Running Head: HERPES 1

Description and Management of Herpes

Name

Institution
HERPES 2

Description of the Disease

Herpes is commonly regarded as an STI, which is caused by Herpes simplex viruses type

1 (HSV 1) and types 2 (HSV 2). HSV 1 is mainly transmitted orally by kissing, touching, and

can also be through sexual intercourse. This causes cold sores on the lips and around the gums

affecting teeth and can also lead to genital herpes. The HSV 2 virus is mainly transmitted

through sexual intercourse and leads to infection with genital herpes causing painful lesions

around the genitalia including the penis, vulva, anus and the cervix (Sen and Barton 2007). The

herpes simplex virus type 1 is seen to have been present in humans for a longer period than type

2. This means that the HSV-1 infected humans long before their split with chimpanzees through

evolution. Researchers argue that genetics show that HSV virus in human and chimps show

some similarity with HSV-2 virus being more similar to the herpes virus found in chimps and

this shows that the type 2 virus must have been acquired from chimps to ancestor’s years ago.

The first episode of herpes may occur within the first two weeks after infection, and the

outbreak may be mild and unnoticeable or severe depending on individuals. Symptoms

associated with herpes include sores around the lips, gums, and the genitals as well as lesions,

which is a skin break. Other symptoms include flu-like symptoms such as fever, swelling of the

groin, and headaches. However, genital herpes due to HSV 1 or HSV 2 does not show symptoms

in the mouth or face (Sen and Barton 2007). Outbreaks of the infection vary between individuals

and genital herpes resulting from HSV 2 may recur 4 to 5 times a year while the outbreak of

genital HSV 1 can be once a year.

Outbreaks of herpes can be triggered by different triggers, which are individualized.

However, with time, people learn to avoid the factors that trigger the outbreak in their body.

Such factors could include the availability of other infections in the body that affect immunity,
HERPES 3

physical and emotional stress, surgical trauma, poor nutrition, sunburn or prolonged exposure to

UV light and increased use of steroidal drugs may trigger an outbreak of herpes.

Treatment Drugs and Side Effects

Antiviral drugs are mainly used in the treatment of herpes, especially during the first

episodes as they facilitate faster healing. These drugs include Acyclovir, Famciclovir, and

Valacyclovir However, herpes cannot be cured but can be prevented and treated to decrease the

chances of transmitting the infection to other people or recurrences. Antiviral drugs are available

in pill and liquid form.

Acyclovir

This is used in the treatment of infections caused by herpes simplex virus and shingles

that are caused by herpes zoster. The viruses allow the infections to stay in the body even before

the outbreak of the disease, and Acyclovir helps in reducing the rate of outbreaks. Also, it is

crucial in allowing faster healing of sores, prevents pain and itching and also suppress the virus

by preventing its spread/ multiplication to other parts of the body (Kimberlin and Whitley 2007).

Acyclovir is well tolerated in the body but may also have mild to severe side effects. For

instance, oral acyclovir is known to promote mild gastrointestinal upset, skin rash, and mild

headache. Also, intravenous acyclovir can lead to phlebitis and severe inflammation and also

cutaneous necrosis due to vesicular eruption. Other common side effects include hypotension,

nausea, sweating, and hematuria (Kimberlin and Whitley 2007). Severe side effects include

neurotoxicity among the elderly and individuals with kidney problems due to increased

concentration of serum. Neurotoxicity may lead to hallucination, tremors, confusion, seizures,

and lethargy.
HERPES 4

Famciclovir

This drug was approved by the FDA in 1994 for the treatment of herpes zoster and

genital herpes as well as recurrent herpes libialis in adults (Modi et al. 2008). Famciclovir is well

absorbed by the body and has a longer life cycle, which means that it is taken less frequently

than acyclovir. It is used in the treatment of shingles, the outbreak of herpes simplex that cause

genital herpes and oral herpes. The drug is also essential in the prevention of future outbreaks of

genital herpes among individuals infected with the virus. Like, acyclovir, famciclovir works by

preventing/ reducing the growth and spread of the viruses into the body.

Common side effects include mild headache and nausea while adverse side effects may

include wheezing, rashes, itchy and swollen skin, tightness of chest and swelling of the face,

mouth, lips or the tongue. Again, the drug may have an allergic reaction to individuals who are

allergic to penciclovir, and intake could be fatal.

Valaciclovir

It is an antiviral drug that is converted into acyclovir after intake and metabolism in the

liver. The FDA approved it in 1994 due to its potential advantages, including safety and efficacy

in the suppression of HSV virus. The drug is used in the treatment of genital herpes due to its

ability to inhibit herpes simplex viruses (Modi et al. 2008). It is also known to reduce the

duration of healing of lesions, pain, and also viral shedding.

Unlike acyclovir, valaciclovir does not result in neurotoxicity in humans. However, the

high dosage could result in thrombotic microangiopathy, especially among individuals living

with HIV. When used with other drugs such as zidovudine, the patient may develop somnolence
HERPES 5

and lethargy. Also, neurotoxicity may be experienced when used together with nephrotoxic

drugs.

Holistic Approach for management of the Disease

Herpes outbreak can be managed through strategies that promote stress management,

promotion of good nutrition, and physical activity as well as drug therapy with antiviral

medication. Also, the use of natural vitamins and minerals is crucial in the management of

herpes. For instance, vitamin D is a strong and powerful antiviral, and it is responsible for the

activation of immunity by allowing the T-cells to fight infections and viruses. Without vitamin D

in the body, T-cells in the immune system remain inactive leading to less protection against the

invading disease-causing microorganisms and viruses. Vitamin D level can be maintained by

taking supplements and exposure to sunlight. Vitamin C is also crucial as well as selenium as

they inhibit the reproduction and spread of herpes viruses. Also, lithium, zinc, and vitamin A

boost the immune system by promoting the fighting ability.

Amino acids arginine and lysine are correlated with the outbreak of herpes as the

replication of viruses is dependent on amino acids. In this case, arginine is one of the essential

amino acids that help in replication and progression of viral infections, including herpes simplex

virus (Mailoo and Rampes 2017). In this case, avoiding or reducing the intake of foods that are

rich in arginine would reduce the ability of HSVs to complete their replication cycle, leading to

damage/destruction of infected cells. Such foods include red meat, poultry, nuts, and seeds, as

well as dairy products. On the other hand, L-lysine or lysine amino acid is known to reduce the

ability of its antagonist, arginine to replicate viruses and this may benefit people with regular or

frequent herpes outbreaks including genital herpes and cold sores (Mailoo and Rampes 2017). In

this case, supplements of lysine can be used to prevent outbreaks and also reduce the healing
HERPES 6

time. Also, individuals can adjust their diets by taking lysine-rich foods, including soybeans,

legumes, and lentils. However, the lysine supplements should be taken in the right doses as an

overdose could lead to an imbalance of amino acids which alters the absorption of other

nutrients, including essential minerals and vitamins.

HERPES 7

References
Kimberlin DW, Whitley RJ. Antiviral therapy of HSV-1 and -2. In: Arvin A, Campadelli-Fiume

G, Mocarski E, et al., editors. Human Herpesviruses: Biology, Therapy, and

Immunoprophylaxis. Cambridge: Cambridge University Press; 2007. Chapter

64. Available from: https://www.ncbi.nlm.nih.gov/books/NBK47444/

Mailoo VJ, Rampes S. Lysine for Herpes Simplex Prophylaxis: A Review of the

Evidence. Integr Med (Encinitas). 2017 Jun;16(3):42-46. PubMed PMID: 30881246;

PubMed Central PMCID: PMC6419779.

Modi S, Van L, Gewirtzman A, Mendoza N, Bartlett B, Tremaine AM, Tyring S. Single-day

treatment for orolabial and genital herpes: a brief review of pathogenesis and

pharmacology. Ther Clin Risk Manag. 2008 Apr;4(2):409-17. doi: 10.2147/tcrm.s1664.

PubMed PMID: 18728852; PubMed Central PMCID: PMC2504076.

Sen P, Barton SE. Genital herpes and its management. BMJ. 2007 May 19;334(7602):1048-52.

doi: 10.1136/bmj.39189.504306.55. PubMed PMID: 17510153; PubMed Central

PMCID: PMC1871807.