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Treatment options for herpes

October 27, 2009

There is no cure for genital herpes. Once the virus has infected the body, it cannot be eradicated and remains in the body. However, there are several prescribed antiviral drugs that can reduce the intensity of symptoms at the time of outbreaks as well as reduce the frequency of outbreaks. One antiviral drug (Valtrex), has been approved by the U.S. Food and Drug Administration (FDA) to prevent transmission of genital herpes.

Topical creams have been proven to be ineffective. Intravenous (I.V.) treatment may be used to treat people with suppressed immune systems, such as those who have been infected with human immunodeficiency virus (HIV).

There are several treatment regimens including:

  • Episodic therapy. Taking medication when symptoms appear. This involves taking a daily dose of a medication, usually for a week, until symptoms subside. The medications, which are safe and have few side effects, shorten the length of first episodes and reduce the severity of recurring outbreaks, especially if taken within 24 hours of the onset of symptoms.
  • Suppressive therapy. For patients who experience frequent recurrences. This involves taking daily medication, even when symptoms are not present. It reduces the number of outbreaks and the chance of transmitting the virus to a sexual partner.
  • Episodic suppressive therapy. Designed for patients who wish to prevent outbreaks when it is important, such as while on vacation.
During outbreaks, a number of steps can be taken to speed healing and prevent spread of the infection to other parts of the body and other people. They include:

  • Keeping the infected area clean and dry
  • Trying not to touch the sores
  • Washing the hands if sores are touched
  • Avoiding sexual contact from the time symptoms are noticed until they have healed
In addition, there is a number of self-care measures a person can take to relieve the symptoms associated with a herpes outbreak. Applying cool cloths to the affected areas may provide relief. People experiencing an outbreak should also avoid wearing tight or irritating underwear or clothing. Over-the-counter pain medication, such as acetaminophen and ibuprofen, can also be taken to help relieve the pain of genital sores.

Pregnant women may be put on suppressive therapy if the virus is active late in their pregnancy. The goal is to prevent transmission to the baby, which, though rare, can have very serious or fatal consequences. Women with sores detected in or near the vagina at the time of labor may be given Caesarean sections (the surgical delivery of a baby through the mother’s abdomen).

If a newborn is infected, early treatment with antiviral therapy can greatly improve the baby’s health. Early detection and treatment can reduce the more serious complications of neonatal herpes.

Although genital herpes is a common and manageable condition, living with herpes can be distressing, inconvenient and, in some cases, painful. The period after diagnosis may be an especially emotional time, with many people experiencing feelings of shame and fear. As a result, people with genital herpes may benefit from seeking counseling or attending a support group.  

Tags: HIV, Valtrex, FDA

Signs and symptoms of herpes

October 23, 2009

Many people who have genital herpes experience no symptoms. If symptoms appear during the first outbreak, however, they can be severe. Symptoms may appear within days of contracting the virus, or it may take weeks, months or years. The first outbreak usually occurs within two weeks after the virus is transmitted and typically lasts two to three weeks.

Early symptoms (prodromal phase) of an outbreak may include itching or burning in the genital or anal area. Other early symptoms may include:

  • Fever, muscle aches, swollen glands and other flu-like symptoms
  • Pain in the legs, buttocks or genital area
  • Vaginal discharge
  • A feeling of pressure in the area below the stomach
Within a few days, sores appear near where the virus entered the body, such as the mouth, vagina or penis. They can also occur inside the vagina and on the cervix in women and in the urinary passage (urethra) in men.

Female Reproductive Organs

The sores appear as small red bumps that may become blisters or painful open sores. Over time, the sores crust over and usually heal without scarring within two to 12 days.

Later symptoms may include those listed above, as well as:

  • Headache
  • Painful urination (dysuria)
  • Swollen glands in the genital area
Some people experience mild symptoms that are often mistaken for insect bites, yeast infections, razor burn, ingrown hairs or hemorrhoids. In fact, the American Social Health Association estimates that as many as 90 percent of people with genital herpes are unaware that they have it.

Because the virus remains in the nerve cells, people with genital herpes can have future outbreaks. Most people who experience a first episode of genital herpes have several more within a year, although symptoms tend to be less severe and last only a week.

The frequency of outbreaks experienced by people with genital herpes over the course of a lifetime varies. Some people have one outbreak and never experience another. Some have outbreaks several times a year. According to the American Social Health Association, the average number of outbreaks is four to five a year. In general, the frequency of outbreaks tends to decrease over time.

Tags: HIV, Valtrex, FDA

Genital Herpes & Women

October 15, 2009

Herpes simplex is a virus that causes blisters and sores. There are two types: herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2).

HSV-1 is usually associated with the cold Genital herpes is a sexually transmitted disease (STD) involving blisters on the genitals or mouth.sores or fever blisters people frequently get on the mouth, lips or nose, but in some cases HSV-1 can also cause genital herpes. HSV-1 infection of the genitals can be caused by oral contact with the genitals or genital-to-genital contact with a person infected with HSV-1. Only 5 to 10 percent of genital herpes is caused by HSV-1, according to the National Institutes of Health (NIH).

Most genital herpes cases are caused by HSV-2 infection, which is spread through sexual contact (vaginal, oral or anal) with an infected partner. It can be spread even if the infected person is not experiencing symptoms. Genital herpes is one of the most common sexually transmitted diseases in the United States. The Centers for Disease Control and Prevention (CDC) estimates that 1 million Americans become infected each year with genital herpes.

HPV-1 infection is by far more common. An estimated 90 percent of the U.S. population has been exposed to HSV-1, and 25 percent of young adults (ages 25 to 45) have been exposed to HSV-2, according to the NIH.

Many people with genital herpes experience no symptoms. When present, early symptoms include itching or burning in the genital or anal area and flu-like symptoms. Later symptoms include blisters or sores and vaginal discharge.

If a woman is experiencing sores, genital herpes may be diagnosed during a gynecological examination. Laboratory tests, such as viral cultures (tests performed by placing a tissue sample in a container where a virus can grow) or blood tests, may be performed to confirm diagnosis.

There is no cure for herpes as the herpes simplex virus remains in an individual’s body for life. However, antiviral medications can ease symptoms, reduce the number of outbreaks and help prevent transmission of the virus.

Using a latex condom during vaginal, oral or anal sex can help prevent the spread of the virus. However, abstinence from sexual activity or maintaining a monogamous relationship with an uninfected person is the most effective way of reducing the risk of herpes.

Tags: HIV, Valtrex, FDA

Diseases from toilet

October 07, 2009

Toilet seats are not common vectors (transmission channels) of infections. If you use the toilet seat in the usual manner, it is very unlikely that you will become infected with any disease-causing microbe. Specifically, there is no evidence that HIV (the virus that causes AIDS) or the viruses responsible for hepatitis B or C (chronic forms of liver inflammation) can be spread in this manner.

There are some organisms that conceivably could be acquired by contact with toilet seats, such as the strep (streptococcus) and staph (staphylococcus) bacteria that we routinely carry on our skin. It is possible that you could become colonized with a specific organism (become a carrier) after sharing a toilet seat with someone carrying that organism. But I think that the risk of such transmission is very small, and I personally do not worry too much about it.

Some infections are commonly spread in restrooms in areas other than the toilet. The classic source for bathroom infections is the reusable towel roller -- the device that holds a length of cloth toweling that you pull down for drying your hands. Other people end up using the same area to dry their hands, aiding in the potential spread of infections. Towel rollers can spread several different viruses and have been linked to outbreaks of conjunctivitis (also called pinkeye), inflammation of the membrane that lines the inner surface of the eyelids and the front of the eye. It is also possible that touching contaminated doorknobs and faucets can spread these sorts of infections, as well as the viruses that cause colds.

Bathrooms might seem the logical place for the spread of diseases that may be transmitted through fecal matter, particularly some viruses that cause gastrointestinal illnesses. However, the Norwalk viruses, the most common viral causes of gastroenteritis in adults, are much more often spread by contamination of food and water. When food handlers do not wash their hands after using the toilet and then return to their jobs, they may transmit such viruses through the food they prepare. It's possible, too, that if you touched a faucet or other surface soon after they did, transmission could occur. (Most bacteria that cause gastroenteritis require a large load of bacteria to cause infection, making it less likely they would be transmitted by touching surfaces.)

There is no way to know how frequently such infections are spread in bathrooms, but it probably is rare enough to justify continued use of public toilets. I do want to make clear that we should still use some common sense in public restrooms. But I would not become too concerned if there were a small lapse in the usual hygiene.

Tags: HIV, Valtrex, FDA


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