Herpes simplex. Clinical and pathogenetic aspects

Primary infection with herpes simplex virus of either type 1 or type 2 occurs frequently, however, recurring disease develops in only a small fraction of the population. Circulating antibodies against the virus do not prevent relapses. The cell-mediated immunity probably is more important in determining whether triggering factors will activate the latent infection or not. Changes in the cell-mediated immunity may be one of the factors involved in the pathogenesis of the relapses. New methods for the rapid diagnosis of herpes simplex virus have been developed. These methods (immunofluorescence, enzyme-linked immunosorbent assay) have a very good specificity, but a somewhat lower sensitivity than conventional viral cultures. Topical treatment can be expected to influence the course of the actual recurrence. Systemic treatment ought to have greater potential in affecting the relapse rate as well, either by a direct effect on the virus or by means of immunomodulation, e.g., with thymopentin.