Page 38 - LECTURE NOTES

3.8.5. HSV and HIV Bi-directional Interaction:

HIV and HSV2 manifest a bi-directional interaction. HSV2 increases the efficiency of

HIV acquisition and transmission whereas HIV may increase susceptibility to HSV2
and increase HSV2 shedding, HSV2 recurrence rate and severity of clinical

manifestations.

3.8.6. Orolabial Herpes

Lesions on the lips and face = HPV – 1, the initial infection is usually asymptomatic

Gengivostomatitis occurs chiefly in children and young adults, most often just like

bacterial tonsilopharyngitis The most common form of orolabial herpes is cold sore or
fever blister caused by recurrent HSV1 (95%).

Manifestations: - Grouped blisters on erythematous base on the lips, cheeks, eyelids,

intraoral.

Prodromal symptoms:- tingling, burning, itching in 24 hrs. In most patients recurrent
orolabial herpes is more a nuisance than a disease.

Treatment

Lips: In our setting Gentian, violet 0.5% is effective and if available sunblocks reduces

recurrence. Eg. Zinc oxide paste , zinc oxide ointment or zinc oxide and topical
antiseptic or antibiotic e.g betadine ointment 3 times daily for bacterial super infection.

For recurrent infections Acyclovir 200mg PO for 5 days can be given.

3.8.7. Herpetic Whithlow

Infection of pulp of fingertips, it could appear after touching a primary lesion of ones
owns lesion or that of others.

In children – HSV – 1, Adults – HSV – 2, common in females

Health workers may acquire and transmit it.

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