Herpes Simplex Virus 1 and 2

  • A person's immune system
  • How long ago you became infected
  • Where the virus is

Any person with a compromised immune system will most likely have more problems. A person who has had the infection for a long period of time is less likely to have severe outbreaks. HSV-1 is generally oral Herpes and "prefers" to be oral Herpes. HSV-2 is generally genital Herpes and "prefers" to be genital Herpes. That means if you are infected genitally with HSV-1, generally the outbreaks aren't as severe and don't reoccur as often. The same applies to HSV-2.

Some people report that recurrences are triggered by stress, illness, poor nutrition, menstruation, and friction in the genital area such as that caused by vigorous (or dry) sex. Research also shows that people who don't know they are infected often spread Herpes Simplex infections. These people may have symptoms so mild they don't notice them at all or else don't recognize them as Herpes.

Pregnancy and Herpes

In my search for knowledge I found that being pregnant with HSV will not usually cause problems, while delivering a child vaginally during an outbreak can cause problems.

There is good news however, even for those who DO deliver during an outbreak. The greatest risk to the baby comes when the mother has her FIRST outbreak during the last trimester (delivery), when the risk of transmission is at its highest. This is partially due to the antibodies the mother's body has developed to combat the virus. (The presence of antibodies is one of the reasons that subsequent outbreaks are USUALLY not as bad as the original.)

However, having said that, there is a less than or equal to 3% neonatal transmission rate among women having recurrent (not initial) outbreaks. At the time of delivery, a visual exam is done, many of questions are asked and if there are no signs of an outbreak, a vaginal delivery (if possible) is allowed.

There are also differing medical opinions on how to prevent an outbreak since there are many different triggers, and not everyone has the same one. Some can be triggered by food or stress. If the trigger is known, it can be avoided during the last trimester. Some providers give a prescription for Acyclovir as a preventative.

"The safety of systemic Acyclovir therapy among pregnant women has not been established. Burroughs Wellcome Co., in cooperation with CDC, maintains a registry to assess the effects of the use of Acyclovir during pregnancy. Women who receive Acyclovir during pregnancy should be reported to this registry (1-800-722-9292, ext. 58465). Current registry findings do not indicate an increase in the number of birth defects identified among the prospective reports".

I took Acyclovir for a short time during the end of my pregnancy, but the side effects for me were too great. I knew my trigger and avoided it. Studies so far indicate no additional risk of defects and there are providers out there that prescribe them as a preventative.

There are a few infants that are infected at delivery. The numbers are small, but not zero. Women that do have genital Herpes DO need to keep an eye out for signs of infant infection. They are extremely rare, but not unheard of.

The GOOD news - "Less than 0.1 percent of infants born in the United States each year get infected with genital Herpes during birth, according to the American Social Health Association. A mother who was infected with Herpes prior to getting pregnant passes Herpes antibodies on to her fetus, protecting it from becoming infected with the virus. The FDA has approved the drug Acyclovir in injectable form or Vidarabine to treat infants with Herpes."

If a woman delivers during an outbreak, the infant is watched closely for a period of 24-48 hours for signs of infection. If there are signs of infection, a course of Acyclovir can be given and it usually is effective (very). However, if left untreated, it can be devastating if not fatal. It is imperative that you seek medical advice before, during, and after delivery if you have HSV, both for you AND your child.

Treatment Options

Just about everyone has seen the commercial, you know, the Valtrex one.