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The diagnosis and management of oral herpes simplex infection

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Abstract

Acute herpetic gingivostomatitis and recurrent herpes labialis are the most common manifestations of infection with herpes simplex virus type 1 (HSV-1). In primary and recrudescent HSV-associated disease, the symptoms may range from subclinical to debilitating and life-threatening, depending on the host’s immune responses or competence level. In this paper, the typical and atypical manifestations, and the current diagnostic and treatment options for localized, non-complicated oro-labial HSV infection are reviewed, with attention to cumulative evidence for the ef.cacy and safety of systemic antiviral agents. Some recent data on HSV-1 seroprevalence, viremia, and viral shedding are discussed in relation to disease transmission and global importance of herpesvirus disease.

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References and Recommended Reading

  1. Embil JA, Stephens RG, Manuel FR: Prevalence of recurrent herpes labialis and aphthous ulcers among young adults on six continents. Can Med Assoc J 1975, 113:627–630.

    PubMed  CAS  Google Scholar 

  2. Celum CL: The interaction between herpes simplex virus and human immunodeficiency virus. Herpes 2004, Suppl 1:36A-45A. Excellent review of evidence and clinical implications of increased risk for HSV acquisition in HSV-infection.

    Google Scholar 

  3. Kent JR, Fraser NW: The cellular response to herpes simplex virus type 1 (HSV-1) during latency and reactivation. J Neurovirol 2005, 11:376–383.

    Article  PubMed  CAS  Google Scholar 

  4. Spear PG: Herpes simplex virus: receptors and ligands for cell entry. Cell Microbiol 2004, 6:401–410.

    Article  PubMed  CAS  Google Scholar 

  5. Goodkin ML, Morton ER, Blaho JA: Herpes simplex virus infection and apoptosis. Int Rev Immunol 2004, 23:141–172.

    PubMed  CAS  Google Scholar 

  6. Mohr I: Neutralizing innate host defenses to control viral translation in HSV-1 infected cells. Int Rev Immunol 2004, 23:199–220.

    PubMed  CAS  Google Scholar 

  7. Bystricka M, Russ G: Immunity in latent herpes simplex virus infection. Acta Virol 2005, 49:159–167.

    PubMed  CAS  Google Scholar 

  8. Mori I, Nishiyama Y, Yokochi T, Kimura Y: Olfactory transmission of neurotropic viruses. J Neurovirol 2005, 11:129–137.

    Article  PubMed  Google Scholar 

  9. Malkin JE: Epidemiology of genital herpes simplex virus infection in developed countries. Herpes 2004, Suppl 1:2A-23A. Excellent comprehensive review; posted by The International Herpes Management Forum, http://www.ihmf.org.

    Google Scholar 

  10. Schillinger JA, Xu F, Sternberg MR, et al.: National seroprevalence and trends in herpes simplex virus type 1 in the United States, 1976–1994. Sex Transm Dis 2004, 31:753–760.

    Article  PubMed  Google Scholar 

  11. Miller CS, Avdiushko SA, Kryscio RJ, et al.: Effect of prophylactic valacyclovir on the presence of human herpesvirus DNA in saliva of healthy individuals after dental treatment. J Clin Microbiol 2005, 43:2173–280. Excellent example of clinical applicability of PCR detection of HSV-infection and evidence for efficacy of oral antiviral treatment in suppression of recurrence after dental treatment.

    Article  PubMed  CAS  Google Scholar 

  12. Harel L, Smetana Z, Prais D, et al.: Presence of viremia in patients with primary herpetic gingivostomatitis. Clin Infect Dis 2004, 39:636–640.

    Article  PubMed  Google Scholar 

  13. Namvar L, Olofsson S, Bergstrom T, Lindh M: Detection and typing of Herpes Simplex virus (HSV) in mucocutaneous samples by TaqMan PCR targeting a gB segment homologous for HSV types 1 and 2. J Clin Microbiol 2005, 43:2058–2064.

    Article  PubMed  CAS  Google Scholar 

  14. Birek C: Herpesvirus-induced diseases: oral manifestations and current treatment options. J Calif Dent Assoc 2000, 28:911–921.

    PubMed  CAS  Google Scholar 

  15. Neville BM, Damm DD, Allen CM, Bouquot JF: Oral and Maxillofacial Pathology. Philadelphia: Saunders; 2002.

    Google Scholar 

  16. Waggoner-Fountain LA, Grossman LB: Herpes simplex virus. Pediatr Rev 2004, 25:86–93.

    PubMed  Google Scholar 

  17. Pardo J, Yogev Y, Ben-Haroush A, et al.: Primary herpes simplex virus type 1 gingivostomatitis during the second and third trimester of pregnancy: foetal and pregnancy outcome. Scand J Infect Dis 2004, 36:179–181.

    Article  PubMed  Google Scholar 

  18. Epstein JB, Gorsky M, Hancock P, et al.: The prevalence of herpes simplex virus shedding and infection in the oral cavity of seropositive patients undergoing head and neck radiation therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002, 94:712–716.

    Article  PubMed  Google Scholar 

  19. Raborn GW, Grace MG: Recurrent herpes simplex labialis: selected therapeutic options. J Can Dent Assoc 2003, 69:498–503.

    PubMed  Google Scholar 

  20. Raborn GW, Martel AY, Lassonde M, et al.: Effective treatment of herpes simplex labialis with penciclovir cream: combined results of two trials. J Am Dent Assoc 2002, 133:303–309.

    PubMed  CAS  Google Scholar 

  21. Eisen D: The clinical characteristics of intraoral herpes simplex virus infection in 52 immunocompetent patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998, 86:432–437.

    Article  PubMed  CAS  Google Scholar 

  22. Romanowski B, Aoki FY, Martel AY, et al.: Efficacy and safety of famciclovir for treating mucocutaneous herpes simplex infection in HIV-infected individuals. AIDS 2000, 14:1211–1217.

    Article  PubMed  CAS  Google Scholar 

  23. Ficarra G, Shillitoes EJ: HIV-related infections of the oral cavity. Crit Rev Oral Biol Med 1992, 3:207–231.

    PubMed  CAS  Google Scholar 

  24. Nikkels AF, Pierard GE: Chronic herpes simplex virus type I glossitis in an immunocompromised man. Br J Dermatol 1999, 140:343–346.

    Article  PubMed  CAS  Google Scholar 

  25. Wollenberg A, Wetzel S, Burgdorf WH, Haas J: Viral infections in atopic dermatitis: pathogenic aspects and clinical management. J Allergy Clin Immunol 2003, 112:667–674.

    Article  PubMed  Google Scholar 

  26. Tyler KL: Herpes simplex virus infections of the central nervous system: encephalitis and meningitis, including Mollaret’s. Herpes 2004, Suppl 2:57A-64A. Excellent comprehensive review; posted by The International Herpes Management Forum, http://www.ihmf.org.

    Google Scholar 

  27. Aurelian L, Ono F, Burnett J: Herpes simplex virus (HSV)-associated erythema multiforme (HAEM): a viral disease with an autoimmune component. Dermatol Online J 2003, 9:1.

    PubMed  CAS  Google Scholar 

  28. Linder T, Bossart W, Bodmer D: Bell’s palsy and Herpes simplex virus: fact or mystery?. Otol Neurotol 2005, 26:109–113.

    Article  PubMed  Google Scholar 

  29. Aryee EA, Bailey RL, Natividad-Sancho A, et al.: Detection, quantification and genotyping of Herpes Simplex Virus in cervicovaginal secretions by real-time PCR: a cross sectional survey. Virol J 2005, 11:61. Example of a rapid PCR-based assay to quantify and type HSV in cervicovaginal lavage fluid.

    Article  CAS  Google Scholar 

  30. Amir J, Nussinovitch M, Kleper R, et al.: Primary herpes simplex virus type 1 gingivostomatitis in pediatric personnel. Infection 1997, 25:310–312.

    Article  PubMed  CAS  Google Scholar 

  31. Max RE: Oral and Maxillofacial Pathology: A Rationale for Diagnosis and Treatment. Carol Streem, IL: Quintessence Pub Co; 2003.

    Google Scholar 

  32. Huber MA: Herpes simplex type-1 virus infection. Quintessence Int 2003, 34:453–467.

    PubMed  Google Scholar 

  33. Kimberlin DW: Herpes simplex virus infections in neonates and early childhood. Semin Pediatr Infect Dis 2005, 16:271–281. This article summarizes the current state of neonatal HSV disease presentation, diagnosis, and management.

    Article  PubMed  Google Scholar 

  34. Mofenson LM, Oleske J, Serchuck L, et al.: Treating opportunistic infections among HIV-exposed and infected children: recommendations from CDC, the National Institutes of Health, and the Infectious Diseases Society of America. Clin Infect Dis 2005, 40(Suppl 1):S1–84. This comprehensive report focuses on the treatment of opportunistic infections that are common in HIV-exposed and infected infants, children, and adolescents in the United States.

    Article  PubMed  Google Scholar 

  35. Chilukuri S, Rosen T: Management of acyclovir-resistant herpes simplex virus. Dermatol Clin 2003, 21:311–320.

    PubMed  CAS  Google Scholar 

  36. Wu JJ, Pang KR, Huang DB, Tyring SK: Advances in antiviral therapy. Dermatol Clin 2005, 23:313–322.

    Article  PubMed  CAS  Google Scholar 

  37. Jensen LA, Hoehns JD, Squires CL: Oral antivirals for the acute treatment of recurrent herpes labialis. Ann Pharmacother 2004, 38:705–709.

    Article  PubMed  CAS  Google Scholar 

  38. Spruance SL, Nett R, Marbury T, et al.: Acyclovir cream for treatment of herpes simplex labialis: results of two randomized, double-blind, vehicle-controlled, multicenter clinical trials. Antimicrob Agents Chemother 2002, 46:2238–2243.

    Article  PubMed  CAS  Google Scholar 

  39. Trottet L, Owen H, Holme P, et al.: Are all aciclovir cream formulations bioequivalent? Int J Pharm 2005, 304:63–71.

    Article  PubMed  CAS  Google Scholar 

  40. Bernstein DI, Spruance SL, Arora SS, et al.: Evaluation of imiquimod 5% cream to modify the natural history of herpeslabialis: a pilot study. Clin Infect Dis 2005, 41:808–814.

    Article  PubMed  CAS  Google Scholar 

  41. Sacks SL, Thisted RA, Jones TM, et al.: Clinical efficacy of topical docosanol 10% cream for herpes simplex labialis: a multicenter, randomized, placebo-controlled trial. J Am Acad Dermatol 2001, 45:222–230.

    Article  PubMed  CAS  Google Scholar 

  42. Simmons A: Clinical manifestations and treatment considerations of herpes simplex virus infection. J Infect Dis 2002, 186(Suppl 1):S71-S77.

    Article  PubMed  Google Scholar 

  43. Kleymann G: Agents and strategies in development for improved management of herpes simplex virus infection and disease. Expert Opin Investig Drugs 2005, 14:135–161. This excellent review summarizes the current therapeutic options, discusses the potential of preclinical or investigational drugs, and provides an up-to-date interpretation of the challenge to establish novel treatments for herpes simplex disease.

    Article  PubMed  CAS  Google Scholar 

  44. Bernstein D: Glycoprotein D adjuvant herpes simplex virus vaccine. Expert Rev Vaccines 2005, 4:615–627. This review provides an evaluation of the genital HSV-2 glycoprotein D subunit vaccine (formulated with a new adjuvant) and discusses other current approaches to herpes vaccines.

    Article  PubMed  CAS  Google Scholar 

  45. Elish D, Singh F, Weinberg JM: Therapeutic options for herpes labialis, I: oral agents. Cutis 2004, 74:31–34.

    PubMed  Google Scholar 

  46. Elish D, Singh F, Weinberg JM: Therapeutic options for herpes labialis, II: topical agents. Cutis 2004, 74:35–40.

    PubMed  Google Scholar 

  47. Spruance SL, Rowe NH, Raborn GW, et al.: Peroral famciclovir in the treatment of experimental ultraviolet radiation-induced herpes simplex labialis: a doubleblind, dose-ranging, placebo-controlled, multicenter trial. J Infect Dis 1999, 179:303–310.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Oral Biology, University of Manitoba, 780 Bannatyne Avenue, R3E 0W2, Winnipeg, MB, Canada

    Catalena Birek DDS, PhD, FRCD(C)

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  1. Catalena Birek DDS, PhD, FRCD(C)
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  2. Giuseppe Ficarra MD
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Correspondence to Catalena Birek DDS, PhD, FRCD(C).

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Birek, C., Ficarra, G. The diagnosis and management of oral herpes simplex infection. Curr Infect Dis Rep 8, 181–188 (2006). https://doi.org/10.1007/s11908-006-0057-x

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  • DOI: https://doi.org/10.1007/s11908-006-0057-x

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