Herpes is one of the most common human viral infections. Over 90% of people in the world are infected with the herpes simplex virus (HSV) and up to 20% of them have certain manifestations of the infection.
Herpes simplex virus affects the skin and mucous membranes (most often on the face and in the genital area), the central nervous system ( meningitis, encephalitis ), eyes (conjunctivitis, keratitis ). The herpes virus causes the pathology of pregnancy and childbirth, often leading to “spontaneous” abortions and fetal death, or causes a generalized infection in newborns; connection is marked genital herpes with cervical cancer and prostate cancer.
Factors contributing to the manifestation and / or recurrence of herpes are:
- reduced immunological reactivity
- hypothermia or overheating of the body,
- medical manipulations, including abortion and the introduction of the intrauterine device,
- some mental and physiological conditions.
The source of infection is a sick person, in which the herpes virus is present on the epithelium of the mucous membranes.
The incubation period for herpes is, on average, from 2 to 10 days, sometimes reaching 3 weeks.
The primary symptoms are multiple blistering eruptions that are prone to fusion. Their appearance is accompanied by unpleasant sensations: itching, severe pain.
A significant proportion of the patients have common symptoms: weakness, headache , muscle pain, fever. One-third of women and every tenth man with primary herpes develop complications, the most severe of which is herpetic meningitis (inflammation of the meninges).
In the absence of complications, the rash persists for 2-3 weeks, becomes covered with crusts and then disappears.
Treatment of herpes patients, especially chronic recurrent forms, presents significant difficulties.
As shown by numerous clinical studies in recent years, the drug of first choice for the treatment of acute and recurrent forms of herpes caused by herpes simplex virus types 1 and 2 is acyclovir ( zovirax and its analogs), valacyclovir ( valtrex ), famciclovir ( famvir ).
For the treatment of the primary episode and recurrence of genital herpes in patients with unchanged immune system, acyclovir is prescribed in a dose of 200 mg 5 times a day for 5-10 days or until resolution of clinical manifestations.
5% – s cream acyclovir is prescribed to patients herpes simplex on the skin in the early stages of the disease 5 times a day for 5-7 days.
With genital herpes, valaciclovir is prescribed at 0.5 g 2 times a day for 5-10 days.
Famvir is prescribed for acute herpes infection of 0.25 g 3 times a day for 7 days. During pregnancy and lactation, the drug can be prescribed only for health reasons.
Alpizarin is used to treat herpetic lesions of various localization. Appliques 2% ointment produced at mucosal 4-6 times a day for 5-10 days, 5% – Naja ointment applied to the skin 4-6 times a day 5-10 days. For a more severe course of herpes infection, alpizarin (0.1 g) is prescribed orally, 1–3 tablets 3-4 times a day for 7–10 days.
Vir-IP (vidarabine phosphate) -10% – ing gel. Apply on the affected areas 4 times a day for 7 days.
Gelpin ( brivudin ) – tablets 0.125 g, 1 tablet orally 4 times a day for 5-7 days (after meals with plenty of fluids.
Oxolin. 1% – or 2% – Naya ointment is applied to the affected areas 3 times a day.
Ryodoxol. It is used for mild herpes infections of the skin and mucous membranes in the form of applications of 0.25% -, 0.5% – or 1% ointment (depending on the localization of the process and the nature of the disease) for 5-10 days.
Tromantadine . The drug in the form of a 1% ointment is applied to the affected areas 3 times a day for 7-10 days. For a more successful use of thromantadine, it is prescribed when the first signs of herpes appear.
Flacozid – flavonoid, obtained from the leaves of Amur velvet and Laval velvet, is administered orally after meals in 0.1-0.5 g 3 times a day for 10 days.
Helepin in the form of a 1% ointment is applied to the affected mucous membranes 3_raz per day for 7-10 days. When skin lesions applied 5% – Naja ointment. In severe cases, Helepin (0.1 g) is prescribed orally, 3 tablets per day for 10-15 days.
Epigen- intim (water extract of licorice root). It is applied 6 times a day for 5-10 days.
As a means of preventing the recurrence of genital herpes in various countries, various antiherpetic vaccines have been created and tested . The currently available domestic herpetic polyvaccine includes vaccination cycles (1-2 per year), consisting of intracutaneous injections of the drug in 0.2 ml every 5-10 days, for a total of 5 injections per cycle. Research to improve the method of vaccination of patients with herpes infection continues.
In case of genital herpes, the patient should be advised to refrain from sexual activity until the clinical manifestations disappear. For this period, the use of condoms should be mandatory for all sexual intercourse. The sexual partners of patients with genital herpes should be examined and treated if they have signs of herpes.
Treatment of herpes during pregnancy
Treatment of pregnant women is necessary in the development of disseminated forms of herpes infection (encephalitis, hepatitis etc.); Acyclovir is used in standard dosages. Caesarean section as a prophylaxis of neonatal herpes is indicated in the presence of herpetic lesions on the genitals or in the case of a primary genital herpes infection in the mother within 1 month before delivery. In other cases, natural delivery is possible.
With a weakened immune system, herpes recurs up to 3-6 times per year. Groups of painful blisters appear on the affected area. A few days before, some patients experience discomfort in the area of the appearance of rashes. General symptoms and an increase in nodes for the period of exacerbation is uncharacteristic.The duration of the recurrence of the disease most often is 7-10 days.
The insidiousness of the herpes virus consists in the fact that, once rooted into the body, it almost always remains in it for life. At the same time, the herpes carriage is by no means fatal: almost 100% of adults have antibodies to it (this means that we have ever met this virus and received a natural “vaccination”).
With a good intensity of immunity (or with its correct correction), while observing certain norms of a healthy lifestyle, the body does not allow a small number of dormant viruses to leave the cells, where the causative agents are doomed to be for life.
When immunity is weakened (a characteristic case is after a cold, although there may be a lot of reasons), the herpes viruses become active, multiply, and along the processes of the affected nerve cells enter the latter innervated areas of the epithelium, causing a characteristic clinical picture of herpes infection aggravation.
The consequences of the complications of herpes in women
In addition to periodic exacerbations, the persistence of HSV on the mucous female genital organs is fraught with a number of very unpleasant consequences: persistent itching in the external genital organs and vagina (65%), mucous discharge (58%), “cervical erosion (sixteen%), habitual miscarriage in the early stages (21%).
If infection of the fetus in the early stages can lead to spontaneous abortion, then infection at a later time can cause damage to the skin, eyes, nervous system, followed by delayed development. It should be noted that such severe consequences are characteristic of the primary infection of a woman during pregnancy, with the presence of immunity (which the overwhelming percentage of Russian women have) even its temporary decline during pregnancy is not so dangerous.
The consequences of herpes during pregnancy
Pregnancy is very often a physiological immunosuppressive factor (a natural decrease in immunity occurs). The presence of herpes simplex virus in the cervical canal of pregnant women significantly increases the risk of intrauterine infection of the fetus, as well as infection of the child during childbirth.
Therefore, before the expected pregnancy, we recommend that expectant mothers be tested for HSV (and CMV) on mucous genital organs, determine the presence and level of antibodies to these viruses and, if necessary, receive a course of prophylactic treatment. It is desirable to re-study during pregnancy, given the above-mentioned changes in immunity. Detection of genital herpes simplex virus in the last weeks before delivery is the basis for caesarean section.