HSV 1/2 infection and treatment

Herpes Simplex virus 1 and 2 (HSV-1 and HSV-2) are both members of the a-herpesvirinae subfamily. Infections with especially HSV-1 are common and may be clinically insignificant or may give rise to symptoms ranging from mild and trivial to severe disease. Approximately 90% of the adult population in Europe has gone through an infection with HSV 1 and/or 2.

Following a primary infection the virus establishes latency in nerve cells in the dorsal ganglion. Throughout an infected person´s life the virus may reactivate at intervals and is either shed silently or produces clear symptoms. HSV disease is very frequent and severe in patients receiving cytotoxic therapy e.g. after organ or bone marrow transplantation and in AIDS patients. Usually a severe local disease (e.g. CNS) or disseminated infection is seen in these patient groups and may be life-threatening.

The drugs of choice are acyclovir and valacyclovir. They have been shown to be effective for treatment of HSV infections in bone marrow and renal transplant patients as well as in HIV infected patients. Acyclovir is routinely used as prophylaxis in patients receiving organ graft transplants. However, the emerging resistance to acyclovir is a clinical problem.

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