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Genital herpes

Genital herpes – virus defeat mucous genitals, characterized by appearance of group of bubbles, and then erosion and sores. Is followed by local burning sensation, puffiness, hyperaemia, increase in inguinal lymph nodes and the phenomena of intoxication. It is inclined to a recurrence and subsequently can entail serious complications: decrease in local and general immunity, development of bacterial infections of genitals, defeat of nervous system, development of cancer of neck of a uterus and prostate. It is especially dangerous at pregnant women since increases probability of a spontaneous abortion, pathology and even the death of the newborn. Enters into group of the diseases, sexually transmitted (D,ST).

Genital herpes

Genital herpes – virus defeat mucous genitals, characterized by appearance of group of bubbles, and then erosion and sores. Is followed by local burning sensation, puffiness, hyperaemia, increase in inguinal lymph nodes and the phenomena of intoxication. It is inclined to a recurrence and subsequently can entail serious complications: decrease in local and general immunity, development of bacterial infections of genitals, defeat of nervous system, development of cancer of neck of a uterus and prostate. It is especially dangerous at pregnant women since increases probability of a spontaneous abortion, pathology and even the death of the newborn. Enters into group of the diseases, sexually transmitted (D,ST).

The causative agent of genital herpes is a kind of the virus of simple herpes (VSH). Contamination a herpetic infection among the population of the globe makes about 90%.

Allocate several types of a virus of herpes causing damages of skin, mucous membranes, the central nervous system and other bodies (viruses of simple herpes of 1 and 2 types, a cytomegalovirus, a virus of chicken pox, Epstein's virus – Barre, shingles, etc.). Viruses of simple herpes of 1 and 2 types cause oral and genital forms of a disease, and VPG of 1 type strikes mainly the face, lips, nose wings, and VPG 2 types most often is the reason of genital herpes. VPG, often comes to light in the commonwealth with an ureaplasma and a cytomegalovirus.

Genital herpes has a sexual way of transfer, at various forms of sexual contacts easily gets through the injured skin and an epithelium of a mucous membrane. After infection of VPG migrates in nervous gangliya, remaining there for life. Reproduction of VPG in epitelialny cells of skin and mucous membranes leads to their dystrophy and death. The infection is characterized by a chronic current and shown cyclically: the periods of activity or a recurrence (2-21 days) which are followed by emergence of rashes in the form of bubbles alternate with the periods of remissions when clinical symptoms disappear. Quite often genital herpes proceeds asymptomatically, but patients at the same time all the same are an infection source.

Reasons of genital herpes

Primary infection of VPG happens in usually airborne way at children's age (in population of children 6-7 summer age the incidence makes already 50%). The reasons of it are dense population, low socially – economic level of life, non-compliance with rules of hygiene.

Secondary infection results, as a rule, from sexual contacts. The high percent of incidence of genital herpes is noted among aged people of 20-30 years. It is connected with early sexual activity, chaotic sexual communications, frequent change or presence of several partners, the unprotected sexual contacts. The venereology also carries the internal reasons to risk factors of a disease of genital herpes:

The immune system of the person reacts to penetration of VPG development of specific antibodies, and at the normal level of immune reactions of clinical displays of an infection is not observed. Under the influence of a number of the adverse factors reducing immune responsiveness of an organism, VPG becomes more active that is shown by rashes on skin and mucous, neuralgic pains. Episodes of a recurrence of genital herpes often arise against the background of a chronic stress, a lack of vitamins, overcooling, overheating, change of climate, at catarrhal diseases.

Ways of transfer of genital herpes

Infection with genital herpes most often occurs through mucous membranes of genitals, a rectum, an urethra or damage of an integument at genital, oralno – genital and analno – genital contacts.

Also transfer of VPG is possible:

  • vozdushno – a drop way;
  • in the vertical way from sick mother to a fruit (at the time of delivery at contact with patrimonial ways of mother, transplatsentarno, in the ascending way from genitalia of mother via the tservikalny channel in a uterus cavity);
  • at self-infection - an autoinokulyation (the sick person himself transfers an infection from the infected parts of the body to not infected – from a face on genitals);
  • in the household way - it is rare (through damp sanitary products).

Usually infection with genital herpes occurs when the infected partner does not even guess a disease as he has no clinical displays of a disease (in case of asymptomatic virus infection carrier state).

Forms and displays of genital herpes

On a clinical current distinguish primary genital herpes (the first episode of a disease) and recuring (all subsequent episodes of a disease).

Recurrent genital herpes can proceed in typical, atypical clinical forms and a form of asymptomatic virus infection carrier state.

Primary genital herpes

Puffiness, reddening, pain, burning in a zone of entrance gate of an infection belong to the earliest symptoms of primary genital herpes. Local displays of genital herpes quite often are followed by rise in temperature, an indisposition, head and muscular pain. Several days later herpetic rashes - small bubbles with transparent contents develop. The rupture of bubbles is followed by formation of painful erosive and ulcer elements. At localization of sores on genitals the painful urination is noted. Healing of rashes happens within two weeks.

Genital herpes at women usually affects genitalia, area of a crotch and an anus, an urethra, the internal surfaces of hips. At men of a rash at genital herpes are most often localized on a head of a penis and extreme flesh, is more rare – in an urethra, sometimes are followed by development of a herpetic uretrit or prostatitis.

Recurrent genital herpes

Development of a recurrence of genital herpes occurs at 50-70% of the patients who had primary infection. Depending on the frequency of repeated episodes distinguish several forms of recurrent genital herpes:

  • easy form (aggravations are not more often than 3 times a year)
  • medium-weight form (aggravations from 4 to 6 times a year)
  • severe form (monthly aggravations)

The course of recurrent genital herpes can be arrhythmic, monotonous and abating.

The arrhythmic course of genital herpes is characterized by alternation of remissions from 2 weeks to 5 months. At the same time, the periods of remissions, the more intensively and more for a long time a recurrence of genital herpes and vice versa are longer.

At the monotonous course of genital herpes frequent episodes of a disease after few changing periods of remissions are noted. The menstrual herpes having a persistent current and which is badly giving in to treatment belongs to this type.

More favorable current has genital herpes of the abating type. It is characterized by reduction of intensity of a recurrence and increase in the periods of remissions.

Development of a recurrence of genital herpes happens under the influence of various factors: overcoolings, sexual intercourses, stressful situations, overfatigue, developing of other pathology (flu, SARS).

Symptomatic a recurrence of genital herpes proceeds more weakly, than primary disease, however, their consequences can be much more serious.

Rashes at genital herpes are followed by extreme morbidity, complicating the patient of the movement, visit of a toilet, interrupting a sleep. Quite often psychological state of the person changes: there are an irritability, fear of new rashes, fear for health of relatives, suicide thoughts etc.

Atypical forms of genital herpes

Atypical forms of ingenious herpes proceed is erased, in the form of a chronic inflammation of external and internal genitals (a vulvovaginit, a colpitis, an endotservitsit, an uretrit, cystitis, prostatitis etc.). The diagnosis of genital herpes is based on laboratory confirmation of existence of a herpetic infection. Atypical forms of a course of genital herpes make more than a half of clinical cases - 65%.

Poorly expressed puffiness, sites of an eritema, melkotochechny bubbles, permanent burning and itch, the plentiful, not giving in therapies are characteristic of an atypical form of genital herpes, bleach. At the long course of genital herpes increase and morbidity of inguinal lymph nodes is noted.

On localization of herpetic rashes allocate 3 stages:

  • The I stage — genital herpes affects genitalia;
  • The II stage — genital herpes affects a vagina, a uterus neck, an urethra;
  • The III stage — genital herpes affects a uterus, appendages, a bladder, a prostate.

The above the herpetic infection gets on an urinogenital path, the forecast is more serious. The started form of genital herpes can lead to a condition of an immunodeficiency, and at women increases risk of development of infertility, uterus neck cancer. VPG is dangerous to the people with the weakened immunity (HIV-positive people) and who underwent an operation on organ transplantation.

Genital herpes and pregnancy

During pregnancy genital herpes constitutes the greatest danger in case of primary infection if earlier displays of a disease were not observed. There is a probability of developing of malformations if the disease of mother happened on the early term of pregnancy when at a fruit laying of all bodies and fabrics is carried out. VPG can be transmitted through a placenta, striking generally nervous tissue of a fruit. Genital herpes increases threat of a spontaneous abortion, premature birth, uglinesses of a fruit and its death.

Pregnant women with atypical forms of genital herpes in the last 6 weeks of pregnancy are examined on VPG twice. At detection of a virus of herpes in a planned order operation of Cesarean section is made for an exception of possible infection of a fruit when passing in patrimonial ways.

Optimal variant is inspection on VPG of women at a stage of preparation for pregnancy, and also during conducting pregnancy during each trimester.

Genital herpes at newborns

Most often infection of a fruit occurs in the first 4-6 hours of childbirth after a rupture of fetal covers, or during passing of a fruit on patrimonial ways of the infected mother. Usually VPG at newborns are surprised eyes, mucous a mouth, skin, airways. After primary infection of newborn VPG extends in an organism in the hematogenic or contact way. The probability of infection of newborns increases at infection of mother with genital herpes in the last trimester of pregnancy.

At the localized form of a herpetic infection newborns can have a reddening, vesicles, hemorrhages of skin and mucous a mouth, to develop an encephalomeningitis, keratokonjyunktivit and horioretinit (an inflammation of vessels and a retina of an eye), a cataract. The children infected with genital herpes quite often suffer from permanent neurologic frustration.

Genital herpes can cause development of a generalized infection of newborns. Symptoms of a generalized herpetic infection are shown in 1-2 weeks after the child's birth. The refusal of food, vomiting, fever, jaundice, respiratory frustration, bleedings, shock join local symptoms. The death of the child can come from sharp blood loss and vascular insufficiency.

Diagnosis of genital herpes

At diagnosis of genital herpes the venereologist considers complaints, data of the anamnesis and an objective research. Diagnostics of typical cases of genital herpes is, as a rule, not complicated and based on clinical manifestations. The herpetic ulcers existing a long time should be distinguished from syphilitic.

Laboratory methods of diagnosis of genital herpes include:

  • methods of detection of VPG in material of the struck bodies (scrapes from a vagina and a neck of a uterus, dab from an urethra, histologic material of uterine tubes etc.). The method of cultivation of VPG on culture of fabrics and the subsequent studying of its properties is for this purpose applied, the method of recognition of a virus under an electronic microscope is used;
  • methods of detection of antibodies to VPG in serum of blood (immunoglobulins M and G). Allow to reveal genital herpes even at an asymptomatic current and to define antibodies to type VPG 1 or 2. IFA - a method of the immuno-fermental analysis concerns to them.

Treatment of genital herpes

The medicines existing today from VPG can reduce weight and terms of a course of genital herpes, however is not able to save from a disease completely.

In order to avoid development of stability of VPG to the classical antiviral medicines intended including, and for treatment of genital herpes (acyclic nucleosides - Valatsiklovir, the Acyclovir, Famtsiklovir), their serial use, and also a combination to interferon medicines is recommended. Interferon possesses powerful anti-virus action, and its deficiency is one of the main reasons of a recurrence of genital herpes.

Already ready medicine containing at the same time an acyclovir and interferon is ointment Gerpferon. Also the lidocaine providing local anesthetic effect that is extremely important at painful displays of genital herpes is its part. Gerpferon's application for patients with genital herpes provides healing of rashes for the 5th days and considerable simplification of local symptoms.

Prevention of genital herpes

As way of prevention of primary infection with genital herpes serves use of condoms at casual sexual contacts. However, even in this case the probability of infection of VPG through microcracks and damages on the mucous membranes and skin which are not covered by condom remains high. Use of antiseptics (, etc.) for processing of sites on which there can be a hit of a virus is possible.

The recidivous course of genital herpes is noted at decrease in protective reactions of an organism: diseases, overheating, overcooling, arrival of periods, pregnancy, reception of hormonal medicines, stresses. Therefore for prevention of a recurrence of genital herpes the healthy lifestyle, good nutrition and rest, reception of vitamin medicines matters. As measures of prevention of genital herpes serve also respect for intimate hygiene and hygiene of sex life, timely detection and treatment of venereal diseases.

The patient infected with VPG has to warn about it the sexual partner, even in case at present the symptomatology of genital herpes at it is absent. As infection at sexual contact is possible also in the absence of herpetic rashes, in this case use of condom is also necessary.

After the doubtful unprotected sexual contact it is possible to resort to a method of the emergency prevention of genital herpes locally operating antiviral medicine in the first 1-2 hours after intimate proximity.

Prevention of self-infection when the virus of genital herpes is transferred by dirty hands from lips to genitals, requires implementation of elementary hygienic requirements: careful and frequent washing of hands (especially in the presence of fever on lips), use of separate towels for hands, the person and a body, and also for each family member.

For the purpose of decrease in risk of infection of VPG of newborns, the operational rodorazresheniye (Cesarean section) is shown to pregnant women with genital herpes. At the planned natural childbirth to women with the recidivous course of genital herpes the preventive course of reception of an acyclovir is appointed.

After the unprotected sexual contacts, when planning pregnancy, and also at the sexual relations with the VPG carrier it is recommended to be examined on genital herpes and other STD.

Genital herpes - treatment should be carried out only under the supervision of a doctor. Self-treatment is unacceptable!!!

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