History Of Recurrent Herpes Labialis Research Articles

Vitamin D serum level in participants with positive history of recurrent herpes labialis

AimVitamin D plays an important role in immune system regulation, also its deficiency is assumed to affect the patients’ predisposition to viral diseases such as recurrent herpes labialis. In this cross-sectional study, we tried to compare the mean serum level of vitamin D in participants with a positive history of recurrent herpes labial lesions and healthy controls.Materials and methodsThe vitamin D serum level of 43 participants with a positive history of recurrent herpes labial lesions who were referred to the Motahhari laboratory in Shiraz during 2020–2022, was compared with 42 healthy controls. It was assessed by an Elisa kit. An Independent T-test was used to compare the vitamin D serum level between two genders. In order to assess the mean age value and gender distribution, an independent T-test and Pearson Chi-Square were used, respectively for the two groups. The serum vitamin D level was compared between both control and test groups.ResultsThere was no significant difference between vitamin D mean serum levels in the two evaluated groups (p.value = 0.72). Although the age (p.value = 0.09) and recurrence (p.value = 0.13) of herpes labialis had no statistically significant relation to the vitamin D serum level, the healing duration of herpes labialis was inversely related (p.value = 0.01). Lower-level of serum vitamin D were accompanied by a longer healing duration of the lesions.ConclusionAlthough the vitamin D serum level of participants with a history of recurrent herpes labialis had no relation with age and herpes virus recurrence frequency, a longer healing duration of lesions had been reported in patients with lower serum levels of vitamin D.

Recurrent herpes labialis and Herpes simplex virus-1 genitalis: what is the link?

Recently, Herpes simplex virus (HSV)-1 seroprevalence declined among adolescents, rendering young people lacking HSV-1 antibodies more susceptible to genital HSV-1 acquisition, if sexually exposed. The aim of the present study was to identify the possible risk factors for the development of HSV-1 related Herpes genitalis (HG). From January 2012 to December 2015, patients with HG attending three Sexually Transmitted Infections Units in Northern Italy were recruited. A genital swab on the lesions for the search of HSV-1/2 DNA through real time polymerase chain reaction (PCR) and a serum sample for HSV-1/2 specific serology were performed. Moreover, patients were asked whether they had personal history of herpes labialis (HL). Patients with PCR proved HSV-1 HG were included as cases; asymptomatic subjects attending STI Units for a blood check were recruited as controls and were checked for HSV-1/2 serology. The study included 141 cases and 70 controls. Specific HSV-1 antibodies were found in 34.7% of the cases and 67% of the controls. History of recurrent herpes labialis (RHL) was found in 4% of the cases and 31% of the controls. The occurrence of RHL in HSV-1 seropositive patients resulted lower in the case group compared to the control group. We can speculate about a protective role for RHL against the clinical appearance of HSV-1 HG. The clinical usefulness of our study involved especially the counselling in serodiscordant couples. The presence of HSV-1 antibodies in asymptomatic sexual partners does appear protective for HG manifestation only in presence of RHL history.

Comparison of the Effectiveness of Mellisan Gel and Acyclovir 5% Cream in the Improvement of Recurrent Herpes Labialis

BACKGROUND AND OBJECTIVE: Recurrent herpes labialis is a common infection of the mouth area, caused by herpes simplex virus. This infection appears in the mucus or lip skin and is commonly known as oral herpes. The purpose of this study was to compare the effectiveness of Mellisan gel and acyclovir 5% cream in the improvement of recurrent herpes labialis. METHODS: This double-blind clinical trial was conducted on 60 patients (14 men and 46 women), with the average age of 23.8 years (minimum of 20 and maximum of 32 years) and a prior history of recurrent herpes labialis three times a year. The previously-coded medicines were randomly distributed among patients. The subjects were asked to apply the cream or gel locally on the infected region three times a day, according to the manufacturer's instructions. All patients were examined within one, two, four and seven days after using the cream or gel to determine the changes in pain intensity, size of the ulcer, inflammation and recovery time. IRCT: 13870819144281. FINDINGS: Mellisan gel and acyclovir cream were not significantly different in reducing the size of the ulcer, inflammation or the associated side-effects. Mellisan gel was accompanied by a significant reduction in pain intensity in patients on the second and fourth days of the examination (p=0.0001 and p=0.02, respectively). Moreover, on the second day, there was a significant difference in recovery (p=0.001). CONCLUSION: The results of this study suggested that Mellisan gel is more effective than acyclovir cream in terms of pain reduction and recovery, whereas no significant difference was observed regarding the size of the ulcer or inflammation. Also, the administration of Mellisan gel and acyclovir cream was associated with no

Herpes simplex virus reactivation and dental procedures

Dental extraction is reported to trigger recurrent herpes labialis (RHL). This aims to prospectively study the clinical occurrence of RHL and the oral herpes simplex virus type 1 (HSV-1) viral shedding before and 3 days after different dental procedures. Oral HSV-1 DNA was measured by real-time PCR before and 3 days after dental procedures of the inferior dentition in 57 immunocompetent patients (mean age 32.4 years) who were selected and divided into four distinct subgroups (dental inspection without anesthesia, n = 19; dental filling under local anesthesia, n = 14; molar extraction under local anesthesia, n = 15; and molar extraction under general anesthesia, n = 9) and compared to 32 healthy controls (mean age 33 years). None of the patients suffered from RHL at day 3. Oral HSV-1 DNA was detected before and after procedure in 1.7 % (1/57) and 5.3 % (3/57), respectively [dental inspection without anesthesia, 5.3 % (1/19); molar extraction under local anesthesia, 6.7 % (1/15); and molar extraction under general anesthesia, 11 % (1/9)]. None of the controls presented RHL or detectable oral HSV-1 DNA. There was no statistically significant difference between the study groups and controls. Molar extraction increases the risk of oral HSV-1 shedding but not of RHL. Procedure-related nerve damage probably accounts for HSV reactivation. Antiviral prophylaxis for RHL is not routinely recommended for dental procedures, regardless of a prior history of RHL.

Recurrent herpes labialis among health school students in Kahramanmaraş, Turkey: A cross-sectional survey

Objective: The aim of this study was to determine the epidemiologic characteristics of, and the treatments used for, recurrent herpes labialis (RHL) in health students. Methods: A cross-sectional study was conducted with the participation of 333 nursing and midwifery students. Data on the sociodemographic characteristics of the participants, their history of RHL, and the treatments were collected by means of a standard self-reported questionnaire form. Results: The point prevalence of RHL was 3.9%, the annual prevalence was 44.7%, and the lifetime prevalence was 52.5%. These prevalences were not related to the participants’ place of residence, level of income, school, gender, marital status, or smoking status (p > 0.05). RHL was frequently seen on the right side of the lower lip (17.9%). One third of the students who experienced RHL stated that they had applied treatment to the lesion. However, only 20.1% stated that they had used antiviral therapy. Treatment was recommended by a physician for only 16.1% of the subjects. Conclusions: The prevalence of RHL was high among the health students, who were considered to represent young adults. Although they were students in a school of health, they lacked knowledge about RHL.

Herpes Zoster with Cutaneous Dissemination in a Patient 21 Years after Splenectomy for Idiopathic Thrombocytopenic Purpura

Varicella-zoster virus is a member of the herpes virus family that causes varicella during a primary infection and herpes zoster (HZ) when reactivated. Patients who are immunocompromised often have atypical presentations of HZ and experience complications such as multidermal involvement and dissemination. We report a case of disseminated HZ in an immunocompetent patient with a history of splenectomy for idiopathic thrombocytopenic purpura (ITP). Our 46-year-old female patient presented with a painful vesiculopapular dermatomal rash with approximately 80 other lesions diffusely spread over her body. She was in good health but had a splenectomy for ITP 21 years earlier and a history of recurrent herpes labialis. The latter led to the tentative diagnosis of a widespread herpes simplex infection. However, laboratory results confirmed a diagnosis of disseminated herpes zoster. A workup of the patient's immune status did not reveal any abnormalities other than the patient's previously noted splenectomy. This case adds to the two reports of patients developing cutaneous disseminated HZ several years after splenectomy. Our case serves as a reminder that patients with a history of splenectomy appear to be at increased risk for cutaneous dissemination of HZ.

Interferon-λ in immunocompetent individuals with a history of recurrent herpes labialis

Herpes labialis (HL) is the most common manifestation of recurrent oral herpes simplex virus type-1 (HSV-1) infection. Between 20% and 40% of the population is affected by recurrent HL. The biological basis for the difference between HSV-1-infected individuals who do and who do not suffer recurrences, has long been investigated. Interferon (IFN)-alpha and IFN-lambda are essential for antiviral immunity, but the precise role of IFN-lambda in vivo is not yet well understood. Healthy immunocompetent patients with or without a history of recurrent HL were recruited from the Policlinico of the University of Rome Tor Vergata (Rome, Italy), and HSV-1-seronegative individuals were recruited from the Department of Experimental Medicine of the University of Rome Tor Vergata, between July 2007 and December 2008. Participants were interviewed by medically trained investigators and underwent a blood test. Peripheral blood mononuclear cells (PBMCs) were obtained from heparinized blood of patients and stimulated in vitro with intact HSV-1 strain F1 (1 plaque-forming unit/cell). PBMC supernatants were assayed for IFN-alpha, IFN-gamma and IFN-lambda production by ELISA at 24 and 48 h after viral challenge. PBMC from patients with a history of recurrent HL produced markedly lower levels of IFN-lambda and marginally lower levels of IFN-alpha and IFN-gamma than those from the history-negative HSV-1-seropositive controls. Among individuals with HL recurrences, those with more frequent and severe manifestations showed a significant trend towards lower levels of IFN-lambda production. A reduced IFN-lambda response might correlate with the development of recurrent HSV-1 infection in immunocompetent individuals. Testing for IFN-lambda response might be useful to predict individual patterns of antiviral response, contributing to more successful therapeutic or prophylactic interventions.

Recurrent herpes labialis: a pilot study of the efficacy of zinc therapy

The objective of this study was to investigate the effect of zinc on recurrent herpes labialis. Twenty patients (12 females; median age 26.6 years) with a history of recurrent herpes labialis >6 episodes each year were treated with systemic zinc sulphate 22.5 mg twice daily for the months of February, March, September and October. All patients were followed for 12 months. Herpetic lesions reduced to <4 episodes (average 3) for the 12 months and the duration was <7 days for each episode (average 5.7). Systemic zinc sulphate appeared to reduce both the number of episodes and the time to recovery of herpes labialis.

Herpes simplex virus type 1 shedding in the oral cavity of seropositive patients

Investigate the frequency of herpes simplex virus type 1 (HSV-1) reactivation in the oral cavity of seropositive patients with previous history of recurrent herpes labialis (recrudescent group) compared with those without any history of recrudescent lesions (asymptomatic HSV-1 infection). In addition, the relation between recrudescence and the presence of the virus in the saliva was assessed. Fourteen individuals with previous history of herpes labialis (recrudescent group) and 11 HSV-1 seropositive asymptomatic volunteers were included in the study. Swabs were performed periodically in all subjects and the presence of HSV-1 DNA was identified by nested PCR. All the 25 subjects enrolled in the study, revealed at least one positive swab for HSV-1. The frequency of HSV-1 positivity in the group with recrudescent herpes labialis was not statistically different from the other group. Ten subjects of the recrudescent group presented with herpes labialis at least once during the study. HSV-1 shedding in the oral cavity occurs independently of herpes labialis recrudescence.

Delayed peripheral facial palsy in the stapes surgery: can it be prevented?

Purpose The aim of this study was to evaluate poststapedectomy-delayed facial palsy etiopathogenesis, risk factors, evolution, and prevention. Materials and methods Seven hundred six stapedectomies performed in 580 patients were reviewed. In all patients who developed delayed facial palsy, the dates of onset and subside of facial palsy, the anatomic and pathologic predisposing factors, and a possible history for recurrent labial herpetic lesions were considered. The House-Brackmann (H-B) grading system was used to evaluate the facial function. Virus-specific immunoglobulin (Ig) G and IgM antibodies against herpes simplex virus type 1 (HSV-1) were determined by enzyme-linked immunosorbent assay (ELISA) 3 weeks after the onset of the paralysis. The results were compared with a control group without a history of recurrent herpes labialis. Results Poststapedectomy facial palsy developed in 7 out of 706 procedures. All 7 patients referred a history of recurrent labial herpetic lesions. One patient showed a facial palsy H-B grade II, 2 a grade III, and 3 a grade IV. After acyclovir therapy, 6 subjects recovered completely, whereas 1 maintained an H-B grade II. An increased IgG antibody titer was found in 6 of the patients with delayed facial palsy and in 1 out of 7 controls. Mean IgG titer was 1:14,050 in the subjects with delayed facial palsy and 1:2,300 in controls ( P < .001). Conclusions Poststapedectomy-delayed facial palsy is likely caused by a reactivation of HSV-1, latent within the geniculate ganglion. The activation of the latent virus is more frequent in patients with a history of herpes labialis and can be prevented by an adequate acyclovir therapy.

Oral acyclovir in prevention of herpes labialis: A randomized, double-blind, multi-centered clinical trial

Objective. A three-center, randomized, double-blind, placebo-controlled acyclovir clinical trial was conducted among Canadian skiers over a 2-year period. Study Design. All patients enrolled in the study reported a history of recurrent herpes labialis with a greater-than-50% chance of a sun-induced trigger. There were 239 patients enrolled, and 237 of these were included in the analysis. For a minimum of 3 days and a maximum of 7 days, each patient received 800 mg of oral acyclovir twice daily (1600 mg/day) 12 to 24 hours before exposure to the sun. A minimum of 3 hours of outdoor activity was required each day. Results. No differences were detected in baseline and outcome measures among the centers, and results from all three centers were combined for further analysis. There was no difference in healing rate between the acyclovir and placebo groups for the first 4 days. Patients using acyclovir healed slightly faster on days 5 and 6, and nearly all patients in both the acyclovir and placebo groups were healed by day 7. Adverse events were evenly distributed; no withdrawals were required in either group. Conclusion. 800-mg oral acyclovir taken twice a day was not significantly better than a placebo either in effectiveness and prevention of recurrent herpes labialis or in adverse effects.

Epidemiology of oral mucosal lesions in United States schoolchildren: 1986‐87

Oral mucosal lesion findings from a national multistage probability oral health survey of United States schoolchildren in kindergarten through grade 12 are reported. In the 1986-87 school year 39,206 children aged 5-17 yr were examined by 14 dentists trained in standardized clinical diagnostic criteria for dental caries, periodontal conditions and oral mucosal lesions. In addition all children were asked whether or not they ever had "cold sores," "fever blisters," or "canker sores", and adolescents (grades 6-12) were questioned about their history of tobacco use. About 4% of the children had one or more oral mucosal lesions present at the time of the examination, while 33 and 37% reported a history of recurrent herpes labialis and recurrent aphthous ulcers, respectively. The most prevalent lesions clinically observed were recurrent aphthous ulcers (1.23%), recurrent herpes labialis (0.78), smokeless tobacco lesions (0.71), and geographic tongue (0.60). Differences in prevalence were analyzed by age, sex, race, metropolitan area, and geographic region. Almost 10% of 12-17-yr-olds reported current use of some type of tobacco product. In adolescents the current use of tobacco products had a marked effect on the prevalence of oral lesions.

Immune inhibition of virus release from herpes simplex virus-infected cells by human sera.

Human sera contain antibody (IVR antibody) which will inhibit the release of herpes simplex virus type 1 from virus-infected cells. This antibody activity was removed by adsorption of sera with virus-infected cell extract. There was a positive correlation between IVR and neutralizing antibody activity, particularly when measured by augmented neutralization test; measurement of IVR antibody was equally as sensitive as measurement of neutralizing antibody by augmented neutralization test. IVR antibody levels provided indication of a history of recurrent herpes labialis, the pattern of antibody response following primary herpetic infection, and indication of response to Skinner herpes vaccine in human subjects. It is suggested that consideration should be given to measurement of IVR antibody in both clinical and epidemiological studies of herpes and other virus infections.

The negative association between a history of recurrent herpes labialis and cervical neoplasia.

We considered the possibility that herpetic recurrences and herpes virus associated neoplasia are mutually exclusive disorders because they are expressions of different herpes virus-host relationships. We assumed that the human body copes with orofacial and genital herpes infections in the same manner. In our retrospective study, the relative risk of a history of fever blisters for cervical neoplasia was estimated to be 0.49, with 0.34 and 0.69 as the limits of the 95% confidence interval. It is suggested that recurrent herpes labialis is presumably a determinant of an effective immune response in general.

Immune response to herpes simplex virus in patients with recurrent herpes labialis. II. Relationship between interferon production and cytotoxic responses.

The relationship between the development of cytotoxic cellular immune response to herpes simplex virus type I (HSV-1)-infected autologous cells and the production of interferon (IFN) was studied using in vitro secondary sensitization of peripheral blood leukocytes in subjects with recurrent herpes labialis (RHL) and in normal controls without any history of recurrent herpes labialis. There was a significant discordance between optimal HSV-1 antigen dose required for induction of peak cytotoxic responses and for maximal activity of IFN. Moderate IFN activity (6-100 U/ml) was demonstrated in all HSV-1 antigen-stimulated peripheral blood leukocytes collected from subjects during both acute and convalescent phase of RHL. However, only 50% of seropositive controls and no seronegative controls exhibited detectable IFN activity, when stimulated with HSV-1 antigen, although such in vitro stimulation resulted in maximal virus-specific cell-mediated cytotoxicity. A correlation of virus specific cytotoxic activity to HSV-1 and IFN production (r = 0.38, p less than 0.05) was less marked than that of cytotoxic activity to K562 (natural killer-sensitive target cells) and IFN titer (r = 0.48, p less than 0.01). Furthermore significant reverse correlations between cytotoxicity against HSV-1-infected autologous cells and a titer of gamma-IFN was observed in samples with high cytotoxic activity. These observations suggest that gamma-IFN produced by HSV immune T cell may also act as an autoregulatory factor against the production of cytotoxic cellular activity against HSV-1-infected autologous cells.

Silent genital herpes simplex infection among asymptomatic female college students

A STUDY examined the risk for silent genital herpes simplex infection in a systematic sample of a population known to have above average prevalence and incidence of clinical infections. Using virus isolation and identification for diagnosis, validating the technique by achieving com plete agreement between clinical diagnoses of herpes infection and laboratory confirmation during the study period and comparing the results with those obtained from conventional cervical cytology, no instances of silent infection were found. Routine screening of high risk populations for silent genital herpes simplex infection may be conducted adequately by cervical cytology. 23% of this population of young women gave a history of recurrent herpes labialis.

Activation of herpes simplex following dermabrasion: Report of a patient successfully treated with intravenous acyclovir and brief review of the literature

Herpes simplex labialis developed in a patient immediately following dermabrasion. The patient was hospitalized because the infection had spread rapidly over the dermabraded face and was complicated by secondary impetiginization. Herpesvirus hominis type I and Enterobacter aerogenes were isolated from cultures. Intravenous acyclovir and oral antibiotics were administered. On this regimen, new vesicle formation ceased in 36 hours. Complete resolution of the infection occurred within 6 days, with an excellent cosmetic result. Observation at 1 month confirmed no sequelae (in particular, scarring). The "at risk" patient with a history of recurrent herpes labialis should be identified prospectively in an attempt to prevent possible reactivation; should this complication ensue, appropriate treatment should be immediately administered because a state of local immunocompromise exists. We believe our patient benefited greatly from vigorous treatment, with significant shortening of time to healing. Prophylaxis with oral acyclovir of "at risk" patients prior to dermabrasion is proposed.

Human T cell response to Herpes simplex virus antigen in vitro.

Herpes simplex virus type I antigen (HSV-Ag) added to T cells from individuals with clinical history of recurrent herpes labialis causes a proliferative response in vitro. This T cell response requires presensitization of the responding cell donor and will occur only in the presence of adherent cells (macrophages). The intensity of the response is closely related to the number of adherent cells present, being optimal at a ratio of 10:1 between T cells and adherent cells. Preliminary studies also indicate that the response to HVS-Ag is restricted by the HLA-D/DR determinants of the T cell donor.

Reactivation of herpes simplex virus after decompression of the trigeminal nerve root.

Reactivation of herpes simplex virus was prospectively studied in patients after microneurosurgical decompression of the trigeminal sensory root, a new operation for trigeminal neuralgia in which the nerve is not sectioned. Reactivation was detected in 28 (50%) of 56 patients. Virus was cultured from oropharyngeal secretions in 25 patients, and 21 patients developed cutaneous herpetic lesions. Seven patients had positive throat-wash (TW) cultures but did not develop lesions, and the converse occurred in three patients. Eighteen patients had both positive TW cultures and herpetic lesions. In eight of nine instances in which a sequence was determinable, TW cultures were positive before lesions developed. A history of recurrent herpes labialis was associated with a higher risk of developing reactivation postoperatively (59.4% vs. 31.6%, P less than 0.05). These observations suggest that minimal stimulation or inapparent trauma to the trigeminal sensory root is sufficient to activate latent herpes simplex virus in humans. These patients provide unique opportunities to study immunologic responses and therapeutic measures.

A retrospective study of recurrent herpes labialis (RHL) in a professional population, 1958–1971

A retrospective 12-year investigation of 1,788 professional school students from the schools of medicine, veterinary medicine, dental medicine, nursing, and dental hygiene was conducted by the mailed distribution of questionnaires requesting information on current and prior disease history of recurrent herpes labialis (RHL). Because of changes in address, death, loss of married names, and unwillingness to participate in the investigation, only 683 proband subjects were available for the follow-up study. The data suggested a trend toward a decrease in the prevalence and severity of RHL during the interval of study: only slightly more than one firth (23.9 per cent) of the proband population of the present study experienced RHL as compared with almost two fifths (39.6 per cent) at the time when they were students.