Q9. What about asymptomatic shedding? How frequent is it and how long does it last?
A. The frequency of asymptomatic shedding parallels that of symptomatic outbreaks. There is little asymptomatic shedding in people with genital herpes due to HSV-1 (and therefore not much risk of transmitting herpes to their partners). For genital herpes due to HSV-2, every infected person sheds virus without symptoms from time to time. Just as symptomatic outbreaks are most common in the first months or years after catching the infection, asymptomatic shedding is most frequent in the first year. It isn’t known how long asymptomatic shedding goes on, but in most infected it probably continues for at least several years. Asymptomatic shedding isn’t present all the time, but occurs on and off (and unpredictably). This is why every person with genital herpes due to HSV-2 needs to inform his or her sex partner or partners, so that those persons are aware of the risk.
问题9：关于无症状排毒的情形是什么样？无症状排毒的频率如何以及每次持续多久？
回答：无症状排毒的频率与有症状的复发频率相似。感染HSV-1型生殖器疱疹的病人很少会有无症状排毒的现象（因此传染给他们伴侣的风险就不会很高）。对于HSV-2型生殖器疱疹，每一位感染者都会反复发生无症状排毒。正如有症状的复发在刚感染后的第一个月或第一年内频率最密集一样，无症状排毒在第一年内发生最频繁。目前还不清楚无症状排毒会在感染多久后才不会发生，但是在大多数感染者中至少在感染后几年内会反复发生。无症状排毒并不是一直在进行着，而是时断时续（并且无法预测）。这就是为什么每个感染有HSV-2的患者需要告诉他的性伴侣的原因，这样可以使伴侣明了他们应该知道的风险。
Q10. What treatments are available and how good are they?
A. No available drugs or other treatments cure herpes, i.e. eliminate the virus from the body. However, three drugs are highly effective in speeding healing of the first infection, preventing recurrences, and, to a lesser extent, healing recurrent outbreaks. These are acyclovir (trade name Zovirax, also available generically); valacyclovir (Valtrex), which actually is a variation of acyclovir that produces higher levels of the drug in the system; and famciclovir (Famvir). They are all about equally effective; the differences are in dosing frequency and cost. (Actual cost varies widely, and the drug that is least expensive in one city or pharmacy might be the most expensive in another.) There are topical versions of acyclovir and famciclovir (actually, penciclovir, the active ingredient in the latter drug) – that is creams or ointments to put directly on herpes lesions. However, they have little effect; most people who need treatment should take one of the drugs by mouth. Do not be tempted by other products sold in health food stores, over the counter, or online. Such things like Blistex, lysine, or various vitamins or “immunity boosters” have no effect whatsoever and are a waste of your money. To my knowledge, there are no drugs in the research pipeline that are likely to truly eradicate HSV infection, and none that are likely to be any better than acyclovir, valacyclovir, or famciclovir.
问题10：有哪些治疗方式，以及效果如何？
回答：目前没有药物和其他治疗方式可以治愈疱疹，即完全从体内清除这种病毒。但是三种药物对于加速初发症状的愈合，最大限度的防止复发频率和程度以及治愈复发有非常显著的效果。它们是阿昔洛维（商品名叫Zovirax，不是这个品牌的也可以）、valacyclovir (Valtrex)，实际上是一种品质较高的阿昔洛维、famciclovir (Famvir)。他们的疗效差不多都一样，不同之处在于服药的剂量、频率以及价格。（实际上价格差异非常大，并且可能其中一种药在某地是最便宜的但是在另一个地方却是最贵的。）目前有一种倍受谈论的阿昔洛维和famciclovir的药品形式（事实上是penciclovir，一种最近药物中比较流行的成分）。即在疱疹患处直接涂抹的药霜或药膏。然而他们的效果很小，大多数需要治疗的患者应该服用上述三种药物中的口服药剂。不要被健康食品店在柜台或网上卖的其他产品迷惑。比如Blistex、赖氨酸、或者各种维他命以及“加强免疫力”的产品，它们根本没有任何效果，只是对你钱财的一种浪费。以我所知，目前没有任何在研发中的药物可能真正完全根除HSV感染，也没有任何药物可能会比阿昔洛维、valacyclovir、 或者 famciclovir效果好。
Q11. I have herpes and want to be careful not to transmit it to anyone else. What can I do?
A. There are three main strategies to prevent transmission of genital herpes to sex partners. First, avoid sex when having an outbreak. For people with mild or subtle symptoms, this means being on the lookout for even mild symptoms. Second, use condoms. Condoms aren’t perfect, but provide substantial protection. The third approach is to take suppressive antiviral therapy, which not only helps control symptoms, but helps prevent transmission. Suppressive treatment with alacyclovir (Valtrex) has been proved to prevent transmission, and therefore is the drug of choice for this purpose. However, the other anti-herpes drugs, acyclovir (Zovirax and others) and famciclovir (Famvir) probably are helpful as well. By itself, none of these strategies to prevent transmission is perfect. However, using two or more of them probably is effective the large majority of the time. Because prevention isn’t perfect, even if they take all these precautions, people with genital herpes have a moral obligation to tell any and all partners they have the infection, before having sex with them. At the same time, using one or more of these methods, some couples go for several years without transmission despite frequent intercourse.
问题11：我感染了疱疹，我希望注意不要传染给其他人，我该怎样做？
回答：主要靠三种方法来防止生殖器疱疹传染给性伴侣。第一，当生殖器疱疹发作时避免发生性生活。对于症状很轻微或者非典型症状的人来说，即使症状非常轻微时也要做到这一点。第二点，使用安全套。安全套不是完全有效的，但是却可以提供最实质性的保护。第三是采用抗病毒抑制疗法，这种疗法不仅可以帮助控制症状，还有助于防止传播。使用alacyclovir(Valtrex)的抑制性疗法已经被证实可以有助于防止传播，因此出于此目的应该选择这种药物。但是，其他抗疱疹的药物，阿昔洛维（Zovirax和其他同类成分药物）和Famciclovir(Famvir)应该也一样有效果。上述方法仅单独使用，没有哪种对防止病毒传播完全有效。但是，使用两种或以上方法将大大提高有效性。由于防护措施不可能做到完全有效，因此即使上述预防方法全部都有采用，感染生殖器疱疹的人在与每一个和全部性伴侣发生性关系前仍有道德上的责任去告诉对方自己感染有HSV病毒。同时，在使用了上述一种或更多方法后，一些夫妻很多年内都未发生病毒传播，即使他们性生活的频率很频繁。
Q12. Is there a vaccine to prevent herpes?
A. Research has been going on for many years on vaccines to prevent HSV-2 infection. An experimental vaccine is currently in clinical trials. At best, this vaccine will be only partly effective in preventing infection. If the research results are positive, it will be at least another 3-4 years before the vaccine is available.
问题12：有可以预防疱疹的疫苗吗？
回答：研究能预防HSV-2感染的疫苗工作已经进行很多年。一种实验性的疫苗目前正在临床试验。充其量这种疫苗也只能对于防止感染有部分效果。如果研究结果证实这种疫苗是有效的，仍需要再过3-4年时间才可以真正可供使用。
Q13. Can I transmit oral herpes to my own genitals, eyes, or elsewhere?
A. During an initial HSV infection, sometimes the virus is transmitted by the hands to another part of the body, such as they eye (herpetic keratitis, which if untreated can seriously damage the cornea and lead to blindness) or a fingertip (herpetic whitlow). However, once the infection has been present a few weeks, it is almost impossible to auto-inoculate the virus to another part of the body. For example, people with oral cold sores do not transmit the virus to their genitals by masturbation; and persons with recurrent genital herpes almost never self-infect the eye or other body parts. However, because eye infection is so dangerous, to be extra safe, persons with oral or genital herpes are advised to wash their hands frequently and to try to avoid touching their lesions and then their face. But even so, the risk is extremely low.
问题13：我会把我的口腔疱疹传染到自己的生殖器，眼睛或其他部位吗？
回答：在HSV原发感染期间，有时候病毒可以通过手传播到身体的其他部位，例如眼睛（疱疹性角膜炎，如果不治疗会严重损害角膜并且致盲）或者手指（疱疹性素瘤）。然而，一旦感染已经存在几个星期以后，几乎不可能再自动接种病毒到身体的其他任何部位上。比如，口腔疱疹的人不会因为手淫而将病毒传染给自己的生殖器官；生殖器疱疹复发的人几乎不会再自身接种到眼睛或身体其他部位。然而，因为眼部感染非常危险，因此为了完全安全起见，建议有口腔或生殖器疱疹的人经常洗手，并且尽量避免接触患处后接触脸部。但即使接触到，传染的风险也极低。
