Q. How often does HSV infection recur?

Answered by
Dr. Suvash Sahu
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 30, 2017

Hello doctor,

Some months back, I got a sore on my lips. So, I went to see the doctor who diagnosed it as HSV-1 through a swab test. It was the first time I had it, and I did not know about it before. I did not have a recurrence even after three months, but I was told that it is a recurrent condition. How often will I have a recurrence? Is it a serious condition or a common one? What precautions do I need to take? I am very worried because of it. Do I need to worry about it really? Is this condition common in the general population?

#

Hi,

Welcome to icliniq.com.

I have read your query and concerns.

  • It seems you have herpes labialis. It is an infection of the oral mucosa seen in young adults due to HSV (herpes simplex virus) type 1 or rarely type 2. It is a common disease, and in most cases, the transfer is through sexual contact or autoinoculation.
  • The initial episode usually starts around 2 to 10 days post-exposure, with prodromal symptoms of burning, discomfort, or itching with fever and malaise.
  • Following the primary infection, the virus establishes a latent or dormant state within the posterior root ganglia neurons and on reactivation travels down the nerve fiber to cause recurrent infection. If the virus does not get established in the dormant infection, then you may not get a recurrence.
  • The recurrence of infection is not time bound, it depends on your physical fitness and internal immunity, whenever you are stressed or due to any reasons your immunity goes down you may develop these lesions.
  • Whenever you develop these eruptions, I suggest taking Acyclovir 400 mg, three times a day and 5 % Acyclovir ointment for topical application, twice daily for five days. It will reduce the duration of illness and viral shedding.
  • I would advise you to get your HSV IgM and IgG (herpes simplex virus immunoglobulin G and M) levels tested. Review after five days or whenever needed.

Revert after five days to a cosmetologist online --> https://www.icliniq.com/ask-a-doctor-online/cosmetologist

Hello doctor,

Thanks for your reply. What will IgM and IgG levels signify? How to know that the virus has not established latent infection? How common is HSV-1 (oral herpes) in my country? Have you been treating these cases? Is it transmitted only sexually? It does not seem to be the case with me. What is autoinoculation? My primary symptoms lasted for 7 to 8 days. During recurrence, what is the duration normally? I will appreciate your response.

#

Hi,

Welcome back to icliniq.com.

  • HSV IgM and IgG (herpes simplex virus immunoglobulin G and M), if it is positive for IgM it indicates a recent infection, and if it is positive for IgG only, it indicates that the infection is older. It only tells about recent and past infection according to immunoglobulin present in the blood.
  • Frankly speaking, there is no test to rule out latent infection of this virus in nerve root ganglion, it is clinical only. The reactivation and replication of latent HSV always occur in the area supplied by the ganglia in which latency was established, so if by certain stimuli like fever, trauma, emotional stress, sunlight, etc., can lead to overt or covert recurrent infection and shedding of HSV.
  • Recurrent infections are typically milder and shorter may be for 3 to 5 days. This disease is transmitted through close personal contact.
  • HSV infection occurs through inoculation of virus into susceptible mucosal surfaces for example oropharynx, conjunctiva or through small cracks in the skin. Autoinoculation means while shaking hands with another infected person, who may not have clinical symptoms but may act as an asymptomatic carrier of this virus transfer the infection to you. When you touch your oral mucosa with this infected hand, you transfer the infection to the susceptible mucosal site.
  • HSV is a very common STD (sexually transmitted disease) in our country. 1 to 2 % of patients I treat have HSV. So, there is nothing to worry, it is a treatable and very common disease.

For further queries consult a cosmetologist online --> https://www.icliniq.com/ask-a-doctor-online/cosmetologist


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