Despite the fact that the herpes simplex virus gives very characteristic symptoms, doctors often find it difficult to diagnose it. According to foreign researchers, in about 60% of cases when a patient clearly has a herpes infection, the disease remains unrecognized. This means that the patient does not receive adequate therapy for the disease, which increases his suffering, and the infection becomes widespread. The health risks of the herpes simplex virus can be prevented if you know exactly the symptoms of its manifestation.
The herpes simplex virus, its diagnosis and treatment remain an urgent problem in clinical practice, despite the fact that this disease has been known since antiquity, and since the time of Hippocrates, doctors have been trying to find a way to stop and curb the "creeping" disease. infection with "cold sore" symptoms.
Herpetic infection is extremely widespread in the world, according to WHO, the infection rate of the population is almost 100%, with one in five suffering from recurrent forms. Doctors are concerned about the infection due to the fact that the disease caused by the herpes virus often recurs and causes complications, significantly reducing the quality of life of patients.
Features and manifestations of the herpes simplex virus
In addition to type 1 herpes simplex virus (HSV-1), which is most often responsible for rashes on the face, doctors are worried about type 2 (HSV-2), which causes genital herpes. Some foreign sources indicate that in the structure of STIs, genital herpes is the most common infection and the most common cause of genital ulcers, a risk factor for HIV transmission.
Previously it was assumed that HSV-1 affects exclusively the orofascial region, and HSV – only the external genitalia. However, recent scientific evidence suggests that both viruses can cause acute and recurrent forms of the disease in both the oral and genital areas. However, HSV-2 is still more correlated with sexual activity and causes orofascial herpes in only 10-20% of cases. At the same time, in young women (16-20 years old), in half of the cases, primary genital herpes was provoked by HSV-1.
Herpes simplex virus symptoms and causes of relapses
The main ways of infection with the herpes simplex virus – it is airborne and sexual. The virus enters the body through the skin or mucous membranes, then hematogenously enters the paravertebral ganglia, where it remains for life. During primary infection, the virus replicates at the site of its entry, infection is usually not accompanied by vivid clinical manifestations, but sometimes primary herpes has an acute course.
Most often, primary herpes manifests itself as gingivostomatitis on the mucous membrane of the oropharynx, many bubbles appear, which quickly burst, leaving behind erosion, and then covered with a whitish coating. Erosions are very painful, the oral mucosa and gums swell and become inflamed, so that it becomes difficult for the patient not only to eat or drink, but even swallow. Gradually, acute inflammation subsides, erosions heal from the periphery to the center, regression of rashes occurs after 2-3 weeks, and the infection becomes latent. In the event of a decrease in immunity due to various adverse factors, relapses of the disease may occur at intervals from several weeks to several years.
Recurrences of herpes simplex can be caused by the following:
- decreased patient immunity;
- hypothermia or excessive UV exposure;
- stress, nervous disorders, increased physical activity;
- fluctuations in hormonal rhythms;
- Skin trauma during invasive cosmetic procedures.
Favorite localization of recurrent herpes simplex – the area of the red border of the lips, the vestibule of the nose, the chin, the perioral region. If the infection affects the genital area, then rashes appear in women – on the pubis, in the vulva and perineum, and in men – in the region of the shaft of the penis, on the head, head sulcus, inner leaf of the foreskin. In women, relapses often coincide with the menstrual cycle. The blisters open quickly, but do not heal for a long time.
The disease begins with subjective sensations of itching, tingling, burning, all this may be accompanied by a feeling of weakness and weakness, chills and headache. After a day or two, erythema appears in the zone of subjective sensations, a slight swelling, against which small bubbles with transparent contents are grouped, which later becomes cloudy. After a few days, and sometimes even earlier, the vesicles turn into erosion, become covered with serous crusts and are rejected after about a week, leaving a brownish spot that disappears in a week or two.
Severe herpetic infection may be accompanied by lymphadenitis, symptoms of peripheral nervous system damage, joint pain, gastrointestinal disorders, and skin manifestations may leave scars.
Therapy of diseases caused by the herpes simplex virus
Treatment tactics are aimed primarily at stopping relapses of the disease and reducing the risk of infection transmission, and the strategy is determined by the severity of symptoms, the frequency of relapses, the patient's immune status, and the presence of concomitant diseases.
The drugs of choice in the treatment of herpes infections are acyclic nucleosides, which effectively block viral replication. Usually they are assigned according to two schemes:
episodic systemic therapy – carried out in case of relapses on the first day of the manifestation of the disease;
suppressive therapy – has a preventive effect and is appointed for a period of 6 months to a year.
Suppressive therapy is usually recommended for frequent recurrences of herpes simplex virus and for prolonged severe episodes of the disease. Studies have shown that this therapy prevents recurrences of herpes in 80% of cases and reduces the risk of transmission of infection to a sexual partner by half.
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