Download Herpes Simplex Virus: HSV‑1 and HSV‑2

Herpes Simplex Virus: HSV‑1 and HSV‑2
Natural Treatments
by Ashley Kowalski, HBSc, ND
Hampton Wellness Centre
1419 Carling Avenue Suite 209
Ottawa, ON K1Z 8N7
www.ashleykowalskind.com
What Is It?
Herpes simplex virus (HSV) is a viral
infection of the skin and mucous
membranes. Lesions can occur in many
different areas, especially in or around
the mouth, lips, genitals, and eyes. There
are two types of HSV: HSV‑1 and HSV‑2.
HSV‑1 is responsible for the development
of your typical “cold sore”; it therefore has
a predisposition for the mouth and lips,
but it can also cause genital herpes in a
small number of cases. Meanwhile, HSV‑2
is the main herpes virus that affects the
genital area.[1]
HSV‑1 and HSV‑2 are ubiquitous, large double-stranded DNA viruses.[2] HSV‑1 is
commonly transmitted through saliva and skin-to-skin contact with an individual who
carries the virus. On the other hand, HSV‑2 is transmitted through sexual contact with
an infected person.[3] The likelihood of becoming infected with HSV‑2 increases with the
number of sexual partners, having unprotected sex, and having a partner with genital
herpes.[4] HSV‑1 and HSV‑2 must enter the body through broken skin or a mucous
membrane in order to become infectious.[5]
HSV can be present within the body anywhere from 2 to 12 days before displaying any
sign of infection.[1] The virus typically produces symptoms within a week of incubation.[4]
Once the initial infection clears, the virus remains dormant within the body. HSV can
become reactivated under the “proper” circumstances. Infections, trauma, stress,
fever, menstrual periods, and sun exposure are all common triggers for a recurrent
outbreak.[3] HSV has an affinity for the nerve cells; it infects the sensory and autonomic
nerves before ascending to the nerve ganglia in the spinal cord. It is within the nerve
ganglia that the virus can remain dormant and become reactivated at a later time. Once
reactivated, the virus migrates from the ganglia to the target site (usually the skin or
mucous membranes), where it can either cause an outbreak or shed.[4]
The severity of the herpes infection varies, depending upon whether the episode is
primary or recurrent. The first episode of genital herpes generally tends to be the
most severe. These lesions may take one to six weeks to heal. The initial symptomatic
episode is usually followed by a greater likelihood of clinical recurrences as well as
shedding of the virus. Shedding is subclinical, and occurs when the skin tissue harbors
the virus and literally “sheds”; transmission of the virus is simplified through the shedding
process. Recurrences of the infection typically occur four to five times a year in those
with symptomatic outbreaks. Meanwhile, many herpes infections are subclinical and
go undetected. Asymptomatic individuals are likely to sexually transmit the infection to
others without awareness.[4]
The classic herpes lesion begins as a small red papule that evolves into a vesicle
containing clear fluid. This vesicle will eventually form a pustule. Burning pain occurs
following ulceration of these lesions. Lesions ulcerate more rapidly in moist areas than
on dry skin, thus lesions on mucous membranes tend to be more painful.[4] These
ulcerative lesions eventually form a crust.[2]
HSV is one of the most prevalent sexually transmitted infections. The black population
has a higher HSV prevalence than do whites, which may be accounted for by the fact
that developing countries are less educated on safe sexual practices. The highest
annual incidence of genital herpes among women occurs at 20 to 24 years of age
and is estimated to be 210 per 100,000 women. Meanwhile, men are more likely to
have asymptomatic HSV‑2 infections.[4] Individuals with genital HSV‑1 infections have a
much lower risk of viral shedding and symptomatic recurring outbreaks than do those
who are infected with HSV‑2 genital herpes.[2]
Diagnosis
HSV outbreaks are often preceded by a
tingling, burning, and itching sensation
in the affected area.[5] HSV is recurrent
and presents as single or multiple painful
clusters of blisters on top of a red base,
which eventually ulcerate and form a
crust. Lymph nodes are often tender and
inflamed in the presence of infection.[1]
Systemic symptoms may also be present,
and include fever, malaise, body aches,
headaches, and nausea. Meningitis-like symptoms, such as stiffness of the neck and
sensitivity to light, are also common. Women can also present with vaginal discharge
and intermenstrual spotting when HSV infects the cervix. Swollen groin lymph nodes
are common, and discomfort during urination occurs when herpes enters the urethra or
urine comes into contact with lesions on the vulvar surface.[4]
A practitioner can best make a diagnosis based on medical history, laboratory tests,
and inspection of the infected area by means of a physical examination. The physical
examination involves inspecting the lesions and examining the genital area. If systemic
symptoms are present, then a more thorough neurological examination needs to be
performed.[4] Meanwhile, laboratory testing to confirm the diagnosis is indicated for
most people having their initial eruption.
A tissue culture is the best way to isolate the herpes virus for diagnostic purposes.[1]
Polymerase chain reaction (PCR) is the diagnostic standard method for HSV infections
of the central nervous system. HSV PCR, with its consistency and substantially higher
rate of HSV detection, could replace viral culture as the gold standard for diagnosis
in those with active lesions.[2] Many individuals also test positive for the virus in their
blood. A positive blood test, however, does not necessarily mean that the individual had
any previous symptomatic indications of a herpes outbreak. Other acceptable testing
methods include direct immunofluorescent assay (DFA), enzyme-linked immunosorbent
assay (ELISA), and antigen detection tests. The Centers for Disease Control (CDC)
state that isolation of HSV in a cell culture followed by DFA antigen testing can help
distinguish HSV‑1 from HSV‑2.[4]
Natural Treatments
Supplements
Vitamin C and bioflavonoids (600 mg of each three times daily for three days after
onset of symptoms) may help reduce the duration of a HSV outbreak.[4] Vitamin C and
bioflavonoids have anti-inflammatory and antiviral properties which can help speed up
the healing time of blisters and cold sores.[6]
Vitamin E (15‑minute topical applications in and around lesion) may provide pain relief
when applied topically to lesions.[4] Vitamin E is a neuroprotective element which helps
relieve nerve pain during recurrences.[6]
Lysine (1 g three times per day during outbreaks; 1 g per day to limit outbreaks and
recurrences) has been shown to help resolve and prevent HSV outbreaks involving
the mouth, lips, and genital areas. Lysine is thought to have inhibitory effects on HSV
replication, and is antagonistic to arginine, which promotes HSV growth. The HSV
virus requires the manufacture of proteins
rich in arginine in order to replicate. Limit
arginine intake if you want to prevent an
outbreak or hasten healing.[1] Foods high
in lysine include vegetables, beans, fish,
turkey, and chicken. High-arginine foods
include almonds, cashews, and sunflower
seeds.[4]
Vitamin B 12 (1000 mcg per day
intramuscularly) is suggested to have
antiviral activity against herpes viruses.
Vitamin B12 is also good for the treatment of nerve-related conditions; it is good for
overall nerve health and function in general. Thus, vitamin B12 is a good option to help
prevent HSV infections from occurring.[1]
Zinc (50–75 mg per day, combined with 2 mg of copper, to reduce frequency, duration,
and severity of HSV infections) enhances cell-mediated immunity and has been shown
to inhibit HSV replication. It can also be applied topically as a zinc sulfate (4%) solution
to reduce pain and increase healing time.[1]
Botanicals
Lemon balm (topical applications
2–4 times per day) topical ointment
applications have been used on cold
sores. Studies show that lemon balm
significantly reduces the likelihood of
recurrent infections as well as healing
time.[4] Lemon balm seems to exert its
antiviral effects on HSV following viral entry
into cells — viral binding assays show
that the extract does not prevent HSV‑2
entry.[7]
Licorice (apply ointment or gel to lesions several times daily) is known for its immune
system–supporting properties. It is also antiviral by inhibiting growth, activity, and
replication of the herpes simplex virus. Topical application of licorice gels or ointments
reduces both healing time and the uncomfortable symptoms of HSV‑2.[4] Licorice also
appears to be effective against HSV‑1 by reducing membrane fluidity, which inhibits
fusion of the virus with cells.[8]
Siberian ginseng (500–3000 mg dried root capsules per day) has been shown to
decrease the severity of HSV infections.[4] The active ingredients in this herbal preparation
help to stimulate the immune system and also reduce the number of outbreaks.[9]
Aloe vera (0.5%) cream contains constituents which inactivate HSV‑2, both when used
alone and synergistically with acyclovir. Studies reveal that aloe cream shortens healing
time and decreases severity of symptoms.[4] Aloe has the ability to soothe, heal, and
protect against symptoms of HSV.[6]
Conclusion
Herpes simplex viruses are ubiquitous in the environment. HSV is also the most common
sexually transmitted infection. HSV‑1 is mainly responsible for causing outbreaks in and
around the mouth and lips; HSV‑2 is the main type responsible for genital outbreaks. HSV
infections can also be asymptomatic, and they will recur under certain circumstances. It
is there important to control for environmental factors which may precipitate an outbreak.
Meanwhile, an infected person is considered contagious, even when asymptomatic.
HSV does not leave the body, but instead lies dormant within the nerve ganglia. HSV
outbreaks are characterized by papules that eventually form fluid-filled vesicles, which
ulcerate and crust-over. Several nutritional and botanical treatments exist which can
decrease healing time and prevent future outbreaks. Please consult with your doctor
or a licensed health-care professional prior to taking any supplements, botanicals, or
medications. A professional can help determine which supplement is best suited for
your unique presentation and circumstances.
References
1.
Prousky, J. Textbook of Integrative Clinical Nutrition. CCNM Press Inc., 2012. 506 pages (here pp. 246–249).
2.
LeGoff, J., H. Pere, and L. Belec. “Diagnosis of genital herpes simplex virus infection in the clinical laboratory.” Virology Journal Vol. 11 (2014): 83.
3.
American Academy of Dermatology. Herpes Simplex: Who gets and causes · https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/
e---h/herpes-simplex/who-gets-causes · Updated 2015 · Retrieved 2015‑02‑25.
4.
Hudson, T. Women’s Encyclopedia of Natural Medicine: Alternative Therapies and Integrative Medicine for Total Health and Wellness. McGrawHill Publishing, New York, 2008, 528 pages (here pp. 99–108).
5.
University of Maryland Medical Center. Herpes simplex virus · http://umm.edu/health/medical/altmed/condition/herpes-simplex-virus · Updated
2013‑05‑31 · Retrieved 2015‑02‑25.
6.
Institute for Optimum Nutrition (ION). Nutrition Central: Herpes Simplex Simple Solutions for a Troublesome Virus · http://www.ion.ac.uk/
information/onarchives/autumnherpes-simplex-simple-solutions-troublesome-virus · Retrieved 2015‑02‑26.
7.
Mazzanti, G., et al. “Inhibitory activity of Melissa officinalis L. extract on herpes simplex virus type 2 replication.” Natural Product Research
Vol. 22, No. 16 (2008): 1433–1440.
8.
Fiore, C., et al. “Antiviral effects of Glycyrrhiza species.” Phytotherapy Research Vol. 22, No. 2 (2008): 141–148.
9.
University of Maryland Medical Center. Siberian Ginseng · http://umm.edu/health/medical/altmed/herb/siberian-ginseng · Updated
2013‑05‑07 · Retrieved 2015‑02‑26.