From the Guidelines
For a new HSV-1 IgG elevation of 6.8, no specific treatment is typically required if you're not experiencing symptoms. This blood test result simply indicates past exposure to herpes simplex virus type 1 (HSV-1), which is extremely common, affecting about 67% of people worldwide 1. The value of 6.8 confirms you have antibodies from previous infection, but doesn't indicate when you were infected or predict future outbreaks.
Key Considerations
- If you experience active symptoms like cold sores, treatment options include topical antiviral medications (acyclovir 5% cream applied 5 times daily for 4 days) or oral antivirals (valacyclovir 2g twice daily for one day, or acyclovir 400mg five times daily for 5 days) 1.
- For frequent recurrences (more than 6 per year), suppressive therapy with valacyclovir 500mg daily or acyclovir 400mg twice daily may be considered 1.
- HSV-1 typically causes oral herpes but can also cause genital herpes, and the virus remains dormant in nerve cells between outbreaks 1.
- While it cannot be cured, medications can effectively manage symptoms when they occur, and the goal of treatment is to reduce morbidity, mortality, and improve quality of life.
Diagnosis and Management
- The diagnosis of genital herpes can be made using HSV nucleic acid amplification test (NAAT)/polymerase chain reaction (PCR) diagnostic assays, which have high sensitivity and specificity 1.
- Type-specific HSV serologic assays can differentiate between HSV-1 and HSV-2, but the sensitivity and specificity of these assays can vary, and false-positive or false-negative diagnoses can occur 1.
- The management of genital herpes includes antiviral therapy, counseling on the natural history of infection, risk for sexual and perinatal transmission, and methods to prevent further transmission 1.
From the Research
Treatment Options for HSV 1 Infection
- The standard therapy for the management of HSV infections includes acyclovir (ACV) and penciclovir (PCV) with their respective prodrugs valaciclovir and famciclovir 2.
- Valacyclovir is the only oral antiviral agent approved for therapy of herpes labialis, and is also approved for a 3-day course in the episodic treatment of recurrent genital herpes, as well as for once daily dosing for suppressive therapy 3.
- Helicase primase inhibitors (HPIs) are a new class of compounds that have shown efficacy in the treatment of HSV infections, and may be useful for the treatment of severe HSV disease and nucleoside-resistant viral strains 4.
Elevation of HSV 1 IGG
- An elevation of HSV 1 IGG of 6.8 may indicate a current or past infection with HSV 1.
- The treatment of HSV 1 infections can be guided by evidence-based reviews, which provide recommendations for choosing an appropriate drug and dosing regimen 5.
- Combination drug therapies, such as the combination of acyclovir, cidofovir, and amenamevir, may be effective in suppressing viral replication without significant drug-drug interactions 6.
Treatment Considerations
- The choice of treatment for HSV 1 infection should be based on defined clinical characteristics and patient preference.
- The development of drug resistance is a concern in immunocompromised patients, and alternative therapies such as HPIs may be useful in these cases.
- Further study is needed to determine the efficacy and safety of new antiherpetic compounds, including combination drug therapies.