From the Guidelines
Yes, adults can develop HSV-1 (herpes simplex virus type 1) for the first time even if they've never had lesions before, as the virus can be acquired through direct contact with infected saliva or skin, commonly through kissing or sharing items like utensils or lip balm 1.
Key Points to Consider
- HSV-1 infection can occur at any age and is now becoming the most common cause of primary genital HSV infections, with at least 50% of new cases of herpes genitalis in developed countries caused by HSV-1 1.
- When adults contract HSV-1 for the first time, they may experience a primary outbreak that can be more severe than subsequent episodes, with symptoms including painful oral lesions, fever, swollen lymph nodes, and general discomfort lasting 1-2 weeks.
- For symptom management, over-the-counter pain relievers like acetaminophen or ibuprofen can help, along with topical anesthetics such as lidocaine.
- For more severe cases, prescription antivirals like acyclovir, valacyclovir, or famciclovir can reduce symptom duration and severity.
Important Considerations
- The virus establishes latency in the sensory ganglia and, when reactivated, causes herpes labialis, with reactivation stimuli including exposure to ultraviolet light, fever, psychological stress, and menstruation 1.
- Approximately 67% of the global population under age 50 carries HSV-1, and many infected individuals never develop symptoms, unknowingly transmitting the virus to others.
- The aim of antiviral therapy is to block viral replication in order to enable shortening the duration of symptoms and accelerate the resolution of lesions, with treatment initiation as soon as possible to ensure an optimal therapeutic beneficial effect 1.
From the Research
Development of HSV 1 in Adults
- HSV 1 can be developed in adults with no previous lesions, as the virus can be acquired through contact with an infected person, even if they do not have visible symptoms 2.
- The virus can cause lifelong infection, and interventions such as antiviral chemotherapeutic agents are necessary to prevent recurrent outbreaks, especially in immunocompromised patients 2.
Transmission and Infection
- HSV 1 can be transmitted through skin-to-skin contact, and the virus can be shed from the skin even when there are no visible lesions 3.
- The treatment of HSV 1 infections typically involves antiviral medications such as acyclovir, valacyclovir, and famciclovir, which can help reduce the severity and frequency of outbreaks 4, 5, 6, 3.
Diagnosis and Treatment
- The diagnosis of HSV 1 infection is often straightforward, but choosing an appropriate treatment regimen can be confusing due to competing clinical approaches and evolving dosing schedules 3.
- Evidence-based dosing regimens are necessary to provide effective treatment, and the choice of treatment approach (intermittent episodic therapy, intermittent suppressive therapy, or chronic suppressive therapy) depends on clinical characteristics and patient preference 3.