Herpes simplex viruses (HSV), specifically HSV-1 and HSV-2, are common viral infections that can enter a dormant, or latent, state within the body. This ability to hide and reappear later is central to how the virus persists. Understanding this latency is important for managing the infection.
The Latent Phase: How Herpes Hides
After an initial infection, the herpes simplex virus does not leave the body; instead, it retreats into the nervous system. The virus travels along nerve pathways, specifically sensory neurons, to nerve ganglia. For oral herpes (HSV-1), this is often the trigeminal ganglia near the ear, while for genital herpes (HSV-2), it is typically the sacral ganglia near the base of the spine.
Once inside these nerve cell clusters, the virus enters a latent phase, becoming largely inactive. During this period, the virus ceases active replication and “hides” from the immune system. Its DNA persists within the neuron’s nucleus, often as an episome. This allows the virus to remain in the body indefinitely, waiting for conditions that favor its reactivation.
Triggers for Reactivation
The dormant herpes virus can reactivate, leading to an active outbreak, due to various factors. Physical stress, such as illness, fever, or surgery, can trigger reactivation. Emotional stress is also a common factor, as chronic stress can weaken the immune system.
Hormonal changes, like those during menstruation, can also cause outbreaks. Environmental factors, such as sun exposure or UV radiation, are known triggers for oral herpes. Fatigue and a weakened immune system can also allow the virus to reactivate. These triggers cause the virus to begin replicating and travel back down nerve pathways to the skin or mucosal surfaces, resulting in visible sores.
Living with Latent Herpes
Living with latent herpes involves understanding its persistent nature and potential for transmission. Even when no visible sores are present, the virus can intermittently shed from nerve endings, a phenomenon known as asymptomatic shedding. This means the virus can be transmitted to others without an active outbreak, and most new herpes infections are transmitted this way.
The latent state also affects how the infection is diagnosed; antibody tests confirm exposure but do not indicate an active infection. Viral culture or PCR tests detect the virus in active lesions. While there is no cure, understanding latency informs management strategies. Avoiding known triggers can help reduce outbreak frequency. For some, daily suppressive therapy with antiviral medications can significantly reduce both outbreak frequency and viral shedding, lowering transmission risk.