Herpes simplex virus

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 12.08.2022

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herpes simplex virus; HSV

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Enveloped, double-stranded DNA viruses that are equipped with an icosahedral capsid (with a protein envelope consisting of triangular surfaces), each of which is still surrounded by an envelope membrane. S.u. Herpes viruses, human.

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Immunologically, 2 types can be distinguished:

  • Herpes simplex type 1 mainly causes lesions in the area of the lips and the oral mucosa. However, it is also increasingly found in genital herpes. Gingivostomatits herpetica is a classic HSV-1 infection.
  • Herpes simplex type 2 is often responsible for lesions in the genital and gluteal areas. Transmission is most commonly through asymptomatic viral excretors (15-20% of HSV-2 infected individuals are asymptomatic viral excretors).

Biological functions:

  • Neurovirulence: Ability to penetrate the blood-brain barrier and replicate in the CNS (possible development of herpes simplex encephalitis).
  • Neurotoxicity: ability to destroy neurons in the brain.
  • Latency: Persistence in neurons and latent infection in ganglion cells (HSV-1 persists predominantly in trigeminal ganglia; HSV-2 mostly in spinal ganglia S2-S5 or ganglia of the autonomic nervous system).
  • Reactivation: recurrences of latent HSV infections.

Clinical picture
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Primary infections with HSV-2 are often asymptomatic.

Primary infections with HSV-1:

Secondary infections with HSV-1 and 2 as well as symptomatic initial infections: see below. herpes simplex virus infections.

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Cultural cultivation of the virus from vesicle contents (gold standard; specific and safest but costly method).

In the Tzanck test from the base of the vesicle, detection of multinuclear, epidermal giant cells.

Electron microscopy: Virus detection from vesicle contents using the negative staining method (good method but not very relevant in practice).

Detection of HSV antigen with direct immunofluorescence or HSV-DNA (PCR).

Antibody detection (IgM and IgG) is only possible after 10-12 days (detection of IgM antibodies with subsequent increase in IgG titer indicates a fresh infection; recurrences can only be diagnosed insufficiently serologically, as there is usually no titer movement). The importance of serological diagnostics lies in the detection of seroconversion in primary infections!

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Please ask your physician for a reliable diagnosis. This website is only meant as a reference.


Last updated on: 12.08.2022