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Genital herpes is one of the types of herpes infection. There are eight known varieties in total. The causative agent of the disease is a virus. It is found in the body of almost every person living on earth. Only 10% of people in whom pathogens are not found.
For most people, this virus lies dormant throughout their lives in nerve ganglia located near the spinal cord. It does not manifest itself in any way until a malfunction occurs in the human immune system. Primary infection is usually caused by HSV-1 (herpes simplex virus). When the disease relapses, HSV-2 is activated.
Genital herpes most often affects women, although men also sometimes suffer from this disease. Typically, ulcers affect the genitals, areas adjacent to them and the anus. Rarely, genital herpes appears directly on the perineum, cervix, and ovaries. The damage caused by the virus to the ovaries and uterus can be very severe. Genital herpes often leads to infertility and sometimes death of a woman.
Unlike everyday herpes, genital herpes is transmitted only through sexual contact. Oral-genital, oral-anal, genital-oral relationships with strangers are especially dangerous, although classic unprotected contact with a patient can also lead to infection. Using condoms does not eliminate, but reduces the risk of infection by approximately half.
In addition to the sexual method of transmission of genital herpes, infection is possible when a child passes through the birth canal during childbirth or the fetus passes through the placenta of a sick mother. In some cases, human infection can occur in the absence of sexual contact. Infection in this case is the result of non-compliance with personal hygiene rules, when a person transfers the virus from his lips to his genitals with dirty hands.
The virus, which once entered the body through microtraumas to the skin and mucous membrane of the genital organs, remains in the body for life. A person who has good immunity and leads a healthy lifestyle may not find out about the presence of the virus and will not become familiar with the clinical signs of the disease. However, under factors favorable to infection (severe fatigue, stress, hypothermia, colds, overheating in the sun, mental and physical trauma, prolonged alcohol intoxication, hormonal changes), the virus becomes more active and the disease worsens.
The most severe complication is neonatal herpes, when the child is infected from the mother during childbirth. The likelihood of transmitting the herpes virus to a newborn increases if the mother became infected in the last 3 months of pregnancy. Infection in newborns leads to serious damage to the child’s nervous system, blindness and even death. If it has been determined that during pregnancy the expectant mother’s herpetic infection has entered an active phase, then delivery by cesarean section is recommended to avoid the passage of the fetus through the birth canal.
Symptoms of the disease do not always appear externally. But their absence does not make the disease safe: a person infected with the virus is always dangerous for sexual partners. Any contact with the skin of an infected person can make his partner sick. Particularly susceptible to the virus are:
That is why infection is possible through oral, genital, and anal sex. A partner with herpetic sores on the lips easily transfers the infection to the partner’s genitals during oral sex.
The spread of the disease is directly related to the socialization of people.
Risk factors may include:
Genital herpes can become even more dangerous because during the initial infection, signs of the disease do not always appear. The disease can also occur in a latent form, in which all symptoms are absent. Sometimes they are present, but appear so weakly that the sick person simply does not pay attention to them. But, regardless of the presence of symptoms, sexual contact with an infected person in most cases leads to infection.
Every person’s body tries to resist the disease. However, the fight against a genital virus becomes useless if a person:
In some cases, to diagnose herpes with pronounced symptoms, a visual examination of the patient is sufficient. The appearance of a blistering rash in the genital area, accompanied by itching, burning and pain, is a reliable indicator of herpes. However, confirmation of the diagnosis is obtained in laboratory conditions by collecting material directly from the site of the rash. To identify the presence of the virus, a scraping is carried out from the cervix, urethra or rectum, taking into account the lesion. To diagnose antibodies in the absence of characteristic symptoms, the material being tested is the patient’s blood.
Herpes often occurs in combination with a number of other sexually transmitted infections. Therefore, an accurate diagnosis is made after testing for trichomoniasis, chlamydia, syphilis, AIDS and other infections.
There are 4 types of sexually transmitted infections depending on how it manifests itself and who it affects:
Each episode has its own clinical picture and its own primary symptoms.
From this point of view, genital herpes is:
Sometimes it can be difficult to determine what clinical picture is currently present in a woman. Washington doctors, who have been studying the disease for many years, believe that with primary infection there must be three of the following symptoms:
Symptoms usually appear 3–8 days after unprotected sex with an infected partner. In women, the skin in the area of the vulva, perineum, anus, and vagina becomes red and swollen. Vesicles (watery blisters) develop on congested skin, which later turn into open sores. After a few days they become covered with a purulent yellow coating. The skin in this area becomes sensitive, women complain of an unbearable burning sensation, debilitating itching, and sometimes pain in the area of the rash.
More severe symptoms may also occur: frequent urination, heaviness in the abdomen (lower), headache, nausea or fever. Typically, pronounced symptoms disappear within a month. The disease becomes latent.
If a woman has suffered primary genital herpes, then there is a 70% chance that she will develop symptoms of a recurrent type. Depending on how often the exacerbation occurs, the severity of the disease is distinguished:
Symptoms of a recurrent disease may include:
Typically, these symptoms of genital herpes disappear as soon as the sores are localized to the genitals.
Depending on how genital herpes progresses, doctors distinguish:
With atypical genital herpes, not only the skin and mucous membranes are affected, but also (this is especially dangerous) the appendages and the woman’s uterus. Typically, an atypical disease develops as a consequence of recurrent herpes, although in some cases a primary infection is sufficient to damage internal organs. With atypical infection, signs of genital herpes can only appear:
At the first stage, genital herpes affects the external genitalia, at the second stage - the urethra, cervix, vagina, at the third (the most severe) - the bladder, appendages, and uterus.
Advanced genital herpes can be accompanied by severe symptoms:
The causes of relapses can be:
When deciding how to treat herpes, the choice is made in favor of etiotropic and immunocorrective drugs.
Acyclovir is the main drug for the treatment of acute and recurrent forms of genital herpes. It has a powerful etiotropic effect, being activated inside infected cells and inhibiting viral DNA polymerase. Acyclovir has very low toxicity to normal cells. The course of treatment includes enteral administration of acyclovir capsules. In patients with primary acute infection and in patients with manifestations of herpetic infection in immunodeficiency states of various etiologies, the dose can be doubled.
Since it is necessary to treat herpes with the mandatory 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. A peculiarity of the prescription of local antiviral ointments is the frequency of application to the affected areas (at least 5–6 times a day).
At the same time, based on indications, antibacterial therapy can be implemented, since it is more difficult to treat a patient with secondarily infected banal flora. It is undeniable to prescribe interferon inducers (neovir, reoferon, dibazol) and natural antioxidants (vitamins E and C) at this stage. When the exudative component is pronounced, prostaglandin inhibitors (indomethacin) are used.
Reducing the main clinical manifestations is the main goal of preparing the patient for vaccine therapy. Adequate nutrition, adherence to rest and work regimen, and sanitation of chronic foci of infection are indicated. Due to the violation of various parts of the immune system, which persist in the remission phase, it is advisable to use adaptogens of plant origin (golden root, lemongrass) or immunomodulators (for example, neovir, Wobenzym, Dibazol).
It is carried out using herpetic vaccines (inactivated, live, recombinant).
In case of exacerbations, long-term preventive treatment is carried out more than 6 times a year for several months. Thanks to this, 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, you should wash your hands to avoid spreading the infection.
This may be a secondary infection of the ulcers. By scratching ulcers and itchy areas, a woman runs the risk of introducing infections into the wound, which are caused by streptococci, staphylococci, etc.
A pregnant infected woman cannot bear a child. If a miscarriage does not occur, the child may be born with one of the forms of genital herpes or with deformities.
Damage to the uterus and other internal reproductive organs in most cases leads to infertility.
Unfortunately, the world has not yet invented a medicine that can rid humanity of this virus. Drug therapy can alleviate symptoms, lengthen remission times, shorten healing time, and reduce the likelihood of transmitting the virus to partners. The doctor selects treatment individually for each patient. It is believed that the most effective is complex treatment, which is prescribed simultaneously by a gynecologist and an immunologist.
In case of exacerbation, women can supplement drug therapy with independent treatment, which must be agreed with a doctor:
About half of people first become infected with herpes through airborne transmission. However, genital herpes is only transmitted through sexual contact.
In order to reduce the risk of infection, you must:
Discussion 0
- a common viral disease, transmitted mainly through sexual contact, infection is possible through airborne droplets, household transmission, children become infected in the womb or during childbirth. The disease has a pronounced clinical picture, but can remain latent for a long time. Antiviral and immunomodulating drugs and folk remedies are used for treatment.
Genital herpes is transmitted primarily through sexual contact, but airborne transmission is also possible
– a venereal viral disease that affects the genital organs; the disease is diagnosed in adults and children. Pathology can be congenital and acquired, primary, recurrent typical and atypical, asymptomatic carriers are distinguished. The ICD-10 code is A60.
There are 2 types of herpes simplex– HSV-1, HSV-2, it was previously believed that the first type of virus affects only the lips and the area around the mouth, and the second – the genitals. But studies have shown that both types of infectious agents cause genital herpes.
Routes of infection:
Affected skin
The main signs of initial genital herpes:
The initial stage of herpes development
In women, rashes can appear not only on the external genitalia, but also spread to the vaginal mucosa, cervix, anus, buttocks, and pubis. The disease is often accompanied by intense aching pain in the lower abdomen, which radiates to the rectum, perineum, and vaginal discharge mixed with mucus and pus is observed.
External genital herpes in women
Recurrent genital herpes is diagnosed in 75% of patients; the duration of the remission stage depends on the person’s immunity; type 2 virus provokes relapses more often than HSV-1.
In case of relapse, the signs of the disease appear in a blurred form - itching and burning are minor, rashes on the female and male organs are few and cover small areas of the skin and mucous membranes, the temperature is normal, often the symptoms go away on their own within a few days.
In women, genital herpes worsens after abortion, installation of an intrauterine device, during menstruation.
Diagnosis and treatment of genital herpes is carried out by:
Often, the manifestations of herpes can be confused with recurrent candidiasis, streptococcal impetigo, lichen planus, pemphigus, syphilis, Crohn's disease, so a number of specific tests are prescribed to make an accurate diagnosis. For research, serous fluid, blood, mucus, urine, semen are used, and a smear is made from the urethra, cervical canal, and vagina.
PCR analysis is done to accurately detect the virus
Diagnostic methods:
ELISA is the most reliable test for suspected genital herpes; it allows you to detect the presence of specific antibodies in the blood serum and determine the extent of infection. Diagnosis is carried out twice with an interval of 2 weeks.
What the analysis shows
Therapy for herpes is aimed at suppressing the growth of the virus, eliminating the main symptoms of the disease, and prolonging the remission stage. Treatment is carried out using antiviral and antiherpes drugs; laser blood irradiation, plasmapheresis, and traditional methods are used to enhance the therapeutic effect of drugs.
To eliminate the manifestations of herpes, antiviral chemotherapy, immunotherapy and combination therapy are used. The treatment regimen is selected individually, depending on the severity of the pathology. It takes 10–21 days to completely eliminate the external manifestations of the primary form of the disease, and a week for the recurrent stage.
How to treat genital herpes:
Acyclovir is a broad-spectrum antiviral drug
Despite the diverse arsenal of antiherpetic drugs, there is no cure to completely get rid of the virus.
Non-traditional treatment methods help strengthen the immune system and help reduce itching, but they must be used in combination with medications.
How to treat herpes infection with folk remedies:
Echinacea tincture will help strengthen the body's defenses - 20 drops per 120 ml of water, take for 14 days. This treatment method is contraindicated in pregnant women.
– a dangerous disease for pregnant women; if infection occurs in the first trimester, the woman is advised to have an abortion, since the virus can provoke the development of pathologies in the fetus that are incompatible with life. Infection in the later stages is fraught with dropsy of the brain in the child, polyhydramnios, and a sharp decrease in the volume of amniotic fluid.
The presence of the virus in a pregnant woman can lead to the child being born defective, with congenital abnormalities, or dead
Most antiviral drugs are contraindicated during pregnancy; herpetic infection is treated using external agents - Acyclovir, Acyclostad, Zovirax.
In newborns, signs of congenital genital herpes appear within a few hours after birth. Antiviral therapy is prescribed immediately, since a lethal outcome is possible due to weak immunity.
Signs of the disease:
The development of herpes can lead to inflammation of the urethra
Consequences of the disease:
In men, against the background of herpes infection, urogenital pathologies often develop - inflammation of the urethra, prostatitis, erectile dysfunction.
Every year the number of patients with genital herpes increases; about 90% of the adult population are carriers of the virus.
How to avoid infection:
Condoms reduce the risk of infection, but do not provide a 100% guarantee.
Genital herpes is one of the most common sexually transmitted diseases. An analysis of questions asked to doctors on the website herpesu-net.ru showed that this problem is extremely relevant for residents of Russia. However, official incidence statistics are relatively low. This is due to the fact that people suffering from genital herpes do not always go to the doctor, preferring to treat themselves.
With such self-medication, mistakes are inevitable, especially when a person relies on unstudied “folk remedies”, unqualified advice from friends, dietary supplements of dubious origin, etc. This article contains answers to basic questions about the routes of infection, the “behavior” of the pathogen in the body and the treatment of genital herpes .
- Is it possible to get genital herpes from a partner with herpetic rashes on the lips? And vice versa?
Answer: Yes, you can. These diseases are caused by two types of herpes simplex virus (HSV) – HSV-1 and HSV-2. Previously, it was believed that the first type of virus causes rashes on the lips (labial herpes), and the second - on the genitals (genital herpes). However, it turned out that both types of the virus can affect both the lips and genitals. So during oral sex, the infection can be transmitted from the lips of one partner to the genitals of the other and vice versa.
Is genital herpes transmitted through household items? How to avoid infection while living with a person who has an exacerbation of this infection? How long does the virus remain viable in the environment?
Answer: The herpes virus outside the human body is unstable and cannot exist for a long time without it. The likelihood of contracting it from using common household items (for example, a washcloth or towel) is extremely low, but it still exists. To prevent transmission of infection through this route, it is enough to follow basic hygiene rules: use personal hygiene products and keep the bathroom clean. A sick person should wash their hands thoroughly after touching the rash.
- Is it possible to get rid of genital herpes forever?
Answer: It is impossible to completely get rid of herpes - once in the body, the virus “settles” in the nerve cells and remains there forever. However, proper and timely treatment can reduce the frequency and duration of exacerbations to a minimum or prevent them altogether.
Why do rashes continue to appear periodically after treatment for genital herpes and a negative blood test result for the presence of the virus?
Answer: As mentioned above, the herpes virus cannot be destroyed in the body. Therefore, treatment is always aimed only at eliminating and preventing exacerbations. Outside of an exacerbation, the virus is in the nerve cells in an inactive state and may not be detected in a blood test. But when exposed to factors that reduce immune defense (such as stress, hypothermia, repeated contact with the virus, and others), the infection may appear again.
Rashes that appear frequently and in large numbers may be the result of serious disturbances in the functioning of the immune system, therefore, in such cases, consultation with a specialist immunologist is necessary.
How can it be that one of the spouses often suffers from genital herpes, while the other does not experience any manifestations of the infection?
Answer: The reason for this is that in most cases, herpes infection is asymptomatic - the pathogen seems to be dormant in the body. Therefore, a virus received from a husband (wife) does not necessarily lead to rashes. The decisive role in their appearance is played by the state of the immune system, which normally suppresses the activity of HSV and prevents the development of exacerbations.
- Why is genital herpes dangerous during pregnancy?
Answer: The answer to this question could be a topic for a separate article. It is believed that herpes infection can be the cause of non-developing pregnancy in 20 percent, secondary infertility in 60 percent, and miscarriage in 20 percent of cases.
In addition, the herpes simplex virus can be transmitted vertically - from mother to child, and the likelihood of transmission increases sharply if there are rashes on the mother's genitals during childbirth. With such an infection, the virus can “doze off” for a long time in the child’s body, or can cause herpes of the newborn, isolated as a separate form of infection. This disease can affect a variety of organs of the child, often leading to developmental disorders and sometimes death. Therefore, it is extremely important for expectant mothers to be examined for herpes infection and, if necessary, undergo a course of treatment to prevent exacerbations.
- What and how is genital herpes treated?
Answer: Treatment of this infection, like other diseases, should begin with a consultation with a doctor - only a specialist can make the correct diagnosis, assess the condition of a particular patient and choose treatment, taking into account contraindications and side effects of medications.
In recent years, therapy for infections of the reproductive system is almost impossible without the prescription of drugs that increase the body’s own defenses, that is, stimulate the immune system.
The editors thank the specialists of NTFF POLYSAN for their assistance in preparing the material
Herpes is widespread in the human population. This viral infection represents a significant medical and social problem.
The herpes simplex virus (HSV) affects 9 out of 10 people on the planet. In every fifth person it causes some external manifestations. HSV is characterized by neurodermotropism, that is, it prefers to multiply in nerve cells and skin. Favorite places where the virus is affected are the skin near the lips, on the face, mucous membranes lining the genitals, the brain, the conjunctiva and the cornea of the eye. HSV can lead to abnormal pregnancy and childbirth, causing fetal death, miscarriages, and systemic viral disease in newborns. There is evidence that the herpes simplex virus is associated with malignant tumors of the prostate and cervix.
The disease occurs more often in females, but it also occurs in men. The peak incidence occurs at the age of 40 years. However, genital herpes often first appears in boys and girls during sexual intercourse. In young children, infection on the genitals most often comes from the skin of the hands, from contaminated towels in children's groups, and so on.
HSV is unstable in the external environment and dies under the influence of sunlight and ultraviolet rays. It lasts for a long time at low temperatures. In dried form, HSV can exist for up to 10 years.
The cause of the disease is two types of herpes simplex viruses, mainly HSV-2. The first type of virus was previously associated with diseases of the skin and oral cavity. HSV-2 causes genital herpes and meningoencephalitis. Now there are cases of illness caused by the first type of virus or a combination of them. Often the carrier does not have any symptoms of the disease and does not suspect that he is the source of the infection.
How can you become infected with this disease? The most common routes of transmission of genital herpes are sexual and contact. Most often, infection occurs through sexual contact with a carrier of the virus or with a sick person. You can become infected by kissing, as well as by sharing common household items (spoons, toys). The virus can also be transmitted through airborne droplets.
The pathogen enters the child's body from the mother during childbirth. The risk of such transmission depends on the type of lesion in the patient. It is up to 75%. In addition, infection of the fetus is possible through the blood during the period of viremia (the release of viral particles into the blood) during an acute illness in the mother.
Children in most cases become infected with HSV-1 in the first years of life. By the age of 5, HSV-2 infection also increases. During the first six months of life, babies do not get sick, this is due to the presence of maternal antibodies. If the mother was not previously infected and did not pass on her protective antibodies to the child, then children at such an early age become very seriously ill.
From a medical point of view, this disease is called “Anogenital herpetic viral infection caused by the Herpes Simplex virus.” There are two main forms of the disease:
Infection of the genitourinary organs:
Infection of the rectum and skin around the anus.
The virus enters the body through damaged mucous membranes and skin. In the area of the “entrance gate” it multiplies, causing typical manifestations. The pathogen usually does not spread further; it rarely enters the lymph nodes and even less often penetrates the blood, causing viremia. The further fate of the virus largely depends on the properties of the human body.
If the body has good immune defense, a virus carrier is formed, which does not exclude relapses of infection under unfavorable conditions. If the body cannot cope with the infection, the herpes virus enters the internal organs (brain, liver and others) through the blood, affecting them. Antibodies are produced in response to infection, but they do not prevent the development of exacerbations and relapses.
When the immune system is weakened, the virus that was previously stored in the nerve cells is activated and released into the blood, causing an exacerbation of the disease.
In most people who are carriers, HPV does not cause any symptoms over a long period of time. The incubation period for genital herpes in previously uninfected people is 7 days. In men, the virus persists in the organs of the genitourinary system, in women - in the cervical canal, vagina, and urethra. After infection, a lifelong carriage of the genital herpes virus is formed. The disease tends to be persistent with relapses.
Reasons contributing to the development of external signs of infection:
Under the influence of these factors, a prodromal period occurs - “pre-disease”. Initial signs of genital herpes: at the site of the future outbreak, patients note the appearance of itching, pain or burning. After some time, rashes appear in the lesion.
The elements of the rash are located separately or grouped and look like small bubbles with a diameter of up to 4 mm. Such elements are located on a reddened (erythematous), edematous base - the skin of the perineum, perianal zone and the mucous membrane of the genitourinary organs. The appearance of vesicles (bubbles) may be accompanied by moderate fever, headache, malaise, and insomnia. Regional (inguinal) lymph nodes become larger and more painful. The primary episode is especially pronounced in people who have not previously been infected with the virus and who do not have antibodies to it.
After a few days, the vesicles open on their own, forming erosions (superficial damage to the mucous membrane) with uneven outlines. At this time, patients complain of severe itching and a burning sensation in the erosion zone, weeping, severe pain, which intensifies even more during sexual intercourse. During the first ten days of illness, new rashes appear. Viral particles are actively released from them.
Gradually, the erosions become covered with crusts and heal, leaving small areas of weak pigmentation or lighter areas of the skin. The time from the appearance of the rash element to its epithelization (healing) is two to three weeks. The pathogen enters the cells of the nerve trunks, where it remains latent for a long time.
Symptoms of genital herpes in female patients are expressed in the labia, vulva, perineum, vagina, and cervix. In men, the glans penis, foreskin, and urethra are affected.
The pelvic nerves are often involved in the process. This leads to impaired sensitivity of the skin of the lower extremities, pain in the lower back and sacrum. Sometimes urination becomes frequent and painful.
In women, the first episode of herpis lasts longer and more noticeably than in men. The duration of an exacerbation without treatment is about 3 weeks.
Approximately 10-20% of those who have recovered from the disease develop recurrent genital herpes. The first manifestation of infection is usually more violent. Recurrence of genital herpes manifests itself less intensely and passes faster than the primary symptoms. This is due to the antibodies already present in the body at this time, which help fight the virus. Type 1 genital herpes recurs less frequently than type 2.
An exacerbation of the disease may manifest itself as minor symptoms - itching, rare rashes. Sometimes the picture of the disease is represented by painful merging erosions and ulcerations of the mucous membrane. Virus shedding lasts 4 days or longer. An enlargement of the inguinal lymph nodes appears, lymphostasis and severe swelling of the genital organs due to stagnation of lymph (elephantiasis) cannot be ruled out.
Relapses occur equally often in men and women. Men have longer episodes, and women have a more vivid clinical picture.
If the frequency of relapses is more than six per year, they speak of a severe form of the disease. The moderate form is accompanied by three to four exacerbations during the year, and the mild form is accompanied by one or two.
In 20% of cases, atypical genital herpes develops. Manifestations of the disease are masked by another infection of the genitourinary system, for example (thrush). Thus, thrush is characterized by discharge, which is practically absent with ordinary genital herpes.
Diagnosis of genital herpes is carried out using the following laboratory tests:
Analysis for genital herpes is recommended to be taken repeatedly at intervals of several days, from 2 to 4 studies from different lesions. In women, it is recommended to collect material on days 18-20 of the cycle. This increases the chance of recognizing a viral infection and confirming the diagnosis.
The most informative tests are PCR for examining urine and scrapings from the genitourinary organs (vagina, urethra, cervix).
The diet of patients with genital herpes does not have any special features. It should be complete, balanced, rich in proteins and vitamins. During an exacerbation, it is better to bake or stew food, or steam it. Fermented milk and vegetable products, as well as drinking plenty of fluids, will be beneficial.
Treatment of genital herpes, its intensity and duration depend on the form of the disease and its severity. How to treat genital herpes in each patient is determined by a venereologist based on a complete examination and examination of the patient. Self-medication in this case is unacceptable. To determine how to cure a patient, data from his immunogram is required, that is, an assessment of the state of immunity.
The following groups of drugs are used to treat the disease:
The treatment regimen for acute genital herpes and its relapses primarily includes Acyclovir (Zovirax). If the immunogram is normal, it is prescribed in a daily dose of 1 gram, divided into five doses, for ten days or until recovery. With significant immunodeficiency or damage to the rectum, the daily dose is increased to 2 grams in 4-5 doses. The earlier treatment is started, the higher its effectiveness. The best option for starting therapy, in which the medicine is most effective, is the prodromal period, or the first day of the appearance of the rash.
How to get rid of relapses of the disease? For this purpose, suppressive therapy with Acyclovir is prescribed at a dose of 0.8 g per day. The pills are taken for months and sometimes years. Daily medication helps almost all patients avoid relapses, and a third of them do not experience repeated episodes of the disease.
Acyclovir is produced under trade names that include the word itself, as well as Acyclostad, Vivorax, Virolex, Herperax, Medovir, Provirsan. Its side effects include digestive disorders (nausea, abdominal pain, diarrhea), headache, itching, fatigue. Very rare undesirable effects of the drug are hematopoietic disorders, renal failure, and damage to the nervous system. It is contraindicated only in case of individual intolerance to the drug, and should also be prescribed with caution to patients with impaired renal function. Use is possible during pregnancy and breastfeeding, as well as in children, but only after assessing the possible risk.
In the prodromal period and early stages of the disease, 5% Acyclovir cream is effective. It helps better if the rashes are located on the skin. Apply it several times a day for a week.
There are second generation Acyclovir drugs that are more effective. These include valacyclovir (Vairova, Valavir, Valvir, Valtrex, Valcicon, Virdel). It is well absorbed from the digestive organs, its bioavailability is several times higher than that of Acyclovir. Therefore, the effectiveness of treatment is 25% higher. Exacerbation of the disease develops less frequently by 40%. The drug is contraindicated in cases of manifesting HIV infection, kidney or bone marrow transplantation, as well as in children under 18 years of age. Use during pregnancy and while breastfeeding is possible after assessing the risks and benefits.
How to treat genital herpes if it is caused by Acyclovir-resistant viruses? In this case, alternative drugs are prescribed - Famciclovir or Foscarnet. Famciclovir is available under such names as Minaker, Famacivir, Famvir. The drug is very well tolerated, only occasionally causing headache or nausea. The only contraindication is individual intolerance. Since this drug is new, its effect on the fetus has been little studied. Therefore, its use during pregnancy and breastfeeding is possible only according to individual indications.
Some antiviral medications used to treat rashes come in the form of an ointment. Among them the following can be noted:
The frequency of application and duration of treatment with local drugs is determined by the doctor. They are usually prescribed several times a day for a week.
In recent years, there has been increasing interest in interferons or interferon inducers that help the body cope with the infection itself, often having a direct antiviral effect. These include the following:
They can be prescribed both internally and locally. Some of these drugs are suppositories. Thus, Viferon rectal suppositories are often prescribed as part of complex therapy for genital herpes.
To relieve symptoms, you can take non-steroidal anti-inflammatory drugs, such as paracetamol or ibuprofen.
Antibiotics are not prescribed for genital herpes, since they only act on bacteria, not viruses. The effectiveness of such areas of therapy as homeopathy and traditional methods has not been proven.
A specific prevention of genital herpes, that is, a vaccine, has been developed. The Russian-made polyvaccine must be administered several times a year in courses of 5 injections. It is an inactivated culture vaccine. The effectiveness of such prevention is being studied.
Nonspecific prevention consists of maintaining sexual hygiene and avoiding casual sex.
A person infected with genital herpes should not overcool, avoid emotional stress, intense exercise and other causes of exacerbation.
It is believed that pregnancy is not a factor causing exacerbation of genital herpes. However, some scientists have a different opinion.
Pregnancy and childbirth with HSV carriage without clinical manifestations are usually normal. Treatment of a pregnant woman is carried out if she develops systemic manifestations, for example, meningitis, hepatitis. This usually happens when a woman first encounters the virus during pregnancy. Acyclovir is prescribed for treatment.
If such treatment is not carried out, then as a result of viral particles entering the baby’s blood through the placenta (damaged or even healthy), an intrauterine infection will develop. In the first trimester of pregnancy, malformations form. In the second and third trimesters, the baby's mucous membranes, skin, eyes, liver, and brain are affected. Intrauterine fetal death may occur. The risk of premature birth increases. After the birth of such a baby, severe complications are possible: microcephaly (underdevelopment of the brain), microophthalmia and chorioretinitis (eye damage leading to blindness).
Delivery is carried out naturally. A caesarean section is prescribed only in cases where the mother has a rash on the genitals, as well as if her first episode of infection occurred during pregnancy. In these same cases, prenatal prevention of transmission of the herpes virus to the child is recommended with the help of Acyclovir, prescribed from 36 weeks. An even more convenient and cost-effective drug for the prenatal preparation of a sick woman is the drug Valcicon (Valacyclovir). The use of antiviral drugs before childbirth helps reduce the frequency of exacerbations of genital herpes and reduce the likelihood of asymptomatic release of viral particles that infect the child.
When giving birth to a sick woman, premature rupture of water and weakness of labor are dangerous. Therefore, she needs special attention from medical personnel.
If a child comes into contact with HSV while passing through the birth canal, he will develop neonatal herpes 6 days after birth. Its consequences are generalized sepsis, that is, infection of all internal organs of the child. A newborn may even die from infectious-toxic shock.
Due to the potential threat to the child, every pregnant woman is examined for HSV carriage and, if necessary, undergoes treatment as prescribed by a doctor. After the baby is born, he is also examined and, if necessary, treated. If the child does not show any signs of infection, he needs to be monitored for 2 months, since the manifestations of the disease are not always visible immediately.
To avoid the unpleasant consequences of the disease during pregnancy, an infected woman must undergo special preparation before pregnancy, the so-called pre-conception training. In particular, antiviral and immunostimulating agents of plant origin (Alpizarin) are prescribed orally and in the form of an ointment when exacerbations occur in the patient. At the same time, her immunity is corrected using interferon inducers. During the three months before the planned pregnancy, metabolic therapy is also prescribed to improve cellular metabolism (riboflavin, lipoic acid, calcium pantothenate, vitamin E, folic acid). At the same time, you can use passive immunization, that is, the introduction into a woman’s body of ready-made antiviral antibodies - immunoglobulins, which reduce the risk of exacerbation.
Pregnancy planning should be carried out only if there are no relapses within six months. Diagnosis and treatment of genital herpes before pregnancy can reduce the incidence of complications on the part of the mother and child, reduce the likelihood of relapse during pregnancy, and minimize the risk of intrauterine infection or neonatal herpes. All this helps reduce infant morbidity and mortality.
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