Medical Forum / General / General / July 2005
Herpes Simplex 1
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snowboardkeith@hotmail.com - 08 Apr 2005 04:32 GMT I have a question (few questions) about HSV-1 that I haven't been able to find an answer to anywhere.
If over 90% of the population has HSV-1, why do we have to worry about transmitting it to other people during an outbreak? How can you 'transmit' it to somebody if everyone already has it? Doesn't our body create antigens or antibodies that protect us against the virus after our initial exposure to it? If everyone already has HSV-1, how will being externally exposed to it from another person cause an infection when the virus is already present, not causing any harm? (i.e. how can some 'transmit' oral HSV-1 to another's genital by performing oral sex when that person already has HSV-1?)
Bear - 08 Apr 2005 05:39 GMT > I have a question (few questions) about HSV-1 that I haven't been able > to find an answer to anywhere. [quoted text clipped - 8 lines] > some 'transmit' oral HSV-1 to another's genital by performing oral sex > when that person already has HSV-1?) The numbers I've read show 50% - 80% infected w/ HSV1. The reason to be cautious is so you don't spread it to the 50% - 20% (or even 10%) of the population who doesn't have it. If you know the person you are with has it, REALLY know, like, it showed up on blood work, then go nuts.
xyzer@hotmail.com - 08 Apr 2005 05:52 GMT > > I have a question (few questions) about HSV-1 that I haven't been able > > to find an answer to anywhere. [quoted text clipped - 13 lines] > population who doesn't have it. If you know the person you are with has > it, REALLY know, like, it showed up on blood work, then go nuts. I think his point is that if it doesn't bother most people who have it, and most people do have it (50% or more), then it doesn't really matter if the rest of the world gets it.
Bear - 08 Apr 2005 05:57 GMT >>>I have a question (few questions) about HSV-1 that I haven't been > [quoted text clipped - 50 lines] > and most people do have it (50% or more), then it doesn't really matter > if the rest of the world gets it. anyone who doesn't have it, and does get it on their genitals, won't be really happy
even people who don't have it and get it on their lips won't be really happy - not everyone who gets it gets cold sores, but they are annoying and painful
so if someone doesn't have it, it's best to take precautions not to give it to them
chris - 08 Apr 2005 16:26 GMT >>>I have a question (few questions) about HSV-1 that I haven't been > [quoted text clipped - 50 lines] > and most people do have it (50% or more), then it doesn't really matter > if the rest of the world gets it. xyzer, let me thank you for reminding me why you were in my killfile before hubby changed my email to Thunderbird and lost all my killfile settings. This demonstrates what I feel is an extremely cavilere disregard for a potential partner's health and well-being.
That said, Even if the current strain is harmless, viruses, bacteria and other assorted nasties mutate all the time. Some strains are extremely nasty. Look at the bird flu in Asia, for just one example.
I dream of a world where everyone uses barrier methods to prevent spread of sexually transmitted diseases. ALL sexually transmitted diseases, whether relatively harmless or eventually deadly. Of course, I also dream of a world where contracting an std is as much concern as going to the doctor for a quick shot and a bottle of pills or, even better, getting a set of vaccinations around eight or ten years old.
Deliberately transmitting any disease is ethically WRONG!!! By deliberate, I mean not taking sensible precautions. I cover my mouth when I cough or sneeze, even when I'm sure it is just alergies that are not contagious. I would expect a partner to use a condom if he had any doubt about his status or mine. If I had any doubt about my status I would insist on barrier methods such as condoms to protect him.
A number of years ago, there was talk about making transmission of AIDS a criminal act. Haven't followed it. So knowing your positive std status and not using safer sex methods, such as condoms or another barrier, might be a criminal act. If not, it could potentially be a civil lawsuit. If a woman can successfully sue for dumping hot coffee on herself...
Several reasons why spreading sexually transmitted diseases is not a good idea.
xyzer@hotmail.com - 08 Apr 2005 18:14 GMT > >>>I have a question (few questions) about HSV-1 that I haven't been > > [quoted text clipped - 53 lines] > xyzer, let me thank you for reminding me why you were in my killfile > before hubby changed my email to Thunderbird and lost all my killfile
> settings. This demonstrates what I feel is an extremely cavilere > disregard for a potential partner's health and well-being. [quoted text clipped - 5 lines] > I dream of a world where everyone uses barrier methods to prevent spread > of sexually transmitted diseases. ALL sexually transmitted diseases,
> whether relatively harmless or eventually deadly. Of course, I also > dream of a world where contracting an std is as much concern as going to [quoted text clipped - 3 lines] > Deliberately transmitting any disease is ethically WRONG!!! By > deliberate, I mean not taking sensible precautions. I cover my mouth
> when I cough or sneeze, even when I'm sure it is just alergies that are > not contagious. I would expect a partner to use a condom if he had any > doubt about his status or mine. If I had any doubt about my status I
> would insist on barrier methods such as condoms to protect him. Why would you put someone in your killfile simply for thinking it's ok to kiss someone without telling them you've ever had a coldsore in your life? You'd be putting a lot of people on killfile if you were to killfile everyone who thought as I do. You probably killfiled me based on similar rantings I've done on HPV.
Just to go back to that topic for a second, yearly incidence of genital warts happens to be around 1% of the pop in the US, and its prevalence (depending on how you define prevalence of HPV) could be as high as 50% in this country, with a lenient definition. THis makes more sense when you consider that only 1% of those who come in contact with a genital wart causing HPV strain ever get visible genital warts. I mean, if you dislike me so much, then dislike parents who feed their kids crap food, who smoke around them too much. Or dislike people who speed too much on the roads, or who drive sleepily. I guess my question is who does more harm: these forementioned people or those who don't tell others of ever having had a past cold sore?
You must agree that there comes a point where it doesn't matter really if tell or not. Is that point at 80%? 90%? 95%? 97? 99%? Even you would agree that if 99% of the population had oral herpes, then it wouldn't matter if you mentioned that you have had a past cold sore. But some believe that's true at 80%. You just might believe it for 99.9%. Which is necessarily morally superior?
xyzer@hotmail.com - 08 Apr 2005 18:20 GMT x...@hotmail.com wrote: <snip>
>THis makes more sense when > you consider that only 1% of those who come in contact with a genital > wart causing HPV strain ever get visible genital warts. <snip>
heh, I of course meant to say "come in contact with a type of genital-wart causing HPV strand." For those who come in contact with actual visible warts, it might be a higher percentage. I type too fast I think.
Delila - 08 Apr 2005 12:46 GMT >I have a question (few questions) about HSV-1 that I haven't been able > to find an answer to anywhere. > > If over 90% of the population has HSV-1, why do we have to worry about > transmitting it to other people during an outbreak?
Because IF 90% already have it (are you sure it's that high?) that means 10% don't. I don't have it and I don't want it. My coworker is just getting over a nasty outbreak she had around her mouth. It's nasty to look at and takes forever to heal.
D.
FDJIM94@HOTMAIL.COM - 08 Apr 2005 13:10 GMT try topicla applications of hydrogen peroxide. I have found that if you do that as soon as any redness appears it stops the process and begins the healing. Gotta stay with it though, 3 times a day or more.
snowboardkeith@hotmail.com - 08 Apr 2005 15:27 GMT Actually, you most likely do have it. I believe almost everyone is exposed to the virus as a child. Then the virus just lies dormant (usually) in your nerve cells forever. Thus, being asymptomatic doesn't mean you don't carry the virus. I guess only certain people have an immune system that can't completely control the outbreaks.
suzee - 10 Apr 2005 14:46 GMT > Actually, you most likely do have it. I believe almost everyone is > exposed to the virus as a child. Then the virus just lies dormant > (usually) in your nerve cells forever. Thus, being asymptomatic > doesn't mean you don't carry the virus. I guess only certain people > have an immune system that can't completely control the outbreaks. Like Delila (is that who you're replying to? Without quoting, I can't tell...) I've never had a cold sore in my life and I'm in my 50s. Some people have very good immune systems and can likely resist a lot of viruses.
sue
Elizabeth - 10 Apr 2005 16:54 GMT //...snip... I believe almost everyone is exposed to the virus as a child. Then the virus just lies dormant (usually) in your nerve cells forever. Thus, being asymptomatic doesn't mean you don't carry the virus. I guess only certain people have an immune system that can't completely control the outbreaks.//
Well, as one whose immune system is compromised (not sexually) by a condition known as fibromyalgia and thus a tendency to catch everything that's going around, I can say your thesis is incorrect. I've never had herpes simplex 1.
Tim Fitzmaurice - 11 Apr 2005 13:28 GMT > Actually, you most likely do have it. I believe almost everyone is > exposed to the virus as a child. Serological data would argue with that. Childhood is a huge point of infection (I think the largest if I rememebr correctly) but its not the only one and not to the level of being almost everyone....there's a fair amount of data showing the spike in prevalence of infection in college kids in the US -
Hang on just found the paper...Schillinger et al, Sexually Transmitted Dieseases, 2004, Vol 31, pp753-760. Based off the NHANES III data. It has 68% of the US population aged 12 and over carrying the virus HSV1. Prevalence increasing with age.
Fleming et al did the same for HSV2 and published in New ENgland Journal fo Medicine, 1997, Vol 337, pp1105-1111
> Then the virus just lies dormant > (usually) in your nerve cells forever. Thus, being asymptomatic > doesn't mean you don't carry the virus. I guess only certain people > have an immune system that can't completely control the outbreaks. Its not just the immune system but whatever biolgical factors in the virus and the virus host interactions control coming out of latency. The immune system doesnt get to the virus till its already reactivated and hoppped out of the nerves. Asymptomatic shedding rather makes the point that even if the virus gets held low enough to avoid lesions, the immmune system of even the healthiest still lets virus leak out, and quite a lot of the lesion you do get is the immune systems response anyway. At that point you do have to wonder how much of the outbreak vs shedding and so on it the host's control and how much is the virus'.
Tim -- When playing rugby, its not the winning that counts, but the taking apart ICQ: 5178568
xyzer@hotmail.com - 08 Apr 2005 18:16 GMT > >I have a question (few questions) about HSV-1 that I haven't been able > > to find an answer to anywhere. [quoted text clipped - 8 lines] > > D. Actually, you don't know if you don't have it. Most people have it, but most people don't break out. I have no idea if I have it, as I can't remember ever having had a cold sore. SOme people have better immune systems than others. It's also true that many people just can't say for sure whether or not they have HPV (and that's the truth). But be honest. Do you actually expect future lovers or those who kiss you to tell you if they remember ever having had a past cold sore? As a kid perhaps? Perhaps they haven't had one in years and just don't think about that stuff anymore.
I doubt you would expect them to remember it and to tell you.
xyzer@hotmail.com - 08 Apr 2005 18:33 GMT x...@hotmail.com wrote:
> > >I have a question (few questions) about HSV-1 that I haven't been > able [quoted text clipped - 15 lines] > > Actually, you don't know if you don't have it. <snip>
I like to admit when I'm possibly wrong, and I think I'm wrong here. I failed to remember that there's a herpes blood test that tests for antibodies to HSV, so you may very well know if you don't have it. I guess I get in an HPV mindset sometimes. Sorry!
Delila - 08 Apr 2005 18:52 GMT > > > > Actually, you don't know if you don't have it. Most people have it, > but most people don't break out. I have no idea if I have it, as I > can't remember ever having had a cold sore. SOme people have better > immune systems than others. It's also true that many people just can't > say for sure whether or not they have HPV (and that's the truth). But > be honest. Do you actually expect future lovers or those who kiss you > to tell you if they remember ever having had a past cold sore? As a > kid perhaps? Perhaps they haven't had one in years and just don't > think about that stuff anymore. > > I doubt you would expect them to remember it and to tell you.
No, I guess I wouldn't. I still hope I never get one of those nasty outbreaks.
D.
xyzer@hotmail.com - 09 Apr 2005 01:03 GMT > > > > [quoted text clipped - 4 lines] > > immune systems than others. It's also true that many people just can't > > say for sure whether or not they have HPV (and that's the truth). But
> > be honest. Do you actually expect future lovers or those who kiss you > > to tell you if they remember ever having had a past cold sore? As a [quoted text clipped - 4 lines] > > No, I guess I wouldn't. I still hope I never get one of those nasty
> outbreaks. > > D. Yeah, well I don't blame you for that, but the good news is that even if you don't have oral HSV and you ever kiss someone who has it, and you get it, you *probably* wouldn't have many problems with it besides maybe an initial breakout (if that). Of course, maybe you would be someone who would have special problems with it. Some people do. A lot of times these people are stressed out, have immune system problems, or other types of issues such as winter time. THen again, other people who have very bad problems with cold sores might not be stressed out and have immune systems that are perfectly ok. Your co-worker, for example, might not be stressed out or might even get them in the summer. But, just be glad that when you consider 50-80% of the country supposedly has oral herpes, that you don't see very many people day-to-day who have problems with cold sores.
snowboardkeith@hotmail.com - 08 Apr 2005 15:32 GMT Can anyone answer the question on whether you can 'transmit' the virus to someone who already has it?
xyzer@hotmail.com - 08 Apr 2005 21:44 GMT snowboardke...@hotmail.com wrote:
> Can anyone answer the question on whether you can 'transmit' the virus > to someone who already has it? Well, yes, it's possible. THis is possible because there are different "strands" of the virus. Two types are HSV-1 and HSV-2. To give an example, someone could have HSV-2 in his or her genital area, but perhaps not have HSV-1 in his or her mouth or genital area. If a person with HSV-1 comes along and licks someone's private area or kisses someone, then it's possible that that person could spread the HSV-1 type to the person.
I personally know of a girl who was a virgin who had oral sex done on her, and she got a breakout of herpes from it. I obviously don't know if HSV-1 or HSV-2 was given to her, but, while HSV-2 I've heard "likes" the genital area more than HSV-1 (and vice versa for oral herpes), I've heard it's possible that either HSV-1 or HSV-2 can infect either area. Regardless, it was kind of sad. She's only ever had one bad breakout, the first breakout she had. She's never had a breakout since. Yet, her whole relationship was RUINED with this man she loved, yet I'm sure he didn't even know he had "oral herpes." They were both young adults at the time. Yet, when she went to the doctor and the doctor told her that she had herpes, she probably thought of him as evil for doing that to her. Yet, has it ruined her life? Not exactly...one bad breakout originally... none after that. Yet, a love was lost because of mostly ignorance and a world that thinks that getting herpes is somehow so terribly awful.
xyzer@hotmail.com - 08 Apr 2005 21:58 GMT x...@hotmail.com wrote:
> snowboardke...@hotmail.com wrote: > > Can anyone answer the question on whether you can 'transmit' the [quoted text clipped - 22 lines] > to her. Yet, has it ruined her life? Not exactly...one bad breakout > originally... none after that. I guess some could argue that if it didn't ruin her life, it definitely did affect it negatively. But, isn't that because of the world's stigma on herpes? I guess to be fair that's real nonetheless. And, I guess I should point out that some people DO have lifelong problems with herpes, both oral and genital.
I do think that for most though it's not a huge problem, in the sense that they're constantly having breakouts, either oral or genital. I'm not sure breakout rates are the same for oral and genital herpes (so this might not be an accurate analogy), but if 50-80% of people have oral herpes, and you don't always see people with cold sores, and only 20-25% of the population has genital herpes, and, assuming the breakout rates are the same (which again, I'm not sure of), you can see where it's not a huge problem for the average person who has it --again, not to say there aren't those that have worse problems with it.
Bear - 08 Apr 2005 22:07 GMT > snowboardke...@hotmail.com wrote: > [quoted text clipped - 27 lines] > ignorance and a world that thinks that getting herpes is somehow so > terribly awful. I think the question was, if someone has HSV1 on their mouth, and you have it on your mouth, and if you go down on them, can you give it to them on their genitals? I'm 99.99% sure you can't, since their body is already making antibodies for hsv1, but i'd love to here other thoughts on this
xyzer@hotmail.com - 08 Apr 2005 22:41 GMT > > snowboardke...@hotmail.com wrote: > > [quoted text clipped - 29 lines] > > I think the question was, if someone has HSV1 on their mouth, and you
> have it on your mouth, and if you go down on them, can you give it to
> them on their genitals? I'm 99.99% sure you can't, since their body is > already making antibodies for hsv1, but i'd love to here other thoughts > on this I'm no virulogist, but I think there can be different types of HSV-1 as well -- mutated types, perhaps? I don't know. I could be wrong though.
snowboardkeith@hotmail.com - 09 Apr 2005 00:29 GMT I thought there were multiple strains of the HSV-1 also, but my doctor told me that there aren't. Although I doubt I should trust anything he says regarding herpes. He told me the "HSV-1 stays above the waist and HSV-2 stays below the waist," line, which apparenly USED to be accepted knowledge among doctors. However, now that seems to be completely false (verified by my online research). I guess my doctor needs to get up-to-date.
Enuf - 10 Apr 2005 04:01 GMT > I thought there were multiple strains of the HSV-1 also, but my doctor > told me that there aren't. Although I doubt I should trust anything he [quoted text clipped - 3 lines] > false (verified by my online research). I guess my doctor needs to get > up-to-date. This is what I was told by my Dermatologist also. HSV1 is oral and HSV2 is genital.
I was also told that the HSV1 virus is acquired as a child and it remains dormant until you become an adult. If you don't acquire it as a child, it is very rare that you will acquire it later in life (immunity factor?). This would explain why the virus is not passed during kissing.
HSV1 is not confined to the lip area. I have had it occur as low as the chin or as high as a cheek. I also know an individual who lost eyesight in one eye from HSV1.
HSV1 & HSV2 responds very quickly to the drug Valtrex if taken at the first sign of itching/burning. A 2-3 week normal run of outbreak can be reduced to 1-3 days.
Enuf (who has battled oral HSV1 for 45 years)
xyzer@hotmail.com - 10 Apr 2005 05:11 GMT > > I thought there were multiple strains of the HSV-1 also, but my > doctor [quoted text clipped - 11 lines] > This is what I was told by my Dermatologist also. HSV1 is oral and HSV2 > is genital. Technically, also less likely, it is possible to have HSV-1 in the genital area as well, as well as HSV-2 in the oral area.
> I was also told that the HSV1 virus is acquired as a child and it > remains dormant until you become an adult. If you don't acquire it as a > child, it is very rare that you will acquire it later in life (immunity > factor?). This would explain why the virus is not passed during > kissing. Are you sure about this? Where did you hear this from? Not saying you're wrong necessarily, but I've never heard that, if you don't have oral herpes as an adult, that it's very rare to get as an adult if you're exposed to it. Again, I know of a girl who got an outbreak of genital herpes from having oral sex performed on her (she was a virgin).
<snip>
Enuf - 10 Apr 2005 20:18 GMT > Are you sure about this? Where did you hear this from? Not saying > you're wrong necessarily, but I've never heard that, if you don't have > oral herpes as an adult, that it's very rare to get as an adult if > you're exposed to it. Again, I know of a girl who got an outbreak of > genital herpes from having oral sex performed on her (she was a > virgin). Am I sure? No. As I said, this is what I was told by a doctor years ago. And bear in mind I was referring to the oral-to-oral HSV1, not the genital variety which is a whole different ballgame. In fact all HSV is now a whole new ballgame since virus mutates fairly rapidly depending on where it takes up residence.
Enuf
Tim Fitzmaurice - 11 Apr 2005 13:15 GMT >> I thought there were multiple strains of the HSV-1 also, but my > doctor [quoted text clipped - 11 lines] > This is what I was told by my Dermatologist also. HSV1 is oral and HSV2 > is genital. Thats a long long way out of date. These days about 1 in 3 new cases in the US of genital herpes turns out to be HSV1, not HSV2. HSV2 does not seem to be migrating to the oral area to the same extent...my guess if I had to put money on it would be that that is due to the different level of response to a genital vs oral infection brings about plus the general level of care about STDs thats been in the population in the last 30 years or so.
> HSV1 is not confined to the lip area. I have had it occur as low as > the chin or as high as a cheek. I also know an individual who lost > eyesight in one eye from HSV1. Yup, it will potentially go anywhere the infected nerve ganglion innervates.
Tim -- When playing rugby, its not the winning that counts, but the taking apart ICQ: 5178568
Mark - 11 Apr 2005 13:43 GMT > Can anyone answer the question on whether you can 'transmit' the virus > to someone who already has it? . Good data is available at http://www.herpes.org/ (this site also discusses HPV) and http://www.herpes.org.uk/ (run by herpes "sufferers") - there are undoubtedly other sources of information. . First myth to dispel - HSV-1 is not purely above the waist and HSV-2 is not purely below the waist, you can get HSV-1 genitally and HSV-2 orally. . They tend to be happier in those contexts, according to recent information from G-U medical specialists - this seems to mean that if you get HSV-1 genitally, you'll probably have one (quite unpleasant) episode but once your immune system gets on top of it, you probably won't have another major episode. . Anti-virals tend to get on top of it quite well during that first outbreak and will also be useful for controlling later outbreaks. If you have an ongoing HSV problem - lots of outbreaks, it's worth consulting a physician and trying anti-viral treatments (orally, not just creams). . I've also been told (by a specialist I was consulting) that although it's possible, contracting HSV-2 by oral contact is frankly unheard of. Transmitting HSV-1 from mouth to genitals is possible and not uncommon. . Having one form of HSV tends, apparently, to protect against the other - the specialist told me that animal experiments attempting to doubly infect were almost invariably unsuccessful. Don't rely on this to avoid infection, however. . Other interesting points - HSV is a very successful virus, found in almost all animals from molluscs upwards; My specialist remarked that outbreaks are, from the virus' point of view, a bad thing - the ideal for the virus is to be present for infection without exhibiting symptoms; In general, HSV tends to become less of a problem the longer you have it. . Hope that's interesting and helpful.
suzee - 11 Apr 2005 15:18 GMT >>Can anyone answer the question on whether you can 'transmit' the virus >>to someone who already has it? [quoted text clipped - 36 lines] > . > Hope that's interesting and helpful. Yes it is, thanks.
sue
Tim Fitzmaurice - 11 Apr 2005 13:45 GMT > Can anyone answer the question on whether you can 'transmit' the virus > to someone who already has it? The basic answer always used to be no, with the detailed answer running down to a complex set of variables that suggested that its a) very difficult but possible and b) may not make a great deal of difference long term as it may not really be able to colonise terribly well.
If you hunt in the literature you will find papers like The latency-associated gene of herpes simplex virus type 1 (HSV-1) interferes with superinfection by HSV-1. J Neurovirol. 2002 Dec;8 Suppl 2:97-102.
These obviously point out that the virus has evolved to try to avoid superinfection happening. Superinfection has been described in the eue but that is an immune privileged site.
As ever with this virus, it aint that simple and a lot of the issue is what tools were available. Now you see the papers like this one Roest et al, Journal of Medical Virology, vol 73, p 601-604. It is entitled 'Genotypic analysis of sequential genital herpes simplex virus type 1 (HSV-1) isolates of patients with recurrent HSV-1 associated genital herpes'
They took a smallish number of patients, and sequenced the DNA of virus got from swabs from patients sequentially. In 3 of their 13 subject the sequence differed in a region known to be variable bewteeen HSV1 strains. This suggests that those individual had more than one strain, raising the possiblility of having been infected there mnore than once. That immediately raises the possiblility of someone with HSV1 in the oral site getting it in the genital.... (Note this is looking at strains of HSV1, NOT HSV1 vs HSV2 which are two seperate viruses and have different interactions where one can clearly infect someone with the other).
However I dont think how big a possiblity that is and what that means in terms of changes in how you suffer or not from HSV in you has been established. The basic line of 8 or 9 of 10 infections doesnt produce symptoms still holds true and presumably will hold on these superinfections too (if it isnt even more difficult). The 2 roughly 1 in 10s there sort of pulls about 1 in 100 infected people having to deal with it as a sort of thrown together guess (but it is just an extrapolated guess)
So I think it boils down to possible, but difficult to get more than one virus strain in you, and not really well established if it changes what happens to you if you do get superinfected...does it add to the issue, does it just follow the other pattern etc.
Tim -- When playing rugby, its not the winning that counts, but the taking apart ICQ: 5178568
xyzer@hotmail.com - 09 Apr 2005 00:42 GMT > I have a question (few questions) about HSV-1 that I haven't been able > to find an answer to anywhere. [quoted text clipped - 8 lines] > some 'transmit' oral HSV-1 to another's genital by performing oral sex > when that person already has HSV-1?) I realize I'm probably posting too much in here, but just to give you a taste of how much a lot of people don't know about herpes, read this Mike Vick fan blog (don't have to sign in to read their posts).
http://tinyurl.com/4oydl
This is their reaction to him and his herpes lawsuit. One poster even wonders how people with herpes can even play football. Perhaps he has the misconception that people with herpes actually have sores all the time. He or she wonders why they don't "check for that" in the yearly physicals. I don't mean to be hard on these people too much, but when people aren't educated about things, that's when things get to be overblown.
PF Riley - 10 Apr 2005 19:41 GMT >I have a question (few questions) about HSV-1 that I haven't been able >to find an answer to anywhere. [quoted text clipped - 8 lines] >some 'transmit' oral HSV-1 to another's genital by performing oral sex >when that person already has HSV-1?) It's amazing how many misconceptions and misunderstandings about HSV have been echoed on this thread alone let alone on the internet at large.
Herpes simplex is a virus well adapted to humans. There are two main types. It is nonsense that HSV-1 "only" infects the mouth and HSV-2 "only" infects the genitals. Anyone who believes this and willingly receives oral sex from a person with a mouth full of cold sores may be in for an unpleasant surprise.
The difference is that HSV-1 more easily reactivates in the oral region, and HSV-2 more easily reactivates in the genital region. This is why that majority of oral cases are HSV-1 and genital cases are HSV-2. However, cross infections can and do occur and are not at all rare.
Next, the prevalence of antibodies to HSV-1 varies among the population selected, generally from 30% to 80%. "Over 90%" is a gross overestimation. With HSV-1, many who acquire it either have no symptoms at all, or had the primary infection manifest as herpetic gingivostomatitis in young childhood, which most people will not remember. It is only a certain percentage of people thereafter who have recurrent cold sores. The others remain unaware that they have had HSV-1.
Antibodies levels, however, are not the best surrogate marker for actual immunity. One may indeed have protective immunologic memory for HSV-1 but undectable antibody levels (although unlikely), and another may have HSV-1 antibodies from an oral infection in childhood which may not protect him from herpetic keratitis should someone with a cold sore spit in his eye.
In other words, someone who has known HSV-1 antibodies could also be in for an unpleasant surprise if they believe they are completely protected from any further infections. It is well known that varicella, which is a herpes virus as well, can infect people twice, and so can HSV.
Finally, someone's suggestion that Valtrex can shorten an outbreak from several weeks to several days is wishful thinking. It shortens the duration by at most 1 or 2 days, only if started immediately at the first tingling sign of an outbreak. If vesicles have already started forming, it pretty much does nothing.
PF
xyzer@hotmail.com - 11 Apr 2005 22:23 GMT <snip>
> It's amazing how many misconceptions and misunderstandings about HSV > have been echoed on this thread alone let alone on the internet at > large. <snip>
Yup, the worst part about having herpes by far I would think would be having to face an ignorant world. If you *really* think about it, it seems *really* silly that others would expect a potential sex partner who's ever had a past herpes breakout to admit it to the other patner. Most people already don't admit it for oral herpes and aren't thought of as being selfish or bad for doing so. However, I guess the reason people expect others simply to admit to having had a genital herpes infection in the past is because they know others will expect them to tell if they get it and that the world is basically being kind of silly. I guess that's a valid enough reason, but it kind of pisses me off still.
Matt Beckwith - 10 Jul 2005 04:07 GMT >Yup, the worst part about having herpes by far I would think would be >having to face an ignorant world. If you *really* think about it, it >seems *really* silly that others would expect a potential sex partner >who's ever had a past herpes breakout to admit it to the other patner. I'm amazed that anyone would think this way. You seem to be saying that it's silly that people would expect other people to have integrity.
Does this mean that you think it's okay to have sex with someone and give him/her herpes without prior notification of your disease?
If so, are you aware that this is a crime?
Enuf - 12 Apr 2005 15:49 GMT > Finally, someone's suggestion that Valtrex can shorten an outbreak > from several weeks to several days is wishful thinking. It shortens [quoted text clipped - 3 lines] > > PF Bull!! I've had outbreaks of oral HSV for 45 years so I have a great amount of experience in every conceivable treatment for it. If Valtrex is taken at the first sign if symptoms (itching/burning), vesticles do not form. Thus the "outbreak session" is limited to days instead of weeks. Period! Based upon true experience instead of hearsay!
In all fairness, however, there is variation on how Valtrex is prescribed. Some doctors prescribe 1 pill twice a day for 4 days. This delays the drug's action and could result in a longer recovery time. The newer prescription is 2 pills twice a day for 1 day. This gets more drug to the infected site a lot faster and results in a faster response/faster recovery.
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PF Riley - 13 Apr 2005 05:04 GMT >> Finally, someone's suggestion that Valtrex can shorten an outbreak >> from several weeks to several days is wishful thinking. It shortens [quoted text clipped - 7 lines] >not form. Thus the "outbreak session" is limited to days instead of >weeks. Period! Based upon true experience instead of hearsay! Here is what you said:
"HSV1 & HSV2 responds very quickly to the drug Valtrex if taken at the first sign of itching/burning. A 2-3 week normal run of outbreak can be reduced to 1-3 days."
You did NOT say, "In my experience, a 2-3 week normal run of outbreak can be reduced to 1-3 days, but this may not be the case for others." I would have had no problem with that statement.
What is objectionable is your implication that this can be expected for anyone. You readily admit, when challenged, that this is based only on your own personal experience (basically an uncontrolled study with one subject), and is thus meaningless. Flonase did nothing for my allergic rhinitis -- should I shout "Bull!!" at my patients who tell me Flonase helps them? (And by the way, shouting "Period!" and using exclamation points does not make your argument more tenable.)
>In all fairness, however, there is variation on how Valtrex is >prescribed. Some doctors prescribe 1 pill twice a day for 4 days. This >delays the drug's action and could result in a longer recovery time. >The newer prescription is 2 pills twice a day for 1 day. This gets more >drug to the infected site a lot faster and results in a faster >response/faster recovery. You didn't mention that there are two dosing strengths (500 mg and 1g). But, anyway, since you accuse me of reporting "hearsay", here's what GSK has to say in their package insert about the "newer" prescription for recurrent oral HSV:
>Cold Sores (Herpes Labialis): Two double-blind, placebo-controlled >clinical trials were conducted in 1,856 healthy adults and adolescents [quoted text clipped - 10 lines] >VALTREX or placebo in the prevention of progression of cold sore >lesions beyond the papular stage. Let's see... almost 2,000 people starting treatment (using "2 pills" twice a day) within 2 hours of symptoms... before a cold sore develops... shortened the episode by about 1 day. Now let me think... what did I say earlier? Oh yes: "It shortens the duration by at most 1 or 2 days, only if started immediately at the first tingling sign of an outbreak."
PF
Enuf - 13 Apr 2005 16:09 GMT > What is objectionable is your implication that this can be expected > for anyone. You readily admit, when challenged, that this is based > only on your own personal experience. Guilty.
As are you when you said "Finally, someone's suggestion that Valtrex can shorten an outbreak from several weeks to several days is wishful thinking. It shortens the duration by at most 1 or 2 days, only if started immediately at the first tingling sign of an outbreak. If vesicles have already started forming, it pretty much does nothing."
You also inferred that those results apply to everyone, which I objected to. We both know medications work differently on different people. Since we both are guilty of not adding a disclaimer, case closed for Valtrex usage.
On a related note, however, let me share a "personal experience" on treating an oral outbreak if Valtrex doesn't work. I have found that applying a high % alcohol solution to the vesticles for a few days cauterizes them and reduces the duration by several days. (Disclaimer: Not everyone can expect the same results.)
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