What Is HSV-1?

Herpes Simplex Virus 1 (HSV-1)

HSV-1 or herpes simplex virus type 1 is a type of herpes simplex virus that causes cold sores. It is called "oral herpes" because it often causes sores around the mouth or on the lips. Cold sores are also called as fever blisters. However, the sores can also be found inside the mouth, on or inside the nose, and on the face. Cold sores are commonly found in these areas, although the sores may also appear on any part of the body, which includes the genital area. HSV-1 does not usually cause genital herpes because it is caused by another type of herpes, which is called herpes simplex virus type 2 or HSV-2. 

HSV-2 causes sores around the genital and anal regions. Although this type of herpes simplex virus may also occur in other areas of the body, it usually causes sores that are found below the waist. Generally, an individual gets infected by HSV-2 during sexual acts with someone who has an HSV-2 infection. 

HSV-1 is highly contagious. The infection is endemic and common throughout the world. Most of the time, the infection is acquired during childhood. In 2007, an estimated 67 percent of the population or 3.7 billion people under the age of 50 had oral herpes. In 2012, it was estimated that around 140 million people ages 15-49 years old had genital herpes. It was reported that most HSV-1 infections were common in Europe, America, and Western Pacific. 

Signs and Symptoms

In the US, about 58 percent of the population tested positive for the virus, and most of these people are asymptomatic. By the age of 30, almost half of Americans are tested positive without any symptoms. 

Cold sores may sometimes start with a tingling, burning, or itching sensation on the lips and genitals in some cases. Tiny blisters appear, which eventually break up. The blisters may cause painful sores over a period of time, and then develop into a dry, crusty surface later on. Usually, cold sores go away on their own after a week or two without treatment. However, certain medications can be prescribed to help with the discomfort and speed up the healing process. 

Transmission

HSV-1 is transmitted through direct exposure to infected oral secretions or sores, such as kissing and sharing of personal items like eating utensils and toothbrushes. However, an infected individual can still spread the virus even if he or she does not have visible sores.  

Possible Complications

• Severe Disease - An HSV-1 infection in immunocompromised people, such as those with HIV/AIDS, can develop a more severe infection along with frequent recurrent episodes. Although rare, the HSV-1 virus can also cause certain complications, such as keratitis or encephalitis.

• Neonatal Herpes - Neonatal herpes usually occurs when a newborn baby is exposed to herpes simplex virus present in the mother's genital tract during delivery. However, this condition is rare and is estimated to occur in 10 out of 100,000 births worldwide. When pregnant women with genital herpes are infected before conceiving, they usually have a low risk of viral transmission to their babies. However, when pregnant women are infected later in their pregnancy, the risk of developing neonatal herpes is greatest. This condition can also lead to lifelong neurologic damage and even death. 

• Psychological Impact - Having recurrent oral herpes may lead to psychological distress and social stigma. When it comes to people with genital herpes, the infection can significantly affect their sexual relationships and quality of life. However, most people with herpes (either oral or genital) cope by eventually learning how to better live with their condition. 

Treatment

A herpes infection does not have a definite cure. Available treatments are only used to relieve its symptoms. These medications can help ease the pain, speed up one's healing process, and reduce the number of outbreaks. The most commonly prescribed drugs for the treatment of herpes symptoms are valacyclovir (Valtrex), acyclovir (Zovirax), and famciclovir (Famvir). When it comes to genital sores, having warm baths may help relieve pain and discomfort. 

Although these treatments can help reduce the frequency and severity of HSV symptoms, it cannot completely eliminate the infection.

Prevention

Infection is most contagious during an outbreak of symptomatic oral herpes. However, the infection can still be transmitted even though no symptoms are felt. If a person has active symptoms, oral contact should be avoided as well as avoiding the sharing of personal objects that have contact with saliva.

Refrain from oral sex or any sexual activity that can help transmit the virus to other people. People who are already infected with HSV-1 may not get the infection again, but they have an increased risk of getting infected by HSV-2. When engaging in sexual activities, condoms must always be used to help prevent the spread of genital herpes. However, it is also important to note that genital herpes can also occur in areas that are not covered by condoms. 

It is also very important for pregnant women to inform their healthcare provider if they have a history of genital herpes or are experiencing symptoms of the infection. The risk of neonatal herpes is greatest in women who are in their late pregnancy.

Additional research studies are underway to develop more effective preventive methods. One effective preventive measure would be a vaccine for the herpes simplex virus. At present, there are two companies that are developing vaccines for HSV.  

When to See a Doctor

If you suspect that what you have is cold sores, seek help from a healthcare provider. You also need to consult a doctor if you have any of the following conditions:

• If you have a weakened immune system due to another health condition 
• If the sores don't go away after 7-10 days 
• You have frequent cold sores
• If you have signs of a bacterial infection (fever, redness, or pus)

While waiting for your scheduled doctor's appointment, make yourself comfortable by applying home remedies, such as applying an ice pack wrapped in a towel to the affected area. Over-the-counter pain relievers, such as ibuprofen and acetaminophen can also be used to relieve pain and discomfort.