Chronic herpes generally refers to infected people who have six or more herpes outbreaks in a year. Frequent outbreaks are a medical concern because the herpes simplex virus creates a risk for other diseases, such as the development of viral meningitis, and a high frequency of outbreaks can make it difficult for people to have sex. Most people have fewer infections per year, and these become less common the longer a person has the condition. Some people are particularly prone to chronic herpes, especially those with compromised immune systems. Fortunately, there are ways to successfully treat this condition.
When a person has active symptoms of herpes, the condition is generally considered acute - each outbreak is called an acute phase of herpes. Chronic herpes cannot be diagnosed until the number of outbreaks exceeds six acute phases within a year. In the first year that a person contracts herpes, it is possible to have six or more outbreaks, without being considered chronic, as long as the outbreaks are reduced in the second year. Diagnosis is easier if outbreaks continue to be frequent in the second year or several years after contracting the disease.
Most people will not have chronic forms of herpes, but in the first year many doctors recommend that people take antiviral medications such as acyclovir or famciclovir. These can not only help reduce the discomfort of an initial infection, but they can also suppress additional infections. This does not mean that people can expect to be infection-free, but they often have fewer infections if they use an antiviral drug. These drugs are generally only used for six months to a year. In cases where patients appear to have chronic herpes, these drugs are used for a longer period of time.
In addition to reducing the many infections that can accompany chronic herpes, antiviral medications can help reduce the risk of developing diseases that can be very dangerous. In particular, it is essential to decrease the possibility of developing conditions such as meningitis, which is difficult to treat and can cause inflammation of the brain. Since people prone to chronic herpes may be immunosuppressed, it is also important to reduce the incidence of outbreaks so that other complications such as infection do not occur.
The indication of how long a patient should stay on antiviral drugs is really up to the individual. Some people stay on antivirals for a year or more. If a patient continues to have an ongoing autoimmune or immunosuppressed state, they may need medical treatment for herpes for a longer time. Some people with chronic herpes can discontinue medication after a few years and have a significant reduction in the number of outbreaks. Again, it is important to state that most people do not have chronic herpes, but if they experience frequent outbreaks, they should see their doctor for medical advice.