HomeAnswersInfectious DiseasesherpesI have tested positive for Herpes simplex virus IgG. Please suggest some treatment.

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

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At October 11, 2022
Reviewed AtJanuary 17, 2024

Patient's Query

Hello doctor,

Recently I have taken an STD test and it came positive for HSV type 1 IgG. Please suggest some treatment for it.

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.

Patient's Query

Hello doctor,

Currently, there were no lesions around the genital region or mouth region. I am concerned that it might be contagious to my children. Please advise me on what to do and what will be the course of treatment.

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.

Patient's Query

Hello doctor,

I had been vaccinated for hepatitis B and I recently had a viral infection and got a cold and cough that made lymphocyte count high. HSV1 only gets transmitted by sexual transmission rarely by oral route. Can you please elaborate on the above sentence because I do not know from where I contracted this HSV1? I have kids so I am worried to go near them. Can I actively participate in sex with my wife? Can I go near my children and kiss them? Can I do a blood donation? I do it every year that is why I keep a check on my vitals always. Are antivirals safe to use without them affecting kidneys?

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?

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

2. 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?

1. 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?

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. Tablet Valacyclovir 1000 mg orally twice daily (every 12 hour) for 10 days.

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

Patient's Query

Thank you doctor,

I will follow the medication suggested by you for 10 days. After that how much dosage should I continue? And I recently had jock itch few months back is it because of this HSV1. Please approve the prescription. Thank you.

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 don't mean you have the same problem. Consult a doctor now!

Dr. Shubadeep Debabrata Sinha
Dr. Shubadeep Debabrata Sinha

Infectious Diseases

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