Ways of transmission of genital herpes
Genital herpes is classified assexually transmitted diseases. Infection occurs not only from a person who suffers from genital rashes (relapse), but also in the absence of characteristic manifestations of the disease, which is observed in asymptomatic virus carriage and atypical forms. Infection is also possible during oral-genital contacts. Transmission of infection by household means is extremely rare. The highest incidence rate is observed in the age group of 20-29 years. The herpes virus is able to live in the body throughout life. In the interrelapse period, it is located in the nervous system and does not manifest itself, so patients, often unaware of the presence of the disease, can become a source of infection for sexual partners. In addition to the sexual transmission of genital herpes, infection is possible when a child passes through the birth canal during childbirth or the fetus through the placenta of a sick mother. In some cases, a person can become infected without sexual contact: infection in this case is the result of poor personal hygiene, when a person transfers the herpes simplex virus from their lips to their genitals with dirty hands. The herpes simplex virus, which has once entered the body through microtrauma to the skin and mucous membrane of the genitals, remains in the body for life. A person with a strong immune system and a healthy lifestyle may never know about the presence of the virus in the body and not become familiar with the clinical signs of the disease. However, with factors favorable for infection (severe fatigue, stress, hypothermia, colds, overheating in the sun, mental and physical trauma, prolonged alcohol intoxication, hormonal changes), the virus is activated and genital herpes worsens. The most severe complication of genital herpes is herpes in newborns, when the child is infected by the mother during childbirth. The probability of transmitting the herpes virus to newborns increases if the mother became infected in the last 3 months of pregnancy. Infection of newborns leads to serious disorders of the child's nervous system, blindness and even death. If it was established that during pregnancy the expectant mother's herpes infection entered the active phase, then a cesarean section is recommended to avoid the passage of the fetus through the birth canal. In adults, genital herpes does not cause disruption of internal organs and does not provoke infertility. This disease is the least dangerous of all those that are sexually transmitted. The question of how to treat genital herpes is relevant because it brings a lot of suffering to the patient during an exacerbation, worsens his emotional and psychological state, reduces the person's ability to work. In addition, the infection facilitates infection with HIV and provokes the transition of HIV to AIDS.
Genital herpes: symptoms of infection
In medical practice, several are distinguishedstages of the disease: primary genital herpes, when the disease manifests itself for the first time, and secondary - subsequent cases of the disease and relapses. In most cases, relapses are milder compared to the primary manifestation of genital herpes. The first signs of genital herpes appear 2-14 days after infection (in case of weakened immunity). It shows its presence in the body by itching, burning, swelling in the genital area. In addition, the course of the disease is accompanied by a rise in temperature, general malaise, headache, a condition that resembles a cold or flu, periodic numbness, aches in the upper thigh, pain in the lower back or buttocks, nagging pain in the scrotum or perineum. Within a few days, small blisters filled with clear liquid form on the mucous membrane of the genitals and skin, inner thighs, buttocks, urethra, and cervix. After the blisters burst, painful ulcers appear in their place, causing severe suffering to the patient. The ulcers heal within a week, leaving no traces. Relapses are accompanied by similar symptoms, with the exception of fever, headache, and general malaise. The area of the rash is smaller and it heals faster. Relapse is provoked by any infectious diseases, hypothermia, and emotional stress. Relapses can occur with varying frequency from 2 times a month to 1 time per year. After the first episode, genital herpes can proceed without visible clinical manifestations. In addition, genital herpes has very vague symptoms that are similar to other diseases. Therefore, many women are treated for a long time for cracks in the vaginal area, thereby persistently recurring thrush, cystitis, painful urination of an indefinite nature. The above-described form of herpes occurs in women whose rashes are localized inside the vagina and on the cervix, and are not visible to the naked eye.
Diagnosis of genital herpes
In some cases, for the diagnosis of herpes in brightIn the presence of pronounced symptoms, a visual examination of the patient is sufficient. The appearance of a specific vesicular rash in the genital area, accompanied by itching, burning and pain is a reliable indicator of herpes. However, confirmation of the diagnosis is carried out in laboratory conditions by taking material directly from the site of the rash and detecting the presence of the virus (scraping is carried out from the cervix, from the urethra or rectum, taking into account the lesion). To diagnose antibodies in the absence of characteristic symptoms, the patient's blood is the test material. Herpes often occurs in conjunction with a number of other sexually transmitted infections, so an accurate diagnosis is made after testing for trichomoniasis, chlamydia, syphilis, AIDS and other infections.
Principles of treatment of genital herpes
Why treat genital herpes? All cases of genital herpes require mandatory treatment. Otherwise, a number of developing complications will not be long in coming:
- acute urinary retention due to neuropathy or dysuria;
- preservation of symptoms for a long time;
- an increase in the likelihood of developing cervical cancer;
- infection of the sexual partner;
- spread of infection through the body,penetration into the brain and massive damage to the internal organs. This occurs extremely rarely with immunodeficiency. More often the appearance of extragenital herpes of the skin on different parts of the body (buttocks, brushes, mammary glands), mucous membranes of the eyes.
Long-term complication of herpes in womencan cause psychological and psychosexual problems: more than 70% of women noted the appearance of various experiences and a tendency to depression after the first episodes of genital herpes. Therefore, effective treatment is impossible without positive motivation of the patient. The herpes virus remains in the human body for life and is stored in nerve cells. Modern medicine does not have a drug that would be able to remove the herpes virus from the body, so doctors often use the term "incurable disease" in relation to herpes. However, there are drugs that can suppress the reproduction of the virus, significantly increase the intervals between exacerbations of the disease, smooth out the clinical symptoms of the disease during relapses (reduce pain, burning and itching, accelerate the healing of ulcers). Such drugs include drugs that prevent the reproduction of the virus in cells: Acyclovir and Zovirax, produced in the form of tablets, ointments and creams. These are relatively inexpensive but effective drugs that are available to most patients. Antiviral therapy should be combined with actions that help strengthen the immune system, which in turn helps prevent relapses of genital herpes. If severe pain occurs, it is recommended to use painkillers, such as the well-known paracetamol or analgin. In case of exacerbations more often than 6 times a year, long-term preventive treatment is carried out for several months. Thanks to it, it is possible to reduce the severity of repeated exacerbations and reduce the frequency of relapses by 75%. Treatment involves mandatory adherence to strict rules of personal hygiene. The affected area should remain dry and clean. After touching the infected area, it is necessary to wash your hands in order to avoid the spread of infection.
Treatment regimen for herpes
When deciding how to treat herpes, the choice is made in favor of etiotropic and immunocorrective drugs.
- Stage 1. Acyclovir is a drug for the treatment of acute and recurrent forms of genital herpes.
The drug has a powerful etiotropic effect,activating inside infected cells and inhibiting viral DNA polymerase. Acyclovir has very low toxicity for normal cells. The course of treatment includes enteral administration of acyclovir capsules. In patients with primary acute infection and in patients with manifestations of herpes infection in immunodeficiency states of various etiologies, the dose can be doubled. Since herpes must be treated with the obligatory use of ointments and creams, it is recommended to use 5% Acyclovir cream, which is applied to the affected areas of the skin and mucous membranes. Tebrofen in the form of 2% or 3% ointment, Interferon ointment and others are also used as local therapy. The peculiarity of prescribing local antiviral ointments is the frequency of application to the affected areas (at least 5-6 times a day). At the same time, antibacterial therapy can be implemented based on indications, since it is more difficult to treat a patient with a secondarily infected banal flora. The use of interferon inducers (neovir, reoferon, dibazol) and natural antioxidants (vitamins E and C) at this stage is indisputable. In case of a pronounced exudative component, prostaglandin inhibitors (indomethacin) are used.
- 2 stage. Treatment of genital herpes in remission.
Subsidence of the main clinical manifestationsthe main goal is to prepare the patient for vaccine therapy. Adequate nutrition, compliance with the rest and work regime, and sanitation of chronic foci of infection are indicated. Due to the violation of various links of immunity that persist in the remission phase, it is advisable to use adaptogens of plant origin (golden root, lemongrass) or immunomodulators (for example, neovir, wobenzym, dibazol).
- Stage 3. Specific prophylaxis of relapses using herpetic vaccines (inactivated, live, recombinant).
The purpose of this vaccination is activationcellular immune response, hyposensitization of the body. It should be noted that this stage can be carried out 2 months after the completion of the exacerbation phase of the herpes infection.
