. Herpes lesions on/near the genitals may look like cold sores. An outbreak may look like a paper cut, or chafing, or appear to be a yeast infection. Symptoms of a genital outbreak may include aches and pains in the area, discharge from the penis or vagina, and discomfort when urinating. Candidiasis, commonly called yeast infection or thrush, is a fungal infection of any of the Candida species, of which Candida albicans is probably the most common. ... The penis (plural penises, penes, peni) or phallus is an external male sexual organ. ... The vagina, (from Latin, literally sheath or scabbard ) is the tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. ... Urination, also called micturition, is the process of disposing urine from the urinary bladder through the urethra to the outside of the body. ...

Initial outbreaks are usually more severe than subsequent ones, and generally also involve flu-like symptoms and swollen glands for a week or so. Subsequent outbreaks tend to be periodic or episodic, typically occur four to five times a year, and can be triggered by stress, illness, fatigue, menstruation, and other changes. The virus sequesters in the nerve ganglia that serve the infected dermatome during non-eruptive periods, where it cannot be conventionally eliminated by the body's immune system. Influenza, commonly known as the flu, is an infectious disease that infects birds and mammals (primarily of the upper airways and lungs in mammals) and is caused by an RNA virus of the Orthomyxoviridae family (the influenza viruses). ... A gland is an organ in an animals body that synthesizes a substance for release such as hormones, often into the bloodstream (endocrine gland) or into cavities inside the body or its outer surface (exocrine gland). ... In the medical world, stress is defined as one of the following: An applied force or system of forces that tends to strain or deform a body, The resisting force set up in a body as a result of an externally applied force, or A physical or psychological stimulus that... The menstrual cycle is the periodic change in a womans body that occurs every month between puberty and menopause and that relates to reproduction. ... Nerves (yellow) Nerves redirects here. ... This is a dorsal root ganglion (DRG) from a chicken embryo (around stage of day 7) after incubation overnight in NGF growth medium stained with anti-neurofilament antibody. ... Dermatomic area (also known as a dermatome) is an area of skin that is supplied by a single pair of dorsal roots. ...

Herpes simplex encephalitis (generally HSV 1)

</ref>. Without treatment, it results in rapid death in around 70% of cases. Even The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ...

The virus usually infects through the mouth and enters the nucleus during the first 7 days, and will remain latent for 10 days to 100 years, and will then reactivate from common stress, fever, or a sunburn. The virus will soon be contagious through more cold sores, and the disease will start to attack the brain.

Neonatal herpes simplex

HSV at newborn child.

Neonatal HSV disease is a rare, but serious, consequence of vertical HSV transmission from mother to newborn child. Prospective active surveillance data indicates an incidence rate of 3.61 per 100,000 live births in Australia, with similar rates in the UK; but much lower than the USA. ^[1][2] Preliminary studies indicate the epidemiology in Canada is closer to Europe than to the United States. The mortality rate from neonatal HSV disease is high (up to 25%) despite current interventions with antiviral therapies. Death results from disseminated HSV disease and/or HSV encephalitis in the newborn children.
The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Image File history File links SOA-Herpes-neonatorum. ... Image File history File links SOA-Herpes-neonatorum. ...

Outbreak triggers

Many people with herpes have reported that stress, increased exposure to the sun, viral infections, facial injuries and eating foods high in arginine, such as chocolate, peanuts and walnuts, may increase the chance and severity of outbreaks. In addition, some have found that excessive usage of antibiotics can limit the immune system's ability to keep the disease within the nerve ganglia. Allergic reactions can also trigger an outbreak, chronic herpes genitalis may be caused by a chronic undiagnosed low-level food allergy for example. Arginine (Arg) is an α-amino acid. ... Chocolate most commonly comes in dark, milk, and white varieties, with cocoa solids contributing to the brown coloration. ... Charlie Brown is the principal character of the Peanuts comic strip. ... This article is about the walnut tree. ... An antibiotic is a drug that kills or slows the growth of bacteria. ...

Transmission

Herpes is contracted through direct skin contact (not necessarily in the genital area) with an infected person, and less frequently by indirect contact, in particular by sharing lip balm. The virus travels through tiny breaks in the skin or through moist areas, but symptoms may not appear for up to a month or more after infection. Transmission was thought to be most common during an active outbreak - however, in the early 1980s, it was found that the virus can be shed from the skin in the absence of symptoms. It is estimated that between 50% and 80% of new HSV-2 cases are from asymptomatic viral shedding. A close-up of human skin. ... In medicine, a disease is asymptomatic when it is at a stage where the patient does not experience symptoms. ...

HSV asymptomatic shedding is believed to occur on 2.9% of days while on antiviral therapy, versus 10.8% of days without. Shedding is known to be more frequent within the first 12 months of acquiring HSV-2. There are some indications that some individuals may have much lower patterns of shedding, but evidence supporting this is not fully verified. Sex should always be avoided in the presence of symptomic lesions. Oral sex performed by someone with oral lesions, or other symptoms, should be avoided, to avoid transmission of HSV1 to the partner's genitals.

Women are more susceptible to acquiring genital HSV-2 than men. On an annual basis, without the use of antivirals or condoms, the transmission risk from infected male to female is approximately 8-10%. This is believed to be due to the increased exposure of mucosal tissue to potential infection sites. Transmission risk from infected female to male is approximately 4-5% annually. Supressive antiviral therapy reduces these risks by 50%. Antivirals also help prevent the development of symptomatic HSV in infection scenarios by about 50%, meaning the infected partner will be seropositive but symptom free. Condom use also reduces the transmission risk by 50%. Condom use is much more effective at preventing male to female transmission than vice-versa. ^[3] The effects of combining antiviral and condom use is roughly additive, thus resulting in approximately a 75% combined reduction in annual transmission risk. It is important to note that these figures reflect experiences with subjects having frequently recurring genital herpes (>6 recurrences per year), subjects with low recurrence rates and those with no clinical manifestations were excluded from these studies.

Prevention

Condoms are the recommended way to prevent transmission of herpes simplex infection, as demonstrated in research. ^[3][4] However, this is by no means completely effective. The effectiveness of this method is somewhat limited on a public health scale by the limited use of condoms in the community ^[5]; and on an individual scale because some blisters may not be covered by the condom. A 67 m long condom on the Obelisk of Buenos Aires, part of an awareness campaign for the 2005 World AIDS Day A condom is a device, usually made of latex, or more recently polyurethane, that is used during sexual intercourse. ... Public health is concerned with threats to the overall health of a community based on population health analysis. ...

When one partner has herpes simplex infection and the other doesn't, the use of valaciclovir, in conjunction with a condom, has been demonstrated to further decrease the chances of transmission to the uninfected partner, and the Food and Drug Administration (FDA) approved this as a new indication for the drug in August 2003. Valaciclovir (INN) or valacyclovir (USAN) is an antiviral drug used in the management of herpes simplex. ... This article or section is in need of attention from an expert on the subject. ... 2003 (MMIII) was a common year starting on Wednesday of the Gregorian calendar. ...

Other measures that have been suggested include:

• Use of a lip protectant or lip gloss
• Management of stress
• Adequate sleep and nutrition
• Avoidance of cross-infecting different sites on the body if HSV blisters are present

Future vaccines

The National Institutes of Health (NIH) in the United States is currently in the midst of phase III trials of a vaccine against HSV-2. The vaccine has only been shown to be effective for women who have never been exposed to HSV-1. Overall, the vaccine is approximately 48% effective in preventing HSV-2 seropositivity and about 78% effective in preventing symptomatic HSV-2. Assuming FDA approval, a commercial version of the vaccine is estimated to become available around 2008. The National Institutes of Health (NIH) is the primary agency of the United States government responsible for medical research. ... In medicine, a clinical trial (synonyms: clinical studies, research protocols, medical research) is a research study. ...

Treatments

Medications

There are several prescription antiviral medications for controlling herpes outbreaks, including aciclovir (Zovirax), valaciclovir (Valtrex), famciclovir (Famvir), and penciclovir. Aciclovir was the original and prototypical member of this class and generic brands are now available at a greatly reduced cost. Valaciclovir and famciclovir are prodrugs of aciclovir and penciclovir respectively, with improved oral bioavailability (55% vs 20% and 75% vs 5% respectively). These antiviral medications work by interfering with viral replication, effectively slowing the replication rate of the virus and providing a greater opportunity for the immune response to intervene. All drugs in this class depend on the activity of the viral thymidine kinase to convert the drug to a monophosphate form and subsequently interfere with viral DNA replication. Penciclovir's primary advantage over aciclovir is that it has a far longer cellular half-life – 10 hours (HSV-1)/20 hours (HSV-2) for penciclovir versus 3 hours (HSV-1/2) for aciclovir. Antiviral drugs are a class of medication used specifically for treating viral infections. ... Aciclovir (INN) (IPA: ) or acyclovir (USAN), marketed as Zovirax, is one of the main antiviral drugs. ... Valaciclovir (INN) or valacyclovir (USAN) is an antiviral drug used in the management of herpes simplex. ... Famciclovir is an antiviral medicine that stops the varicella zoster virus that causes shingles. ... Penciclovir (INN) (IPA: ) is a guanine analogue antiviral drug used for the treatment of various herpesvirus infections. ... Aciclovir (INN) (IPA: ) or acyclovir (USAN), marketed as Zovirax, is one of the main antiviral drugs. ... A prodrug is a pharmacological substance (drug) which is administered in an inactive (or significantly less active) form. ... In pharmacology, bioavailability is used to describe the fraction of an administered dose of medication that reaches the systemic circulation, one of the principal pharmacokinetic properties of drugs. ... Thymidine kinase TK, is an enzyme, a phosphotransferase (a kinase): 2-deoxythymidine kinase, ATP-thymidine 5-phosphotransferase, {{{EC 2. ... DNA replication. ... The biological halflife of a substance is the time required for half of that substance to be removed from an organism by either a physcial or a chemical process. ...

Docosanol (Abreva) is another treatment that may be effective. Docosanol works by preventing the virus from fusing to cell membranes, thus barring entry into the cell for the virus. This may keep an outbreak contained to a smaller area than would otherwise be observed. Docosanol 10% cream is a topical treatment for recurrent herpes simplex labialis episodes (episodes of cold sores or fever blisters). ...

Tromantadine is another antiviral drug effective against herpes. Tromantadine Tromantadine is an antiviral medicine used to treat herpes simplex virus. ...

Non-prescription analgesics can reduce pain and fever during initial outbreaks. An analgesic (colloquially known as a painkiller) is any member of the diverse group of drugs used to relieve pain and to achieve analgesia. ...

Aciclovir is the recommended antiviral for suppressive therapy to prevent transmission of herpes simplex to the neonate. The use of valaciclovir and famciclovir, while potentially improving treatment compliance and efficacy, are still undergoing safety evaluation in this context. ^[6] There is evidence in mice that treatment with famciclovir, rather than aciclovir, during an initial outbreak can help lower the incidence of future outbreaks by reducing the amount of latent virus in the neural ganglia. This potential effect on latency over aciclovir drops to zero a few months post-infection. ^[7] Aciclovir (INN) (IPA: ) or acyclovir (USAN), marketed as Zovirax, is one of the main antiviral drugs. ... A human infant The word Infant derives from the Latin in-fans, meaning unable to speak. ... Valaciclovir (INN) or valacyclovir (USAN) is an antiviral drug used in the management of herpes simplex. ... Famciclovir is an antiviral medicine that stops the varicella zoster virus that causes shingles. ...

Availability of generic drugs

• Aciclovir is no longer under US patent protection, available in generic form
• Valaciclovir (GlaxoSmithKline) protected under U.S. Patent 4957924 protection expiring June 2009
• Famciclovir (Novartis) protected under U.S. Patent 5246937 protection expiring Sept 2010
• Penciclovir (GlaxoSmithKline) protected under U.S. Patent 5075445 protection expiring Sept 2010
• Docosanol (Avanir) protected under U.S. Patent 4874794 protection expiring April 2014

Aciclovir (INN) (IPA: ) or acyclovir (USAN), marketed as Zovirax, is one of the main antiviral drugs. ... Valaciclovir (INN) or valacyclovir (USAN) is an antiviral drug used in the management of herpes simplex. ... GlaxoSmithKline plc (LSE: GSK NYSE: GSK) is a British based pharmaceutical, biologicals, and healthcare company. ... Famciclovir is an antiviral medicine that stops the varicella zoster virus that causes shingles. ... Novartis International AG is a multinational pharmaceutical company based in Basel, Switzerland. ... Penciclovir (INN) (IPA: ) is a guanine analogue antiviral drug used for the treatment of various herpesvirus infections. ... GlaxoSmithKline plc (LSE: GSK NYSE: GSK) is a British based pharmaceutical, biologicals, and healthcare company. ... Docosanol 10% cream is a topical treatment for recurrent herpes simplex labialis episodes (episodes of cold sores or fever blisters). ...

Research drugs

• BAY 57-1293, a helicase-primase inhibitor researched by Bayer AG scientist Gerald Kleymann's team in Wuppertal, Germany. ^[8][9]

• BILS 179 BS, BILS 45 BS, BILS 22 BS, also inhibitors of helicase-primase enzyme, researched in Ridgefield, Connecticut, by James Crute's team at Boehringer Ingelheim Pharmaceuticals. ^[10][11]

• Roscovitine is an inhibitor of cellular cyclin-dependent kinase and seems to prevent transcription of viral genomes. Roscovitine has entered clinical trials for HIV infection. ^[12][13][14]

A primosome is a complex of two proteins (primase and helicase), that initiates RNA primers on the lagging DNA strand during DNA replication. ... Bayers logo: the Bayer cross Bayer AG (German pronunciation BYE-er, in US usually pronounced BAY-er) (TYO: 4863) is a German chemical and pharmaceutical company founded in 1863. ... Boehringer Ingelheim is a global pharmaceutical company based in Germany. ... Cyclins are a family of proteins involved in the progression of cells through the cell cycle. ... In biochemistry, a kinase is a type of enzyme that transfers phosphate groups from high-energy donor molecules, such as ATP, to specific target molecules (substrates); the process is termed phosphorylation. An enzyme that removes phosphate groups from targets is known as a phosphatase. ... Human immunodeficiency virus (commonly known as HIV, and formerly known as HTLV-III and lymphadenopathy-associated virus) is a retrovirus that is the cause of the disease known as AIDS, or Acquired Immunodeficiency Syndrome, a syndrome where the immune system begins to fail, leading to many life-threatening opportunistic infections. ...

Lysine

Lysine supplementation has been proposed as a complementary therapy for the prophylaxis and treatment of herpes simplex. Lysine supplementation is highly dose-dependent, with beneficial effects apparent only at doses exceeding 1000 mg per day. A small randomised controlled trial indicated a decrease in recurrence rates in nonimmunocompromised patients at a dose of 1248 mg of lysine monohydrochloride, but no effect at 624 mg daily. This study did not show any evidence of shortening the healing time compared to placebo. ^[15] Another small randomised controlled trial indicated the benefit of 3000 mg lysine daily for the reduction of occurrence, severity and healing time for recurrent HSV infection. ^[16] Lysine is one of the 20 amino acids normally found in proteins. ... Prophylaxis refers to any medical or public health procedure whose purpose is to prevent, rather than treat or cure, disease. ... A randomized controlled trial (RCT) is a form of clinical trial, or scientific procedure used in the testing of the efficacy of medicine, used because of its record of reliability. ...

Tissue culture studies have shown the suppression of viral replication when the lysine to arginine ratio in vitro favours lysine. The therapeutic consequence of this finding is unclear, but dietary arginine may affect the effectiveness of lysine supplementation. ^[17]

High doses of lysine (greater than 10 grams daily) are known to cause gastrointestinal adverse effects. Dyspepsia was reported in 3 of 114 subjects treated with L-lysine in one study. ^[16] Prolonged and/or very high lysine doses may also have adverse effects on renal function, indeed lysine is contraindicated in lysine hypersensitivity and kidney or liver disease. (Anon., 2005) One patient, with a history of risk factors for renal impairment, developed tubulointerstitial nephritis (Fanconi's Syndrome) after taking lysine 3000 mg daily for approximately 5 years. ^[18] Nephritis is inflammation of the kidney. ... Fanconi syndrome is a disorder in which the proximal tubular function of the kidney is impaired. ...

Other natural compounds

Carrageenans, linear sulphated polysaccharides extracted from red seaweeds, have been shown to have antiviral effects in HSV-infected cells. Carrageenan (pronounced ) is a family of linear sulphated polysaccharides extracted from red seaweeds. ... Polysaccharides (sometimes called glycans) are relatively complex carbohydrates. ... Seaweed-covered rocks in the UK Biologists, specifically Phycologists, consider seaweed to refer any of a large number of marine benthic algae that are multicellular, macrothallic, and thus differentiated from most algae that tend to be microscopic in size [1]. Seaweeds are usually types of brown or red algae that...

• There are indications that a carrageenan based gel may offer some protection against HSV-2 transmission by binding to the receptors on the herpes virus thus preventing the virus from binding to cells. Researchers have shown that a carrageenan-based gel effectively prevented HSV-2 infection at a rate of 85% in a mouse model. ^[19] There is an ongoing large-scale trial of the efficacy of a similar formulation on humans results are expected to be published in 2007.
• The natural carrageenans 1T1, 1C1, 1C3 isolated from Gigartina skottsbergii seaweed inhibited the replication avtivity of HSV-1 and HSV-2 in infected mouse astrocyte nerve cells and vero cells. ^[20]

Lactoferrin, a component of whey protein, has been shown to have a synergistic effect with aciclovir against HSV in vitro. ^[21] The concentration of lactoferrin which achieved 50% of maximum effectiveness observed (i.e., the EC₅₀) also acted in synergy with aciclovir; the concentration required to achieve EC₅₀ for each substance was reduced "two- to seven-fold." Carrageenan (pronounced ) is a family of linear sulphated polysaccharides extracted from red seaweeds. ... Seaweed-covered rocks in the UK Biologists, specifically Phycologists, consider seaweed to refer any of a large number of marine benthic algae that are multicellular, macrothallic, and thus differentiated from most algae that tend to be microscopic in size [1]. Seaweeds are usually types of brown or red algae that... Astrocytes, also known as astroglia, are characteristic star-shaped glial cells in the brain. ... Vero cells are used in cell cultures. ... Lactoferrin is a globular protein found in milk and many mucosal secretions such as tears. ... The term EC50 represents the concentration of a compound where 50% of its effect is observed. ...

Resveratrol, a compound in red wine, has been shown by researchers to prevent HSV replication in vitro by inhibiting a protein needed by the virus to replicate. Resveratrol alone was not considered potent enough by the researchers to be an effective treatment. ^[22] A more recent in vivo study in mice showed the efficacy of topical resveratrol cream in preventing cutaneous HSV lesion formation. ^[23] Research on a much more potent derivative of resveratol, named stil-5, is ongoing. There is no evidence that red wine consumption provides any similar benefits. Resveratrol is a substance that is produced by several plants and that is sold as a nutritional supplement. ... Wiktionary has a definition of: In vitro In vitro (Latin: within glass) means within a test tube, or, more generally, outside a living organism or cell. ... In vivo (Latin for (with)in the living). ...

Unproven

Limited evidence suggests that low dose aspirin (125 mg daily) might be beneficial in patients with recurrent HSV infections. A small study of 21 volunteers with recurrent HSV indicated a significant reduction in duration of active HSV infections, milder symptoms, and longer symptom-free periods as compared to a control group. ^[24] A recent animal study found that aspirin inhibited thermal stress-induced ocular viral shedding of HSV-1, and a possible benefit in reducing recurrences. ^[25] Aspirin is not recommended in persons under 18 years of age with herpes simplex due to the increased risk of Reye's syndrome. Long term daily doses of aspirin have a side effect of reduced blood coagulation, facilitating bruising. A single 81 mg "daily dose" aspirin is a safer regimen given that there are no studies of the correlation between dosage and anti-viral effects of aspirin. Aspirin or acetylsalicylic acid is a drug in the family of salicylates, often used as an analgesic (against minor pains and aches), antipyretic (against fever), and anti-inflammatory. ... Reyes syndrome is a potentially fatal disease that causes numerous detrimental effects to many organs, especially the brain and liver. ...

Cimetidine, a common component of heartburn medication, and probenecid have been shown to reduce the renal clearance of aciclovir. ^[26] The study showed these compounds reduce the rate, but not the extent, at which valaciclovir is converted into aciclovir. Renal clearence of aciclovir was reduced by approximately 24% and 33% respectively. In addition, respective increases in the peak plasma concentration of acyclovir of 8% and 22% were observed. Due to the tendency of aciclovir to precipitate in renal tubules, combining these drugs should only occur under the supervision of a physician. Cimetidine is a histamine H2-receptor antagonist that inhibits the production of acid in the stomach. ... Probenecid is a uricosuric drug, primarily used in treating gout or hyperuricemia, that increases uric acid removal in the urine. ...

Other

The evidence for the effectiveness of zinc and Vitamin C supplementation is poor. ^[27] Other supplements with anecdotal evidence of benefits include monolaurin, vitamin A, vitamin B12, garlic, and echinacea. Daily multivitamin intake may be beneficial through maintenance of immune system health. High doses of vitamin A should not be taken in early pregnancy due to linkage with birth defects. In addition, some anecdotal reports indicate that placing ice in contact with an emerging cold sore for 5-10 minutes throughout the day can help shorten the duration of the outbreak, or prevent it from developing further. General Name, Symbol, Number zinc, Zn, 30 Chemical series transition metals Group, Period, Block 12, 4, d Appearance bluish pale gray Atomic mass 65. ... It has been suggested that this article or section be merged into Ascorbic acid. ... Retinol, the dietary form of vitamin A, is a fat-soluble, antioxidant vitamin important in vision and bone growth. ... Cobalamin or vitamin B12 is a chemical compound that is also known as cyanocobalamine. ... Binomial name Allium sativum L. Garlic (Allium sativum) is a perennial plant in the family Alliaceae and genus Allium, closely related to the onion, shallot, and leek. ... Species See text. ... The Immune System (also known as the Immunlological System) is made up of all the mechanisms through which a multicellular organism defends itself from internal invaders such as bacteria, virus or parasites. ...

A risky alternative to treat an outbreak of oral HSV 1 is to apply a small amount of bleach via a cotton-bud directly to the blister. This is for directly attacking the pus filled blisters themselves. Bleach can burn the skin and mucous membranes so a very small amount is used. Again this is a risky alternative approach to treating an existing outbreak of oral HSV 1.^{[citation needed]} Commercial chlorine bleach To bleach something is to remove or lighten its color; a bleach is a chemical that can produce these effects, often via oxidization. ...

Latent infection and biology

The herpes virus is a double-stranded DNA (dsDNA)-type virus. Herpes establishes a latent infection in cells of the nervous system. Double-stranded DNA is incorporated into the cell physiology by infection of the cell nucleus, where a loop of dsDNA is maintained. During inactive, or latent, periods of the infection, a subset of the Herpes genome termed LAT or Latency Associated Transcript is active and may be involved in maintenance of latency. dsDNA is an abbreviation for double-stranded DNA ... In cell biology, the nucleus (from Latin nucleus or nuculeus, kernel) is found in all eukaryotic cells and contains the nuclear genes which form most of the cells genetic material. ... In biology the genome of an organism is the whole hereditary information of an organism that is encoded in the DNA (or, for some viruses, RNA). ... This article is in need of attention from an expert on the subject. ... This article is in need of attention from an expert on the subject. ...

Long-term effects

The long-term effects of herpes are not well known, but the blisters may leave scars, and historically it was thought to contribute to the risk of cervical cancer in women. Subsequently, another virus, human papillomavirus (HPV), has been shown to be a primary cause of cervical cancer in women. Additionally, people with herpes are at a higher risk of HIV transmission because of open blisters. In newborns, however, herpes can cause serious damage: death, neurological damage, mental retardation, and blindness. The naked protein coat (capsid) of a papillomavirus HPV redirects here. ... Human immunodeficiency virus (commonly known as HIV, and formerly known as HTLV-III and lymphadenopathy-associated virus) is a retrovirus that is the cause of the disease known as AIDS, or Acquired Immunodeficiency Syndrome, a syndrome where the immune system begins to fail, leading to many life-threatening opportunistic infections. ...

Currently, there is no viable cure for herpes. The immune system is able to destroy active herpes virus particles but the herpes virus has the ability to hide from the immune system in an inactive (or latent) state. Current research suggests that this ability to hide may be achieved via modification to cellular enzyme histone deacetylases (HDACs), namely HDAC1 and HDAC2. ^[28] Hypothetically, by interfering with the HDAC enzymes' effectiveness, it may be possible to block the virus's ability to hide from the immune system, leading to a complete elimination of the virus by the immune system. Studies on the impact of HDAC inhibitors on viral latency are ongoing in the HIV arena.

Psychological and social effects

When a person discovers he or she has genital herpes, it can have a dramatic effect on that person's mental well being and sexual behaviour.

Quality of life issues

Upon diagnosis of genital herpes, people can experience a number of negative feelings related to the condition. One study ^[29] surveyed people about their first episode of genital herpes. Findings showed proportions of people who experienced

• depression 82%
• fear of rejection 75%
• feeling of isolation 69%
• fear of being found out 55%
• self-destructive feelings 28%

All of these proportions reduced over time.

The impact of genital herpes included:

• partial or complete cessation of sexual activity
• total or partial loss of interest in sex
• decreased sexual pleasure
• sex life more inhibited and less spontaneous
• anxiety related to sexual desirability
• increased masturbation
• increased depression

In order to improve the well-being of people with herpes, a number of support groups exist, both physically and with a presence on the Internet.

Disclosure to new partners

People with genital herpes are often hesitant to divulge to other people that they have the virus, especially new or potential sexual partners. Results from one study show that people are less likely to inform what they consider to be 'casual' partners. ^[30] In addition, the perception of the likely reaction is sometimes taken into account before making a decision about whether to inform a new partner. An event such as a couple moving in together was found to be the point when some people disclosed their status.

The study showed people informed 62% of regular partners and 22% of casual partners, and was unrelated to the gender of the person. Strategies used when telling partners included keeping the issue "low key," choosing a relaxed environment and suggestions of the couple being tested jointly for a range of sexually transmitted infections. The ratio of positive reactions to negative reactions to disclosure was 22:4.

Doctors at some hospitals and health clinics actually advise men not to tell their partners^{[citation needed]} unless the woman is pregnant, reasoning that the psychological effects of herpes far outweigh the physical effects in adults. This advice is still controversial, especially as genital herpes affects women significantly worse than it does men.

Myths

Some common myths and misconceptions about herpes (usually meaning "genital") are:

• that it is fatal (only true for newborns, where it is rare, or if it infects the brain, which is again uncommon),
• that it only affects the genital areas (it can affect any part of the body),
• that condoms are completely effective in preventing the spread of this disease,
• that HSV-2 is transmittable only in the presence of symptoms,
• that it can make you sterile,
• that pap smears detect herpes,
• and that only promiscuous people get it (it is so common that anyone is at risk - with the exception of lifelong monogamous couples in the case of genital herpes). However it should be noted that the more sexual partners an individual has the more likely they are to contract the disease. This is especially true for women. [1]

There is a basis in fact that herpes could be transmitted via an inanimate object such as a toilet seat or wet towel but the conditions required for this kind of transmission (high heat, high moisture, and a vulnerable exposure site) make it extremely unlikely. Although there are no confirmed cases of this type of transmission, sharing a towel with somebody with active lesions should be avoided. Likewise, sharing lip or mouth products (toothbrushes, lipstick, lip balm, or similar) with somebody with active lesions should be avoided. The pap smear as we know it is an invention of Dr. Georgios Papanikolaou (1883-1962), an American of Greek birth, the father of cytopathology. ...

Other herpes viruses

There are eight members of the herpes virus family that are known to cause human disease, including not only the Herpes Simplex viruses (HSV-1 and HSV-2), but also the varicella-zoster virus (VZV, or HHV-3) which causes both shingles and chickenpox, Epstein-Barr virus (EBV, or HHV-4), cytomegalovirus (CMV, or HHV-5), human B cell lymphatic virus (HHV-6), roseola poorly characterised virus (HHV-7), and the Kaposi's sarcoma-associated herpesvirus (KSHV, or HHV-8). The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Genera Subfamily Alphaherpesvirinae    Simplexvirus    Varicellovirus    Mardivirus    Iltovirus Subfamily Betaherpesvirinae    Cytomegalovirus    Muromegalovirus    Roseolovirus Subfamily Gammaherpesvirinae    Lymphocryptovirus    Rhadinovirus Unassigned    Ictalurivirus The Herpesviridae is a family of DNA viruses that cause diseases in humans and animals. ... The varicella-zoster virus (VZV), also known as human herpesvirus 3 (HHV-3), is one of the eight herpesviruses known to affect humans (and other vertebrates). ... The Epstein-Barr virus (EBV), also called Human herpesvirus 4 (HHV-4), is a virus of the herpes family (which includes Herpes simplex virus and Cytomegalovirus), and is one of the most common viruses in humans. ... Species see text Cytomegalovirus (CMV), is a genus of Herpes viruses; in humans the species is known as Human herpesvirus 5 (HHV-5). ... Kaposis sarcoma-associated herpesvirus (KSHV) is the eighth human herpesvirus; its formal name according to the International Committee on Taxonomy of Viruses is HHV-8. ...

References

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2006 (MMVI) is a common year starting on Sunday of the Gregorian calendar. ... March 20 is the 79th day of the year in the Gregorian Calendar (80th in Leap years). ...

External links

• Sexually Transmitted Diseases/Infections Resource Center from the Association of Reproductive Health Professionals
• Center for Diseases Control Genital Herpes Fact Sheet
• Genital Shedding of Herpes Simplex Virus among Men
• Herpevac Trial for Women
• The American Social Health Organization
• Links to genital herpes pictures (Hardin MD/Univ of Iowa)
• Mayo Clinic on Cold Sores