Herpes Simplex Virus Type 1 Shedding in Tears and Nasal and Oral Mucosa of Healthy Adults

Abstract

Background Herpes simplex virus type 1 (HSV-1) is prevalent worldwide and causes mucocutaneous infections of the oral area. We aimed to define the frequency and anatomic distribution of HSV-1 reactivation in the facial area in persons with a history of oral herpes. Methods Eight immunocompetent HSV-1 seropositive adults were evaluated for shedding of HSV-1 from 12 separate oro-facial sites (8 from oral mucosa, 2 from nose, and 2 from conjunctiva) five days a week and from the oral cavity seven days a week for approximately 5 consecutive weeks by a HSV DNA PCR assay. Symptoms and lesions were recorded by participants. Results HSV-1 was detected at least from one site on 77 of 291 (26.5%) days. The most frequent site of shedding was the oral mucosa, with widespread shedding throughout the oral cavity. Lesional shedding rate was 36.4% (4 of 11 days with lesions) and the asymptomatic rate was 27.1% (65 of 240 non-lesional days). In individual participants, the median rate of HSV shedding by HSV PCR was 19.7% of days (range 11%-63%). Conclusions Reactivation of HSV-1 on the oral mucosa is common and usually asymptomatic. However, HSV-1 is rarely found in tears and nasal mucosa. Frequent oral shedding of HSV-1 may increase the risk for transmitting the virus to both oral and genital mucosa of sexual partners.

Sexually transmitted infections in oral cavity lesions: Human papillomavirus,Chlamydia trachomatis, and Herpes simplex virus

“…With respect to HSV, it has been described that direct contact with lesions or with infected oral or genital secretions during asymptomatic shedding can be a transmission way of the virus [36]. Thus, HSV oral and genital infections may predispose people to HPV infection.…”

Efficacy of Pleuran (β-Glucan from Pleurotus ostreatus) in the Management of Herpes Simplex Virus Type 1 Infection

“…Clinical management should be rational and should be aimed not only on the treatment of acute symptoms but also on the prevention of recurrent symptoms in the future. Treatment strategies should be aimed at the reduction of the ongoing asymptomatic shedding of the virus, which occurs in the oral mucosa about 20-25% of days of the year [32]. Several antiviral agents were studied in clinical trials (e.g., acyclovir and valacyclovir) in episodic or long-term application.…”

Assessment of Oral Shedding of Herpes Simplex Virus Before and After Endodontic and Fixed Partial Prosthodontics Treatment in Patients with Recurrent Herpes Simplex

“…Thus, pain or pain-induced stress, as well as anxiety associated with dental treatment may also be a risk factor for asymptomatic shedding in specific seropositive patients receiving dental treatment (20). The study by Ramchandani et al (14) indicated that oral reactivation of HSV-1 in comparison with HSV-1 shedding in tears and nasal mucosa is more common and usually asymptomatic. Frequent oral shedding of HSV-1 may increase the risk for transmitting the virus to oral mucosa (14); these findings confirm our results.…”

“…The study by Ramchandani et al (14) indicated that oral reactivation of HSV-1 in comparison with HSV-1 shedding in tears and nasal mucosa is more common and usually asymptomatic. Frequent oral shedding of HSV-1 may increase the risk for transmitting the virus to oral mucosa (14); these findings confirm our results.…”

“…Some factors such as ultraviolet radiation, shock, stress, fever, trauma and menstruation trigger the reactivation of HSV in sensory ganglions (10,11). As a result, the virus moves toward mucus membranes or the skin, a place where the virus can act as a pathogen for epithelial cells (12) and results in recurrent infection in the form of vesicles and topical ulcers (13) or asymptomatic shedding of virus into saliva and oral secretions (14).…”