1. HERPES most common viral infection in oralcavity . The term herpes simplex herpes labialis(coldsores) & herpes progenital(genital herpes), feverblisters

2. Herpes viridae family includesI. HSV-1II. HSV-2III. Varicella zosterIV. Epstein Barr virusV. CytomegalovirusVI. HHV-6VII. HHV 7VIII. HHV 8IX.Herpes virus simian 3. HSV-1 (oral herpes) - permanent infection ,very infectious Oral herpes simplex virus infection(HSV 1) herpes simplex virus(HSV) 4. Structure: VIRION - > double stranded - DNA genome,icosahedral protein cage - capsid ,lipid bilayer envelope ,envelope joined to capsid tegument .HSV1 & HSV2 74 genes within genome . DNA core control replication & infectivity of thevirus . 5. Ballooning degeneration, contain intranuclearinclusions known as Lipschitiz bodies. Cytoplasm of the infected cell forms giant cells. 6. Types of HSV > HSV 1 - >physical contact in oralcavity . HSV 2 ->new epidemicdisease -contracted through sexualcontact . HSV 1 &2 occurs as:1. Primary infection2. Recurrent infection milder than primary infection 7. Susceptible host Virusprimary infectionRecurrent manifestationClinical Subclinicaldisease 1% disease 99%ExcitantsCarries (70% -80% of population)Antibodies & virus presist 8. Primary infection Incubation period > 1-26 days.Prodromal Symptoms ( fever ,headache ,loss ofappetite , tiredness , irritation .) Appearance- group of small red bumps that blister,begin to dry , form yellow crust - preceded by itching&burning -10 to14 days Red swollen , bleeding gums or sore throat andenlarged lymph node Gingivastomatitis - in infant from mother HSV -latent infection in trigeminal ganglion 9. Severe in immunodeficient & neonates . Complication meningoencephalitis andkeratoconjuctivis 10. Impetigo Aphthous ulcers Hand foot & mouth disease 11. Clinical Lab test: Smear test Tissue culture Biopsy 12. Antiviral Acyclovir -> orally- 400mg -800mg .injection-10mg/kg body weight . Famciclovir -> 250mg & 500mg . Valacyclovir -> 500mg & 1gm Antibiotic- (secondary infection like bacteria ) Always keep the infected areadry 13. VIRAL THYMIDINE KINASECELLULAR KINASE 14. ACYCLOVIR Used to treat herpes group of virus Pharmacokinetics poor biocompatibility 20%widely distributed Excreted- mainly in urine ,renal impairment dosereduction Effective in normal as well as deficient immunestatus Adverse effect tiredness ,rashes ,hypotension Toxicity ->1. Decrease in Glomerular filtration rate &produces reversible neurological manifestation to higher doses 15. FAMCYCLOVIR Ester prodrug of guanine nucleoside penciclovir Good oral biocompatibility ,prolonged intracellular t active triphosphate metabolite Treat ->Herpes zoster(shingles)->500mg every 8hoursHSV2 ->250mg 5 days Herpes labialis (immunodeficient patients)->1500mg oral dose Toxicity is more in famciclovir especially in bonemarrow 16. VALACYCLOVIR VALACYCLOVIR herpes simplex Prodrug ->esterases ->aminoacid valine->viahepatic first pass metabolism,greaterbiocompatibility(55%) than acyclovir(10-20%) Dosage Valtrex ->500mg & 1mg /day Adverse effect Vertigo ,edema ,arthralgia 17. Avoid touching the affected area . Vaccines under research HSV 2 condoms can be used