Preliminary evidence for herpes labialis recurrence following experimentally induced disgust

Background: After primary orofacial infection with the herpes simplex virus (type 1, HSV-1), up to 40% of HSV seropositive subjects suffer recurrent h erpes infections which are characterized by painful erosions of the involve d skin mainly around the lips (herpes labialis). Besides various other fact ors, there is growing evidence suggesting that psychosocial factors might t rigger HSV. The present study was designed to investigate modulation of rec urrent HSV infection by experimentally induced emotional distress. Methods: Among patients with herpes labialis (n = 91), subjects who showed recurren t HSV infection (> 5 acute infections/year) and who reported to suffer from HSV symptoms exclusively after confrontation with dirty dishes, i.e. dirty plates or dirty glasses were selected by standardized interview. Subjects (n = 20) were randomly assigned to two treatment groups. The experimental g roup (n = 10) was first exposed to 5 slides showing dirty glasses and subse quently to the glasses previously presented on the slides in vivo. The cont rol group (n = 10) was exposed to neutral slides and neutral objects. In or der to determine the proportion of leukocyte subpopulations and concentrati ons of tumor necrosis factor alpha (TNF-alpha), blood samples were collecte d 15 min before as well as 40 min and 48 h after stimulus presentation. Sal iva cortisol was obtained 45, 20, 15 and 1 min before and 1, 10, 20 and 30 min after stimulus confrontation. Results: Medical examination of the volun teers 48 h after the experiment indicated that four experimental subjects s howed HSV-1 symptoms while not a single herpetic infection could be determi ned in the control subjects (p = 0.033). Moreover, significantly elevated c oncentrations of TNF-alpha were observed in the experimental, but not in th e control group. No significant alterations of the number of leukocyte subp opulations were found 30 min or 48 h after stimulus presentation. Further, cortisol concentrations were found to be unchanged after the treatment. Con clusions: The present findings suggest that experimentally induced emotiona l stress such as disgust may be associated with reactivation of HSV. Copyri ght (C) 2001 S. Karger AG, Basel.