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How concered and worried should I be about getting HSV encephalitis? I'm a 28 year old caucasion american male and I have been getting cold sores on my lips since 2011. My ex got them and I had no clue what they were so never paid attention and now I get 1-3 outbreaks on my lips only per year so Im guessing I have hsv-1. How worried and concerned and cautious should I be about HSV encephalitis?

Category: Sexually Transmitted Diseases(STD)Specialist

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Category: HIV- AIDS Specialist
 25 Doctors Online

Thank you for your query at
I understand your concern.
Mostly if you lesions restricted to the lips and oral cavity it is due to HSV-1.
However i will still advise you to get yourself tested for the IgG levels.
The good thing though is HSV encephalitis is extremely rare, with a prevalence of only 2-3 cases/ million/ year. And such cases also have very bad immunity. Approximately half of such cases are in neonates or children, who don't have developed immunity.
So in adults it is extremely rare. You can take a course of Acyclovir each time you get an outbreak, to make sure it gets limited easily. And it does not progress.
Please do not worry.
Let me know if you have further queries,

Patient replied :

I had considered going to get an antiviral medication like acyclovir to take when I get an outbreak, however I take an l-lysine supplement everyday outbreak or not and that limits me to just 1-3 per year and the outbreak only lasts 4 to 5 days tops when I do get them rather than the typical 7-10 days so I never bothered to see a doctor about them. So I don't need to worry or even think about HSV encephalitis? I take a daily multivitamin with vitamin C in it and I get the occasional cold and all but rarely anything more than that. I've seen where encephalitis is rare but I've also seen where hsv-1 is the main cause of it which is what I have and I just worry about these things. Especially since I've only been exposed to hsv-1 for 3 years old patientnow and I'm in my late 20's and I had chickenpox as a kid.

If the I-lysine supplement is so helpful and can limit the number of outbreaks then you should continue doing that.
Yes you do not need to worry about encephalitis at all. It is very very rare and again present in immuno compromised people.

Patient replied :

I've also read through Google that HSV can spread to other organs like the liver and lungs and other areas. Should I worry about that at all?

HSV does have varied manifestations, with individualistic variations.
But in most of the people, it is asymptomatic and present with a very mild form of the disease, with a few outbreaks.
People who are immunocompromised, or who have other STIs, present with Herpes, are prone for this widespread form of the disease.
In your case only a few out breaks a year, shows that your immunity is good enough to make sure it never gets widespread, and hence please do not be worried at all .

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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