Presented by: Raj Patel. Royal South Hants Hospital, Southampton, UK.

The herpes simplex virus is characterized by its ability to establish reversible latency within the spinal sensory dorsal root ganglia or the trigeminal ganglia when the face is involved. Initial infections may be prolonged and severe although increasing evidence suggests that the majority of individuals have mild or asymptomatic acquisition.

In most populations that have been studied, the rates of herpes simplex virus (HSV) infection are generally rising. Within the USA, an estimated 135 million episodes of cold sores occur annually. One in five Americans is seropositive for HSV-2 – the vast majority of individuals being unaware of their infection.

Recurrence frequency and severity are highly variable and trigger mechanisms are not clearly understood. Although highly effective, suppressive (continuous) therapy is not appropriate for most individuals. Many patients experience characteristic prodromes during the early phases of a recurrence.

A number of lines of evidence from episodic therapy studies suggest that during an episode of HSV recurrence there is a rapid phase of viral replication within the first 24 h and that healing often starts soon after this. This limits the therapeutic window during which treatments are likely to be beneficial and supports the use of early, patient-initiated, and pre-emptive therapies.

Presentation coming soon.