Q. Please suggest treatment for someone who has tested positive for HSV type 1 IgG.

Hello,

Welcome to icliniq.com

Kindly send your reports.

HSV is one of the most common causes of genital ulcers in the United States. HSV-1 (herpes simplex virus- 1) is usually acquired in childhood by contact with oral secretions that contain the virus. HSV-1 is traditionally associated with the orofacial disease.

Antibody testing can demonstrate a primary seroconversion, particularly with HSV-1.

HSV-1 and HSV-2, each encode a serologically distinct glycoprotein G, IgG-1 and IgG-2.

Overall, medical treatment of herpes simplex virus (HSV) infection is centered around specific antiviral treatment.

The location of the lesions and the chronicity (primary or reactivation) of the infection dictate the dosage and frequency of medication.

Antivirals are effective when taken within 72 hours of the lesion appearing in genital herpes. Various oral and also intravenous antivirals are available for usage.

Please send the test reports for further discussion.

Thank you.

Hi,

Welcome back to icliniq.com.

Your HSV1 IgG titer is equivocal and not blatantly elevated but the lymphocyte count is high suggesting active infection. You have excellent HepB (hepatitis B) protection with high antibody titers and negative HBsAg, HIV (human immunodeficiency virus), HCV (hepatitis C virus), and bacterial infections are negative.

HSV1 only gets transmitted by sexual transmission rarely by oral route.

Antivirals will be needed.

Hi,

Welcome back to icliniq.com.

1. The lymphocytosis reported is more likely due to HSV infection than cough and cold (possibly common cold) unless the pathogen was COVID-19 virus or bacterial respiratory tract infection.

2. HSV-1 is implicated in both genital and orofacial primary infections after contact with infectious secretions that contain either HSV-1 (usually oral secretions or genital secretions (usually HSV2). The clinical course worsens in extremes of age, low immune status, the anatomic site of involvement, and the antigenic virus type.

3) Transmission of Herpes- HSV-1 is usually acquired in childhood by contact with oral secretions that contain the virus.

Epidemiology of HSV-1 infection is however changing globally, a remarkable and subtle transition, with less exposure in childhood and more in adulthood, and less oral acquisition but more genital acquisition.

4) Prevention of Transmission- Because of the highly prevalent nature of herpes simplex virus (HSV), avoiding contact with individuals who (often asymptomatically) are excreting the virus in saliva or genital secretions is needed. Daily antiviral therapy can be given to reduce episodes of asymptomatic genital shedding and to further reduce the risk of transmission.

Questions by patient

Can I actively participate in sex with my wife?

- It would be preferable to avoid the same till the completion of 10-day antiviral therapy.

- Since HSV-1 could spread by sexual route, it is preferable to avoid sexual relationships till completion of primary treatment.

Can I go near my children and kiss them?

- Since HSV-1 is transmitted by oral route, it is preferable to avoid going near children and kiss the children till the completion of 10-day therapy.

There are various types of manifestations of the herpes simplex 1 infection-

1) Lip and mouth infection-

The most common manifestation in the recurrent case is called a ”cold sore" where pain, burning, and tingling sensation often occurs at the affected site, commonly the face, around the lips, followed by the development of reddish eruptions that rapidly develop into tiny, thin-walled, water-filled lesions that becomes pus-filled and may ulcerate.

2) Acute herpes gum and mouth infection is caused by the transmission of infected saliva from another adult or another child. This is a symptomatic disease with high fever, markedly swollen gums and palate, inflammation of blood vessels in the mouth, and skin lesions due to skin contact.

3) Pharyngotonsillitis -If this spreads to the palate and throat, it may cause sore throat besides pharyngitis and high fever.

4) Herpetic whitlow that is reddish, painful eruptions in fingers.

5) Herpes lesions in the face arms and trunk.

6) Herpes genital infection- Most Genital acquisitions are primarily due to oral-to-genital transmission through oral sex, as opposed to the genital-to-genital transmission through sexual intercourse.

What are your signs and symptoms at this time?

Other Questions

1. Can I do a blood donation?

Ans- Yes, you can donate blood even if you have herpes — but only if you are not having an outbreak of symptoms and if it has been more than 48 hours since you finished an antiviral treatment.

2. Is antivirals safe to use without affecting kidneys?

Ans- Antiviral dosages used are usually unlikely to affect kidneys, however, there are reports of acute kidney injury and raised renal function test parameters. However, in routine clinical practice, it is rarely seen, however, renal test monitoring is very important.

Treatment suggested by me:

1. Tab Valacyclovir 1000 mg orally twice daily (every 12 hr) for 10 days.

This can be followed by prolonged suppressive therapy at a lower dose depending on symptoms.

Hi,

Welcome back to icliniq.com.

Jock itch or tinea cruris is a fungal infection of the skin around the pubic and genital areas and is not the same disease as your current condition. The treatment and medications are very different in type and duration.

The prescription will only be made available by video consultation as per prevailing rules and regulations.

Thank you.

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Dr. Shubadeep Debabrata Sinha

Experience: 27 + Yrs

Infectious Diseases

---

Related Questions:
Do painless dark vaginal pigmentation suggest herpes or genital warts?

With both concerns do they look like herpes, genital warts, or STD ... In herpes, usually, there are a lot of painful eruptions which is not so in your case ...   Read full

Kindly interpret test results taken after erotic massage.

.. gone through your query and the reports attached (attachment removed to protect patient identity). Herpes 1 IgG positive indicates a history of herpes virus type 1 infection which is usually spread by oral contact and causes lesions in the facial regio   Read full

I am at the risk of HIV AIDS. Please help.

Hello doctor, My wife is 13 weeks and 5 days pregnant at present. She vomits in the mornings, and she has continuous light stomach pain. Once or twice a day, she has intense stomach pain for 5 to 7 minutes.   Read full