The continuing problem of herpes simplex virus persistence

Area of Science:

• Virology
• Neuroscience
• Infectious Diseases

Background:

• Herpes simplex virus (HSV) pathogenesis research shifted from acute to latent infections in the 1970s.
• HSV persistence remains a significant challenge in both clinical and theoretical contexts.
• Understanding HSV latency is crucial for managing recurrent infections.

Purpose of the Study:

• To summarize the current understanding of herpes simplex virus (HSV) latency and persistence.
• To elucidate the mechanisms of HSV neural spread and lifelong residency.
• To describe the intermittent reactivation patterns of HSV.

Main Methods:

• Review of existing literature on HSV pathogenesis and latency.
• Analysis of studies investigating HSV neural tropism.
• Examination of evidence for non-productive viral persistence in ganglia.

Main Results:

• HSV disseminates along neuronal pathways, both intra- and extra-axonally.
• The virus establishes a non-productive, lifelong latent state within sensory or autonomic ganglia.
• Intermittent viral reactivation leads to peripheral shedding or recurrent clinical manifestations.

Conclusions:

• HSV latency involves minimal viral transcription and translation within neurons.
• Despite viral DNA presence, ganglia are largely non-infectious during latency.
• HSV persistence highlights the complex interplay between the virus and the host nervous system.