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Comment by pravda | Hacker News Reader

If you get the cold sores, get the Abreva®. That magical balm knocks 'em out like Tyson deckin' your grandmother.

Can anyone explain this: "That is because improved hygiene in rich countries is lowering HSV-1 infection rates in childhood, leaving young people more at risk of catching it via oral sex when they become sexually active."

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They mean that because children aren't contracting HSV-1 from ordinary contamination and contact at early ages, as they typically do in developing countries, they are more likely to contract it from oral sex later in life. My guess is that if you contract the virus in childhood, there is less risk of a genital infection later in life because the antibodies would already be present.

I just read it as "improved hygiene increases the chance that young people are not yet infected when they inevitably become infected via oral sex." In other words, the improved hygiene has not lowered the adult infection rate.

If you get it above the neck, you are immune to it below the neck. So having occasional cold sores (being one of their two thirds) is actually a good thing....one less thing to worry about.

Citation needed.

Actually not. There are multiple strains for each type. A HSV-1 "above the neck" infection does not prevent a HSV-2 infection below the neck.

http://www.jci.org/articles/view/57148

I took gp to mean that HSV-1 "on top" renders one immune to HSV-1 below, not HSV-1 and 2 below. And that appears to be true. Interesting that 1 and 2 appear to be "assymetrically" related, from your link: "As HSV-1 and HSV-2 have similar pathogenesis and host interactions, many of the concepts for development of an effective vaccine are likely relevant to both viruses. In addition, infection with HSV-2 provides partial protection against HSV-1, although the reverse does not appear to be true, and thus there is potential for generation of cross-reactive immunity. The possibility that an HSV-2 vaccine may provide protection against HSV-1 increases its potential value and may shift the optimal time for immunization to early childhood, instead of the more problematic adolescent vaccination series." (My emphasis, references removed)

[ed: to add, I'm not entirely sure on how/if hsv-1 (the same strain of hsv-1) can "move" -- I recall sex. ed. stating that the most common cause of HSV-1 in the genitals and eyes were self-induced -- but that might have been the other way around (HSV-2 moving from the genitals to the eyes)]

This is 100% false. Per Mertz, Annals of Internal Medicine, 1992, previous oral HSV-1 infection reduces the acquisition of subsequent HSV-2 infection by 40%. That is not immunity.

I don't think that's true.

http://www.healthcentral.com/genital-herpes/c/86/6903/hsv1-o...

I got it when I was a kid, and still occasionally get coldsores on my lips. I used to mess around with Zovirax and related creams, but now just leave them until they go away (usually a couple of days). No touching, or licking because that just makes them last longer, or worse, spread.

Abreva is pretty useless. Its really expensive and only reduces the duration of a cold sore by 17.5 hours in clinical trials. That is not a noticeable timeframe to me.

I'm just making this up, but it seems possible that having oral herpes confers some resistance to getting genital herpes?

Yes, but only to getting the "oral kind of herpes" genitally...

That's my assumption. Once you have it, you have antibodies to it as well, which prevent new cases. But you're still stuck with it in the original place, because the virus's genome hides out where the antibodies can't get it, then from time-to-time it decides to go on a rampage.

IANAI (Immunologist)

Far better, take 400 mg/day acyclovir to prevent breakouts.

I read that several times. It still makes no sense to me.

So, in poor countries all children are infected, which means as they age there's no risk to them as teenagers, because there's nothing risky about already having it and messing around with someone else that already has it.

Welcome to the wonderful world of spin doctoring.

To restate in different words:

"In developing countries, kids will get herpes from playing in the mud or other things. In the developed world, we incubate kids in sterile bedrooms, so their first exposure to this pathogen is during sexual activity."

This seems very elitist to me - having grown up in a first world country, where I played in the mud and hit things with sticks.

Small children can also get HSV-1 from things like being kissed by an older relative with an active cold sore.

That kind of thing probably happens less in developed countries due to higher awareness. [citation needed]

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