Sunday, 7 June 2015

Herpes simplex

Herpes simplex (Greek: ἕρπης herpēs, "creeping" or "latent") is a viral disease caused by the herpes simplex virus. Infections are categorized based on the part of the body infected. Oral herpes involves the face or mouth. It may result in small blisters in groups often called cold sores or fever blisters or may just cause a sore throat.Genital herpes, often simply known as herpes, may have minimal symptoms or form blisters that break open and result in small ulcers. These typically heal over two to four weeks. Tingling or shooting pains may occur before the blisters appear. Herpes cycles between periods of active disease followed by periods without symptoms. The first episode is often more severe and may be associated with fever, muscle pains, swollen lymph nodes and headaches. Over time, episodes of active disease decrease in frequency and severity. Other disorders caused by herpes simplex include: herpetic whitlow when it involves the fingers,herpes of the eye,herpes infection of the brain, and neonatal herpes when it affects a newborn, among others.

There are two types of herpes simplex virus, type 1 (HSV-1) and type 2 (HSV-2). HSV-1 more commonly causes oral infections while HSV-2 more commonly causes genital infections. They are transmitted by direct contact with body fluids or lesions of an infected individual. Transmission may still occur when symptoms are not present. Genital herpes is classified as a sexually transmitted infection. It may be spread to an infant during childbirth. After infection, the viruses are transported along sensory nerves to the nerve cell bodies, where they reside lifelong. Causes of recurrence may include: decreased immune function, stress, and sunlight exposure. Oral and genital herpes is usually diagnosed based on the presenting symptoms. The diagnosis may be confirmed by viral culture or detecting herpes DNA in fluid from blisters. Testing the blood for antibodies against the virus can confirm a previous infection but will be negative in new infections.

The most effective method of avoiding genital infections is by avoiding vaginal, oral and anal sex. Condom use decreases the risk somewhat. Daily antiviral medication taken by someone who has the infection can also reduce spread. There is no available vaccine and once infected, there is no cure.Paracetamol (acetaminophen) and topical lidocaine may be used to help with the symptoms. Treatments with antiviral medication such as aciclovir or valaciclovir can lessen the severity of symptomatic episodes.

Worldwide rates of either HSV-1 or HSV-2 are between 60% and 95% in adults. HSV-1 is usually acquired during childhood. Rates of both increase as people age. Rates of HSV-1 are between 70% and 80% in populations of low socioeconomic status and 40% to 60% in populations of improved socioeconomic status. An estimated 536 million people worldwide (16% of the population) were infected with HSV-2 as of 2003 with greater rates among women and those in the developing world. Most people with HSV-2 do not realize that they are infected.


Herpes simplex is divided into two types; HSV-1 causes primarily mouth, throat, face, eye, and central nervous system infections, whereas HSV-2 causes primarily anogenital infections. However, each may cause infections in all areas.

Signs and symptoms

HSV infection causes several distinct medical disorders. Common infection of the skin or mucosa may affect the face and mouth (orofacial herpes), genitalia (genital herpes), or hands (herpetic whitlow). More serious disorders occur when the virus infects and damages the eye (herpes keratitis), or invades the central nervous system, damaging the brain (herpes encephalitis). People with immature or suppressed immune systems, such as newborns, transplant recipients, or people with AIDS, are prone to severe complications from HSV infections. HSV infection has also been associated with cognitive deficits of bipolar disorder, and Alzheimer's disease, although this is often dependent on the genetics of the infected person.

In all cases, HSV is never removed from the body by the immune system. Following a primary infection, the virus enters the nerves at the site of primary infection, migrates to the cell body of the neuron, and becomes latent in the ganglion. As a result of primary infection, the body produces antibodies to the particular type of HSV involved, preventing a subsequent infection of that type at a different site. In HSV-1-infected individuals, seroconversion after an oral infection prevents additional HSV-1 infections such as whitlow, genital herpes, and herpes of the eye. Prior HSV-1 seroconversion seems to reduce the symptoms of a later HSV-2 infection, although HSV-2 can still be contracted.

Many people infected with HSV-2 display no physical symptoms—individuals with no symptoms are described as asymptomatic or as having subclinical herpes.

Condition Description Illustration
Herpetic gingivostomatitis Herpetic gingivostomatitis is often the initial presentation during the first herpes infection. It is of greater severity than herpes labialis, which is often the subsequent presentations.
Herpes labialis Infection occurs when the virus comes into contact with oral mucosa or abraded skin.
Cold sore.jpg
Herpes genitalis When symptomatic, the typical manifestation of a primary HSV-1 or HSV-2 genital infection is clusters of inflamed papules and vesicles on the outer surface of the genitals resembling cold sores.
Herpetic whitlow and herpes gladiatorum Herpes whitlow is a painful infection that typically affects the fingers or thumbs. On occasion, infection occurs on the toes or on the nail cuticle. Individuals who participate in contact sports such as wrestling, rugby, and football(soccer), sometimes acquire a condition caused by HSV-1 known as herpes gladiatorum, scrumpox, wrestler's herpes, or mat herpes, which presents as skin ulceration on the face, ears, and neck. Symptoms include fever, headache, sore throat, and swollen glands. It occasionally affects the eyes or eyelids.
Herpetic whitlow in young child.jpg
Herpesviral encephalitis and herpesviral meningitis A herpetic infection of the brain thought to be caused by the retrograde transmission of virus from a peripheral site on the face following HSV-1 reactivation, along the trigeminal nerve axon, to the brain. HSV is the most common cause of viral encephalitis. When infecting the brain, the virus shows a preference for the temporal lobe. HSV-2 is the most common cause of Mollaret's meningitis, a type of recurrent viral meningitis.
Hsv encephalitis.jpg
Herpes esophagitis Symptoms may include painful swallowing (odynophagia) and difficulty swallowing (dysphagia). It is often associated with impaired immune function (e.g. HIV/AIDS, immunosuppression in solid organ transplants).
Herpes esophagitis.JPG
Neonatal herpes simplex is a HSV infection in an infant. It is a rare but serious condition, usually caused by vertical transmission of HSV-1 or -2) from mother to newborn. During immunodeficiency, herpes simplex can cause unusual lesions in the skin. One of the most striking is the appearance of clean linear erosions in skin creases, with the appearance of a knife cut.Herpetic sycosis is a recurrent or initial herpes simplex infection affecting primarily the hair follicles.Eczema herpeticum is an infection with herpesvirus in patients with chronic atopic dermatitis may result in spread of herpes simples throughout the eczematous areas.
Herpetic keratoconjunctivitis, a primary infection, typically presents as swelling of the conjunctiva and eyelids (blepharoconjunctivitis), accompanied by small white itchy lesions on the surface of the cornea.

Herpetic sycosis is a recurrent or initial herpes simplex infection affecting primarily the hair follicle.
Bell's palsy
Although the exact cause of Bell's palsy—a type of facial paralysis—is unknown, it may be related to reactivation of HSV-1. This theory has been contested, however, since HSV is detected in large numbers of individuals having never experienced facial paralysis, and higher levels of antibodies for HSV are not found in HSV-infected individuals with Bell's palsy compared to those without. Regardless antivirals have been found to not improve outcomes.

Alzheimer's disease
HSV-1 has been proposed as a possible cause of Alzheimer's disease. In the presence of a certain gene variation (APOE-epsilon4 allele carriers), HSV-1 appears to be particularly damaging to the nervous system and increases one's risk of developing Alzheimer's disease. The virus interacts with the components and receptors of lipoproteins, which may lead to its development.


Herpes shedding
HSV-2 genital 15–25% of days
HSV-1 oral 6–33% of days
HSV-1 genital 5% of days
HSV-2 oral 1% of days
Herpes is contracted through direct contact with an active lesion or body fluid of an infected person. Herpes transmission occurs between discordant partners; a person with a history of infection (HSV seropositive) can pass the virus to an HSV seronegative person. Herpes simplex virus 2 is typically contracted through direct skin-to-skin contact with an infected individual, but can also be contacted by exposure to infected saliva, semen, vaginal fluid, or the fluid from herpetic blisters. To infect a new individual, HSV travels through tiny breaks in the skin or mucous membranes in the mouth or genital areas. Even microscopic abrasions on mucous membranes are sufficient to allow viral entry.

HSV asymptomatic shedding occurs at some time in most individuals infected with herpes. It can occur more than a week before or after a symptomatic recurrence in 50% of cases. Virus enters into susceptible cells by entry receptors such as nectin-1, HVEM and 3-O sulfated heparan sulfate. Infected people who show no visible symptoms may still shed and transmit viruses through their skin; asymptomatic shedding may represent the most common form of HSV-2 transmission. Asymptomatic shedding is more frequent within the first 12 months of acquiring HSV. Concurrent infection with HIV increases the frequency and duration of asymptomatic shedding. Some individuals may have much lower patterns of shedding, but evidence supporting this is not fully verified; no significant differences are seen in the frequency of asymptomatic shedding when comparing persons with one to 12 annual recurrences to those with no recurrences.

Antibodies that develop following an initial infection with a type of HSV prevents reinfection with the same virus type—a person with a history of orofacial infection caused by HSV-1 cannot contract herpes whitlow or a genital infection caused by HSV-1. In a monogamous couple, a seronegative female runs a greater than 30% per year risk of contracting an HSV infection from a seropositive male partner. If an oral HSV-1 infection is contracted first, seroconversion will have occurred after 6 weeks to provide protective antibodies against a future genital HSV-1 infection. Herpes simplex is a double-stranded DNA virus.


Primary orofacial herpes is readily identified by clinical examination of persons with no previous history of lesions and contact with an individual with known HSV-1 infection. The appearance and distribution of sores in these individuals typically presents as multiple, round, superficial oral ulcers, accompanied by acute gingivitis. Adults with atypical presentation are more difficult to diagnose. Prodromal symptoms that occur before the appearance of herpetic lesions help differentiate HSV symptoms from the similar symptoms of other disorders, such as allergic stomatitis. When lesions do not appear inside the mouth, primary orofacial herpes is sometimes mistaken for impetigo, a bacterial infection. Common mouth ulcers (aphthous ulcer) also resemble intraoral herpes, but do not present a vesicular stage.

Genital herpes can be more difficult to diagnose than oral herpes, since most HSV-2-infected persons have no classical symptoms. Further confusing diagnosis, several other conditions resemble genital herpes, including fungal infection, lichen planus, atopic dermatitis, and urethritis.Laboratory testing is often used to confirm a diagnosis of genital herpes. Laboratory tests include culture of the virus, direct fluorescent antibody (DFA) studies to detect virus, skin biopsy, and polymerase chain reaction to test for presence of viral DNA. Although these procedures produce highly sensitive and specific diagnoses, their high costs and time constraints discourage their regular use in clinical practice.

Until recently, serological tests for antibodies to HSV were rarely useful to diagnosis and not routinely used in clinical practice. The older IgM serologic assay could not differentiate between antibodies generated in response to HSV-1 or HSV-2 infection. However, the new Immunodot glycoprotein G-specific (IgG) HSV test is more than 98% specific at discriminating HSV-1 from HSV-2. Some believe the new IgG test should always be preferred to the old IgM test.

It should not be confused with conditions caused by other viruses in the herpesviridae family such as herpes zoster, which is caused by varicella zoster virus. The differential diagnosis includes hand, foot and mouth disease due to similar lesions on the skin.


Barrier protection, such as a condom, can reduce the risk of herpes transmission.
As with almost all sexually transmitted infections, 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 of HSV-2 from infected male to female is about 8–11%. 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 around 4–5% annually. Suppressive antiviral therapy reduces these risks by 50%. Antivirals also help prevent the development of symptomatic HSV in infection scenarios, meaning the infected partner will be seropositive but symptom-free by about 50%. Condom use also reduces the transmission risk significantly. Condom use is much more effective at preventing male-to-female transmission than vice versa. Previous HSV-1 infection appears to reduce the risk for acquisition of HSV-2 infection among women by a factor of three.

However, asymptomatic carriers of the HSV-2 virus are still contagious. In many infections, the first symptom people will have of their own infections is the horizontal transmission to a sexual partner or the vertical transmission of neonatal herpes to a newborn at term. Since most asymptomatic individuals are unaware of their infection, they are considered at high risk for spreading HSV.

In October 2011, the anti-HIV drug tenofovir, when used topically in a microbicidal vaginal gel, was reported to reduce herpes virus sexual transmission by 51%.

Barrier methods
Condoms offer moderate protection against HSV-2 in both men and women, with consistent condom users having a 30%-lower risk of HSV-2 acquisition compared with those who never use condoms. A female condom can provide greater protection than the male condom, as it covers the labia. The virus cannot pass through a synthetic condom, but a male condom's effectiveness is limited because herpes ulcers may appear on areas not covered by it. Neither type of condom prevents contact with the scrotum, anus, buttocks, or upper thighs, areas that may come in contact with ulcers or genital secretions during sexual activity. Protection against herpes simplex depends on the site of the ulcer; therefore, if ulcers appear on areas not covered by condoms, abstaining from sexual activity until the ulcers are fully healed is one way to limit risk of transmission. The risk is not eliminated, however, as viral shedding capable of transmitting infection may still occur while the infected partner is asymptomatic. The use of condoms or dental dams also limits the transmission of herpes from the genitals of one partner to the mouth of the other (or vice versa) during oral sex. When one partner has a herpes simplex infection and the other does not, the use of antiviral medication, such as valaciclovir, in conjunction with a condom, further decreases the chances of transmission to the uninfected partner. Topical microbicides that contain chemicals that directly inactivate the virus and block viral entry are being investigated.

Antivirals may reduce asymptomatic shedding; asymptomatic genital HSV-2 viral shedding is believed to occur on 20% of days per year in patients not undergoing antiviral treatment, versus 10% of days while on antiviral therapy.

The risk of transmission from mother to baby is highest if the mother becomes infected around the time of delivery (30% to 60%), since insufficient time will have occurred for the generation and transfer of protective maternal antibodies before the birth of the child. In contrast, the risk falls to 3% if the infection is recurrent, and is 1–3% if the woman is seropositive for both HSV-1 and HSV-2, and is less than 1% if no lesions are visible. Women seropositive for only one type of HSV are only half as likely to transmit HSV as infected seronegative mothers. To prevent neonatal infections, seronegative women are recommended to avoid unprotected oral-genital contact with an HSV-1-seropositive partner and conventional sex with a partner having a genital infection during the last trimester of pregnancy. Mothers infected with HSV are advised to avoid procedures that would cause trauma to the infant during birth (e.g. fetal scalp electrodes, forceps, and vacuum extractors) and, should lesions be present, to elect caesarean section to reduce exposure of the child to infected secretions in the birth canal. The use of antiviral treatments, such as acyclovir, given from the 36th week of pregnancy, limits HSV recurrence and shedding during childbirth, thereby reducing the need for caesarean section.

Acyclovir is the recommended antiviral for herpes suppressive therapy during the last months of pregnancy. The use of valaciclovir and famciclovir, while potentially improving compliance, have less-well-determined safety in pregnancy.


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.


The antiviral medication acyclovir
Several antiviral drugs are effective for treating herpes, including acyclovir, valaciclovir (valacyclovir), famciclovir, and penciclovir. Acyclovir was the first discovered and is now available in generic. Valacyclovir is also available as a generic.

Evidence supports the use of acyclovir and valacyclovir in the treatment of herpes labialis as well as herpes infections in people with cancer. The evidence to support the use of acyclovir in primary herpetic gingivostomatitis is weaker.

A number of topical antivirals are effective for herpes labialis, including acyclovir, penciclovir, and docosanol.

Alternative medicine
Certain dietary supplements and alternative remedies are claimed to be beneficial in the treatment of herpes. Evidence is insufficient, though, to support use of many of these compounds, including echinacea, eleuthero, L-lysine, zinc, monolaurin bee products, and aloe vera. While a number of small studies show possible benefit from monolaurin, L-lysine, aspirin, lemon balm, topical zinc, or licorice root cream in treatment, these preliminary studies have not been confirmed by higher-quality randomized controlled studies.


Following active infection, herpes viruses establish a latent infection in sensory and autonomic ganglia of the nervous system. The double-stranded DNA of the virus is incorporated into the cell physiology by infection of the nucleus of a nerve's cell body. HSV latency is static; no virus is produced; and is controlled by a number of viral genes, including latency-associated transcript.

Many HSV-infected people experience recurrence within the first year of infection.Prodrome precedes development of lesions. Prodromal symptoms include tingling (paresthesia), itching, and pain where lumbosacral nerves innervate the skin. Prodrome may occur as long as several days or as short as a few hours before lesions develop. Beginning antiviral treatment when prodrome is experienced can reduce the appearance and duration of lesions in some individuals. During recurrence, fewer lesions are likely to develop and are less painful and heal faster (within 5–10 days without antiviral treatment) than those occurring during the primary infection. Subsequent outbreaks tend to be periodic or episodic, occurring on average four or five times a year when not using antiviral therapy.

The causes of reactivation are uncertain, but several potential triggers have been documented. A 2009 study showed the protein VP16 plays a key role in reactivation of the dormant virus. Changes in the immune system during menstruation may play a role in HSV-1 reactivation. Concurrent infections, such as viral upper respiratory tract infection or other febrile diseases, can cause outbreaks. Reactivation due to other infections is the likely source of the historic terms 'cold sore' and 'fever blister'.

Other identified triggers include local injury to the face, lips, eyes, or mouth; trauma; surgery; radiotherapy; and exposure to wind, ultraviolet light, or sunlight.

The frequency and severity of recurrent outbreaks vary greatly between people. Some individuals' outbreaks can be quite debilitating, with large, painful lesions persisting for several weeks, while others experience only minor itching or burning for a few days. Some evidence indicates genetics play a role in the frequency of cold sore outbreaks. An area of human chromosome 21 that includes six genes has been linked to frequent oral herpes outbreaks. An immunity to the virus is built over time. Most infected individuals experience fewer outbreaks and outbreak symptoms often become less severe. After several years, some people become perpetually asymptomatic and no longer experience outbreaks, though they may still be contagious to others. Immunocompromised individuals may experience longer, more frequent, and more severe episodes. Antiviral medication has been proven to shorten the frequency and duration of outbreaks. Outbreaks may occur at the original site of the infection or in proximity to nerve endings that reach out from the infected ganglia. In the case of a genital infection, sores can appear at the original site of infection or near the base of the spine, the buttocks, or the back of the thighs. HSV-2-infected individuals are at higher risk for acquiring HIV when practicing unprotected sex with HIV-positive persons, in particular during an outbreak with active lesions.


Main article: Epidemiology of herpes simplex
Worldwide rates of either HSV-1 and/or HSV-2 are between 60 and 95% in adults. HSV-1 is more common than HSV-2, with rates of both increasing as people age. HSV-1 rates are between 70% and 80% in populations of low socioeconomic status and 40% to 60% in populations of improved socioeconomic status. An estimated 536 million people or 16% of the population worldwide were infected with HSV-2 as of 2003 with greater rates among women and in those in the developing world. Rates of infection are determined by the presence of antibodies against either viral species.

In the US, 57.7% of the population is infected with HSV-1 and 16.2% are infected with HSV-2. Among those HSV-2-seropositive, only 18.9% were aware they were infected. During 2005–2008, the prevalence of HSV-2 was 39.2% in blacks and 20.9% in women.


Herpes has been known for at least 2,000 years. Emperor Tiberius is said to have banned kissing in Rome for a time due to so many people having cold sores. In the 16th-century Romeo and Juliet, blisters "o'er ladies' lips" are mentioned. In the 18th century, it was so common among prostitutes that it was called "a vocational disease of women". The term 'herpes simplex' appeared in Richard Boulton's A System of Rational and Practical Chirurgery in 1713, where the terms 'herpes miliaris' and 'herpes exedens' also appeared. Herpes was not found to be a virus until the 1940s.

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 cytorabine. 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 acyclovir, in the late 1970s raised antiviral treatment another notch and led to vidarabine vs. acyclovir trials in the late 1980s. The lower toxicity and ease of administration over vidarabine has led to acyclovir 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, acyclovir seems to inhibit antibody response, and newborns on acyclovir antiviral treatment experienced a slower rise in antibody titer than those on vidarabine.

Society and culture

Herpes simplex was not always stigmatised. It was merely a cold sore in an unusual place until the 1970s. As late as 1975, a study of "Psychological morbidity in a clinic for sexually transmitted disease" does not mention herpes simplex because at that time, no significant morbidity problem (i.e. mental anxiety or illness) was associated with the virus.

Pedro Cuatrecasas states, "during the R&D of acyclovir (Zovirax), marketing [department of Burroughs Wellcome] insisted that there were 'no markets' for this compound. Most had hardly heard of genital herpes..." Thus, marketing the medical condition – separating the 'normal cold sore' from the 'stigmatized genital infection' was to become the key to marketing the drug, a process now known as 'disease mongering'.

Since the creation of the herpes hype, some people experience negative feelings related to the condition following diagnosis, in particular if they have acquired the genital form of the disease. Feelings can include depression, fear of rejection, feelings of isolation, fear of being found out, and self-destructive feelings. These feelings usually lessen over time. Much of the hysteria and stigma surrounding herpes stems from a media campaign beginning in the late 1970s and peaking in the early 1980s. Multiple articles were worded in fear-mongering and anxiety-provoking terminology, such as the now-ubiquitous "attacks", "outbreaks", "victims", and "sufferers". At one point, the term "herpetic" even entered the popular lexicon. The articles were published by Reader's Digest, U.S. News, and Time magazine, among others. A made-for-TV movie was named Intimate Agony. The peak was when Time magazine had 'Herpes: The New Scarlet Letter' on the cover in August 1982, forever stigmatizing the word in the public mind.Herpes support groups have been formed in the United States and the UK, providing information about herpes and running message forums and dating websites for sufferers. People with the herpes virus are often hesitant to divulge to other people, including friends and family, that they are infected. This is especially true of new or potential sexual partners whom they consider casual.


Main article: Herpes simplex research
Substantial research has gone into vaccines for both prevention and treatment of herpes infections. Unsuccessful clinical trials have been conducted for glycoprotein subunit vaccines. For therapy, only a single replication-competent HSV vaccine has undergone human testing. As of 2011, the future pipeline includes several promising replication-incompetent vaccine proposals while two replication-competent vaccine proposals require further animal testing.

Researchers at the University of Florida have made a hammerhead ribozyme that targets and cleaves the mRNA of essential genes in HSV-1. The hammerhead, which targets the mRNA of the UL20 gene, greatly reduced the level of HSV-1 ocular infection in rabbits, and reduced the viral yield in vivo. The gene-targeting approach uses a specially designed RNA enzyme to inhibit strains of the herpes simplex virus. The enzyme disables a gene responsible for producing a protein involved in the maturation and release of viral particles in an infected cell. The technique appears to be effective in experiments with mice and rabbits, but further research is required before it can be attempted in people infected with herpes.

Another possibility to eradicate the HSV-1 variant is being pursued by a team at Duke University. By figuring out how to switch all copies of the virus in the host from latency to their active stage at the same time, rather than the way the virus copies normally stagger their activity stage, leaving some dormant somewhere at all times, conventional antiviral drugs might kill the entire virus population, since they can no longer hide in the nerve cells. One class of drugs called antagomir could serve this purpose. These are chemically engineered oligonucleotides or short segments of RNA that can be made to mirror their target genetic material, namely herpes microRNAs. They could be engineered to attach and thus 'silence' the microRNA, thus rendering the virus incapable of remaining latent in its host. Professor Cullen believes a drug could be developed to block the microRNA whose job it is to suppress HSV-1 into latency.

A genomic study of the herpes simplex type 1 virus confirmed the human migration pattern theory called 'out-of-Africa hypothesis'.


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Sunday, 4 May 2014

The Melanie Addington story

On  probably the most significant breakthrough in herpes cures

soon-to-be ex-sufferer.

Let me ask you a question: What if you didn’t have to buy Zovirax, Famvir, Valtrex or any other “cyclovir” medication again? Sounds impossible? I thought so too before I discovered a big lie Big Pharma kept hidden from people like you and me for decades. There’s a way to wipe out the root cause of herpes without side effects and it’s backed by several scientific studies. After just one treatment it can end your nightmare forever. Imagine….no more feelings of guilt and regret about your infection…no more obsessing of what you have or haven’t done to protect yourself and others…no more paranoia about infecting someone you love or about other people finding out. You can leave the nights of nausea, headaches and pain behind. The days with horrible fatigue will be over because there’s a way to wipe out the root cause of herpes without side effects and it’s backed by several scientific studies. After just one treatment it can end your nightmare forever. Now before I reveal it to you, let me introduce myself… My name is Melanie Addington and to the right you can see a picture of me and my ex. Why am I showing you this? Because a few days after this picture was taken I got diagnosed with type 2 herpes. And he broke up with me. He said it wasn’t his fault. And that he did not want me to ruin his life. “How could this happen to me?” I asked myself. I hadn’t been sleeping around. In fact, John had been just the second man I’d been intimate with. Out of the blue some sores had appeared on my butt. I wouldn’t have taken them seriously but their constant chafing against my underwear drove me insane. Even when my doctor took skin and blood samples I was more annoyed than worried. I felt he was cracking a nut with a sledgehammer. Imagine my shock when I was asked back for the results… Herpes I felt like I’d been punched in the stomach. All I could think was “It can’t be me he’s talking about!” Herpes sounded like a life sentence….in solitary confinement. The only way to escape herpes prison was to die. “All we can do is control your outbreaks”, my doc said. He put me on acyclovir. And the sores on my butt disappeared. But it wasn’t the only thing acyclovir made me lose. I soon started losing hair. And a ton of it. I panicked and asked my doctor. He confirmed acyclovir can cause heavy hair loss. Among other side effects. I switched to Valtrex. It made my stomach violently rebel. I couldn’t focus on work and colleagues cut me out of projects. I had to stop with the Valtrex or my boss would have fired me. The sores came back and I was crushed. The drugs that were meant to heal had ruined my life After months of suffering I gave in to the pleas of my mother and let my father in on my secret. You see, my father is one of Britain’s medical mavericks. You’ve probably never heard of him because he shuns the lime light. He prefers to help as many people as possible by working in the trenches. Doctors from all over the country send him their hopeless cases. It had occurred to me to ask him for help. But I was embarrassed. Now he was my only hope. .. Like me, my father had been disappointed by Big Pharma. A ll the time they tried to get him to peddle their drugs to his patients. They do this everywhere. In the US for example they spend $61,000 on each doctor to get him to push their drugs. But my father rebelled. For him only results count. And all too often chemical warfare on your body isn’t the best option. That’s why he started to research natural treatments. Some of them so old they’ve been used since Roman times. There is an even more important reason why my father avoids mainstream herpes meds. They don’t cure you. They only hide the sign of your illness. But those herpes sores have a function. They are a warning sign from your body telling you there’s a problem. Much like the engine light in your car. Would you just cover that up so you can’t see it anymore? Of course not. And here’s a fact you probably didn’t know: It’s not much different with herpes. If you just cover it up with suppressive drugs it still undermines your health. It can even kill you by swinging the doors wide open for an army of other diseases. For example… You are 2-4 times more likely to catch HIV according to the University of Washington And how about seizures and swelling of your brain tissue so bad it can burst your skull? What sounds like the sick script of a horror movie is called “meningitis”. It kills 11% of its victims. 36% of women and 13% of men with herpes catch meningitis every year. And scientists from Wayne State University discovered that if you escape meningitis once your risk of catching it again quadruples. For my father this is an unacceptable risk for his patients. He had to find a safer way which addresses the root cause. While researching he made an astonish discovery: You see, the herpes virus has been known for more than 2,000 years. And… Our ancestors did know how to treat herpes “What happened to this treatment?” you might ask. Well, a company that’s now part of a $60 billion pharma giant as well as an extended field study in Hungary both proved it effective at killing the herpes virus. Big Pharma never gave a reason why it never released it on the market. But here’s something to think about: This natural substance costs 66 times less than acyclovir and you can’t put a patent on it. The story repeated itself in the early 90s when several studies – for example from the New York University Medical Center – proved the effectiveness of another substance against herpes. Again it cost only a fraction of acyclovir and again it couldn’t be patented. Big Pharma decided to ignore it. You might be curious why you haven’t heard about this. What about independent institutions such as the American Herpes Foundation? Well, look who backs them… It’s obvious… Big Pharma has only one plan: Make money by selling overpriced drugs. Not natural treatments they can’t patent. They aren’t interested in a cure. They only want to profit from your sickness Fortunately, there finally is an alternative. It has already helped thousands of herpes victims just like you escape frequent outbreaks and the limitations they put on your life. People like Maria S. from Houston, Texas. After using this treatment, Maria wrote me: Or Marcus W. from Parma, Ohio: The step-by-step herpes protocol That Was developed worked not only for these people but for literally everyone who tried it. Up to today it has helped more than 7,500 herpes victims ban the virus from their lives, never to suffer from any sore again. Best of all, it’s so simple and inexpensive it hardly costs a buck a day Just a few months ago it was almost impossible to get access to this treatment protocol. You see, my father’s booked months in advance and unless you own a British health insurance you’d have to pay a consultation fee of £300,-, about $500. I would never have been able to pay this with my modest salary as a journalist. Since both my father and I want to help as many herpes victims as possible we had to solve this issue. I thus used my writing skills to condense every single detail of this treatment in an easy-to-follow report which I named the “Ultimate Herpes Protocol – Secrets to Naturally Treat Herpes”. The Ultimate Herpes Protocol is a step-by step blueprint to fight off herpes type I & II as well as shingles without unleashing chemical warfare on your body. Best news: It works even if you’ve already blown hundreds or even thousands of dollars on conventional herpes medication without significant relief…even if you’ve been suffering from herpes for years…and even if your virus is currently in hiding and your doctor claims nothing can reach it. Let this protocol vanish your herpes and restore your health as it has for more than 7,500 folks just like you. The reason it’s called the “ultimate” protocol is simple: It’s the only system that attacks herpes from 3 angles at the same time, guaranteeing its complete destruction. First, it kicks your immune system into high gear. It’s like sharpening the ax when you want to cut down a tree. Your sharper immune system can axe herpes fast and with ease. See, your body is incredibly powerful in healing itself but often its ability is crippled because it’s starved of vital nutrients. Starting on page 14 you’ll learn about 7 vital steps to nourish and restore your immune system naturally. Soon not only herpes but also small infections will be a thing of the past. It’s like having the SEALS stationed at your front door preventing any virus from wiggling its way in. On page 20 you’ll discover how to claw toxic gunk out of your body which slowly poisons you. Kiss headaches, fatigue or problems with your digestion goodbye. And all this while giving the herpes virus a deadly blow. The second angle from which the Ultimate Herpes Protocol attacks the virus is by dissolving its protective protein coat. This leaves the virus as helpless as a newborn baby against the attack by your strengthened immune system. As a last measure the Ultimate Herpes Protocol stops the virus from making copies of itself. Just like an army without reinforcements the herpes virus gets crushed and driven out of your system. Thanks to this state-of-the-art treatment protocol suffering from herpes doesn’t need to be your destiny anymore. Now faith is one thing, actually seeing the results another thing altogether. Just see to what Eva W. from Orem, Utah had to say: Jason P. from Connecticut wrote me saying Now I know each of us is different. So I can’t say how much pain the Ultimate Herpes Protocol will help you escape. I don’t know how much herpes makes you suffer…and I’d be guessing if I’d say the embarrassment this condition causes shattered your zest of life. What I can say with 100% certainty is that traditional meds only reduce the number of outbreaks but do nothing to dismantle the ticking time bomb of the herpes virus inside you. And all drugs come with a long list of side effects. You don’t have to suffer like this anymore! You can stop herpes now without any of this madness. I still remember how just hours into the protocol my sores stopped itching…how they healed after a few days…and how I felt like I had woken up from a nightmare when both the PCR blood test and the lgG came back negative. What would it be worth to you to experience this yourself? $100,000 as taking prescription drugs until you’re old and gray will cost you? Probably not. What about $2,400? Remember, you shell that out every year for acyclovir. Expensive, mmmh? Maybe $500, that’s what one consultation with my father costs. That would be a steal. But you’re NEVER going to pay that. I wanted everyone to be able to have access to this treatment protocol while still covering the cost of our marketing. So I thought $59 to be a very fair price. And you won’t just receive the Ultimate Herpes Protocol report. On top, I’ve prepared two life-enriching bonuses each worth at least twice as much as the total price for this package. Probably the worst thing about herpes is the loneliness it causes. It gets harder to trust others, you get scared of infecting someone else or simply the fear of others finding out and excluding you makes many of us live like hermits. But once the Ultimate Herpes Protocol has taken care of your condition you might want to meet new people again – maybe even go on dates. I know from personal experience how scary walking up to strangers can be. So I prepared a short-cut for you to… Bring your social life back to speed the easy way For this I asked an old friend for help. His name is Scott Valdez. See, Scott with his company Virtual Dating Assistants is THE expert on online dating. He’s helped 1,000s of singles meet new people without even leaving their couch. He’s been featured on CNN, MSNBC, the BBC, Forbes, the Washington Post and many other major media outlets. Scott charges his clients up to $1,520 each month for his services. But for you I cut a special deal. For the first time Scott condensed his wisdom in one simple guide on how to attract new people online. It’s the result of over 4 years of experience working with his team as online dating consultant. Scott could easily get $1,000 for it if he could ever be convinced of selling it. He prefers to charge his Cadillac fees though. So the only way to get your hands on this guide is as a free bonus to the Ultimate Herpes Protocol. Imagine how you just downloaded Scott’s brain and it floods your inbox with messages from high quality people desperate to meet you. And it doesn’t stop there… The second bonus is especially dear to my heart. I know how suffering from herpes can drag you down. This is why I want to show you how to break free from life-devouring depression and enjoy life like you used to. The report I named “Happy Now– Leaving Negativity and Depression Behind” will improve not only your outlook on life but your sense of self-worth and your relationship with all the people you come in contact with. Not to mention that a study from the Harvard University Medical School has clearly proven that thinking positively helps with your healing process. Let me ask you this: How would you feel looking back years from now, still suffering from frequent outbreaks and realize you could have cured your herpes right now with just a few simple steps? What would it mean to you to never worry about untimely outbreaks again? What would it feel like to never have another one of those “come-clean” conversations with a potential partner? Finally relax and feel approachable again knowing that skeleton in your closet has vanished. If you act now, as long as this presentation is still up, you can gain access to this program for just $37 today. Note: This is a 62% price reduction from the usual price of $59 in celebration of the upcoming Herpes Awareness Day. That’s less than what a week’s supply of acyclovir costs you – without the side effects. It’s a fraction of what a visit to any doctor costs. And it’s practically free considering all the heartache and embarrassment it will save you from. And all you need to do is click the blue “Get Instant Access” button below. In just minutes from now you can be well on your way to be free of herpes for life.

You Can Check Out the Original Article Here

Saturday, 19 May 2012

Female Genital Herpes

Genital herpes is a disease which is caused due to the virus called herpes simplex 2 (HSV 2) which passes from one person to another through unprotected sexual activity. Genital herpes is a highly contagious disease which causes uncomfortable and embarrassing symptoms. Though men and women both are affected by genital herpes but it is more prevalent in females.
Symptoms of Female Genital Herpes
Many females who are infected with genital herpes shows no obvious signs of the disease but if they do have symptoms then they only appear within 2 to 20 days of infection. The initial symptoms of herpes include a group of signs which are known as prodome and warn an impending outbreak. The signs also include pain, sensitivity a burning at the areas where the blisters are likely to appear. Other symptoms include flu like feeling, pain in buttocks and leg area, swollen glands, vaginal discharge and pressure below the abdomen. At an average a virus takes around 3 weeks to show its first symptoms however in few cases it may also be early.
The first outbreak of female genital herpes is the worst condition where small clusters of blisters called lesions appear around the vaginal area. These lesions over a period of days break into open sores and then scab and heal. Females may also experience pain while urinating and aching muscles during this time.
Identification of Genital Herpes in Female
Female genital herpes may or may not show symptoms and even if they are, they may be mild or severe. Though there are various signs of genital herpes like formation of blisters, vaginal discharge and others but in order to be sure one should always visit their doctor. The doctor will evaluate the symptoms, examine the blisters and will suggest a blood test for confirmation.
Time Frame for Genital Herpes in Female
In most of the cases the symptoms of female genital herpes appear within 2 weeks after getting the infection. The sores caused due to this disease get healed on their own within 2 to 4 weeks. There may be several weeks or months time before the appearance of the next outbreak signs. The next outbreak is usually less painful and less severe and it also last for a shorter period of time as compared to the first one. During the first year of infection, a person may experience 4 to 5 outbreaks which eventually decrease over the years.
Warning for the Females Suffering from Genital Herpes
It is easier for a female suffering from genital herpes to get infected with other sexually transmitted disease as infection can easily enter through open blisters and sores. The genital herpes infection may also pass to an unborn baby through a pregnant mother and may cause serious health complications.
Treatment of Female Genital Herpes
Since herpes is considered as the most stubborn virus thus there is no treatment available for the same as well. Though various medications are available in order to treat its symptoms and freeze its chances of appearing again. In order to prevent the condition of female genital herpes sexual activity should be avoided or use of use of latex condom should be done.
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Male Genital Herpes

Large number of people all over the globe faces the problem of male genital herpes which is caused by the HSV virus. Since it is a sexually transmitted disease, it cannot be spread by any other means then intercourse or other sexual act. Though this disease results in discomfort, pain and emotional trauma but in most of the cases it is not life threatening. In some of the extreme cases it can even lead to infection being spread to the other areas of the body.
Types of Male Genital Herpes
There are two different types of male genital herpes which include Herpes Simplex Virus Type 1 and Herpes Simplex Virus Type 2. Though male genital herpes are mainly caused by HSV 2 but in some cases HSV 1 can also lead to this problem. There has been increase in the number of people having male genital herpes from HSV 1 infection in the recent years.
Symptoms of Male Genital Herpes
A person infected with male genital herpes experience symptoms like burning or itching at the place of infection before the appearance of the blisters and increased skin sensitivity. The skin which gets affected during this time becomes red and small blisters called vesicles erupt on it. The vesicles gets filled with straw colored clear fluid which ultimately breaks and give rise to shallow ulcers. These ulcers are quite painful and cause discomfort. The other symptoms of male genital herpes include muscle aches, fever, decreased appetite and malaise. In some cases sores on the genital areas also appear and they are painful if urine is passed over them during urinating. If these sores are located on penis then also it leads to pain while urination. Symptoms like back pain, headache swollen glands, discharge from penis, unrelated abdominal pressure and flu like conditions are also experienced by men.
Treatment of Male Genital Herpes
Since herpes is a non curable disease thus there is no treatment available for male genital herpes as well. Some medication can certainly help to deal with the various signs and symptoms of this problem. The treatment for herpes first of all includes a check up with your doctor who needs visual examination to determine the type of outbreak and its treatment. After diagnosis the doctor will prescribe you the combination of medicines which will help you to get relief from various symptoms and will reduce the number of outbreaks. With fewer outbreaks there will be less chance of disease being passed to someone else. A person suffering from male genital herpes should not engage in any type of sexual activity including oral, anal or vaginal sex as the contact of outbreak will cause the disease to spread.
The problem of male genital herpes should always be talked with your sexual partner so that you can protect them from this disease. Natural treatments like H-Away are also an effective way to eliminate the outbreak of herpes. Thus, with an effective treatment you can limit the damage which is caused to your daily life due to this disease.

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Genital Herpes Outbreak

Genital herpes is a virus infection which is caused by Herpes simplex virus 2. Along with the genital areas this virus also infects the area around buttocks, anus and inner thighs. The infection of the genital herpes mainly occurs due to the exposure of the genitals to the virus which comes from a partner having active herpes. Though most of the people do not show any symptoms of the virus but there are ones who have the symptoms. The initial outbreak of this disease is even worse that the recurrences. The initial stage of genital herpes outbreak is mainly associated with symptoms beside rashes.
Occurrence of first genital herpes outbreak
The herpes rash mainly consists of some vesicles clustered on a reddish base. In areas like vagina which are moist, the herpes may also result in ulcerations instead. The initial outbreak in women occurs in the region of cervix, vagina, vulva, anus, urethra, buttocks and thighs. Whereas, men have their outbreak on tip or shaft of the penis and sometimes on the base. Men who practice sex with other men may have blisters on the anus. Men usually have mild rash which include six to ten blisters. The blisters that follow the initial genital herpes outbreak are very painful and contagious as they contain large number of viral particles.
Symptoms of genital herpes outbreak
Majority of people faces general symptoms during their first genital herpes outbreak and they usually last for about a week’s time. Some of the most common symptoms include headache, swollen nymph nodes, muscle aches, fatigue, fever and others.
How long does genital herpes outbreak last?
If you are having the first outbreak then it will generally last for about 2 to 3 weeks but the pain in skin will last for about one to six weeks. In due course of time the blisters becomes dry and crust over. After the crust falls off the area is not contagious anymore.
Sometimes low levels of virus may also be present even when there are no signs and symptoms.
Dealing with genital herpes outbreak:
Since genital herpes is not curable, so once you are infected with this problem you may suffer from numerous outbreaks during your lifetime. But there are also various ways by which these outbreaks can be dealt.
First of all ask your doctor for the medication which can shorten the period of outbreak. Since some outbreaks even last for several weeks thus by reducing their period you can get some relief.
It is always recommended to abstain from any sexual activity while having the genital herpes outbreak as it will prevent your partner from having the infection. And in case if you are having sex during this time then proper protection like condoms should be used.
Infected genital area should be kept clean. It should be washed and dried often during the outbreak.
Comfortable clothes should be worn during the genital outbreak and the affected area should be kept away from the heat of the sun.

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Cures for Herpes

Herpes is caused by the herpes simplex virus and appear in two main forms which include oral herpes and genital herpes. Though there is no cure available for this widely spread sexually transmitted disease but its various symptoms can be treated with medication and other possible methods.
Herpes is mainly caused due to various physical and psychological factors thus when you look for its treatment, both these factors should be well considered. In order to get relief from this problem various methods can be applied which includes taking a salt bath, using soothing creams and medications on the infected area and wearing loose undergarments. In order to prevent the further recurrence of herpes, sex with multiple partners should be avoided.
Preventing the herpes from spreading
Among the various cures for herpes its prevention from being spreading further also plays a major role. Herpes is a sexually transmitted disease and spreads from one person to another during the sexual activity. Thus one of the best ways to prevent herpes is to avoid sex during the infection time or to wear condoms to prevent the transmission of the virus. If you feel that you have been infected with the herpes virus then immediately consult with your partner and seek medical assistance. By being responsible in your sexual relationship you can definitely

Avoiding the potential chances of getting infected

 there is no cure available for herpes thus the best way to avoid this disease is by being sexually responsible. Faithful relations should be maintained with your partners and multiple sex should be avoided to prevent herpes. Moreover wearing condoms during sex is also a safe way to prevent this disease.
Preventing the outbreaks
Preventing the symptoms and the outbreak is also among the various cures for herpes. If the period of outbreak is short or the symptoms are less severe then you will certainly find relief from this disease. Find out the causes that results in outbreaks. By keeping a check on your daily diet you cam easily come to know the reasons which triggers various symptoms and signs.
Medical assistance
Once you have a feeling that you are infected with herpes then immediately seek medical assistance. A doctor can provide you with the medicines which will reduce the frequency of outbreaks and will also prevent the transmission of the virus to your partner.
Take a healthy and well balanced diet
One should always take a health diet including protein, iron and fiber. Regular intake of vitamins supplements can also be used to ensure that all needed nutrients are reaching the body.
Have a positive approach
Along with various other means, one of the most effective way to cure herpes is to have a positive approach. You can find a support group and take control of stress. Though managing with herpes may appear to be a difficult task during initial stages but once you will be confident about yourself you can manage it very effectively. Stick to your doctor’s prescription and follow a healthy lifestyle to find cures for herpes and to prevent various discomforts.

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Friday, 18 May 2012

Genital Herpes

Genital herpes is a virus infection which is caused by herpes simplex virus. It is one of the most common sexually transmitted disease which is spread from one person to another during oral, anal or vaginal sexual contact. There is no cure for genital herpes and if a person gets infected with this disease, it stays with them forever. Symptoms may come and go several times during the entire life span and when they are present it is known as herpes outbreak.
Causes for genital herpes:
Genital herpes is caused by the herpes simplex virus (HSV). There are two types of HSV which includes HSV1 and HSV2. The majority of genital herpes are caused by the infection of HSV2. Though HSV1 virus mainly causes oral herpes but there is a significant increase in the number of cases when HSV1 also results in genital herpes. Genital herpes is transmitted during sexual activity or skin to skin contact.
Symptoms of genital herpes:
An infected person may or may not develop the symptoms of genital herpes which may also result in a situation when a person does not even come to know that he is infected. If symptoms are there then they appear within 3 to 7 days of infection. In majority of people the first outbreak is quite painful and worst.
The main symptoms of it appear as sores around the penis, vagina or anus area. Many a times these sores may also appear in the region of buttocks, thighs and scrotum. In initial stages they look like a rash of red bumps which later turns into blisters. At times the blisters also open up and cause severe pain. After some time the sores gets scab and healed. The first genital herpes outbreak generally takes 10 to 20 days to get completely healed up. Majority of people face general signs during their first outbreak which includes headache, muscle ache, discharge from the vagina or penis, fever, swollen glands, difficult and painful urination.
Treatment for genital herpes:
Though genital herpes is a non curable disease but various means can be used in order to get relief from the disease.
-      First of all consult your doctor who may suggest you the medication that can help to reduce the time period of the symptoms and outbreak.
-      Keep the infected area clean and dry.
-      Be comfortable and wear loose fitted clothes
-      Do not touch the sores or break the blisters.
-      Soothe the affected area with cool cloth and do not use any deodorant or spray on the affected area during the outbreak.
Preventing further spread of genital herpes:
Since genital herpes is sexually transmitted disease thus any type of sexual activity whether it is oral, vaginal or anus should be avoided in order to prevent the further spread of the virus. Genital herpes can also spread to your sex partner even when there are no symptoms, so it is always recommended to practice safe sex.
If you think that you are suffering from genital herpes then you should immediately take the help of your healthcare provider in order to provide any further problem.

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