Genital herpes: features of manifestation in men and women, treatment. All about genital (genital) herpes in men and women and its treatment Psychological reaction to infection

Herpes– an infectious disease that is sexually transmitted and is caused by the herpes simplex virus type 2 (HSV-2). Characteristics of the disease are pain, itching, ulcers in the genital area. The route of infection is sexual contact.

Symptoms of genital herpes

Most people who are infected with herpes do not know it because the symptoms are either mild or non-existent.

Main symptoms include:

groin pain;
severe itching in the groin;
pain in the buttocks or leg;
red spots, blisters, open sores;
painful urination;
headache;
muscle pain;
temperature increase.

Factors that cause exacerbations of the herpes virus:

stress;
menstruation;
avitaminosis;
chronic diseases;
operations.

Causes of genital herpes

The causative agents of genital herpes are two types of virus: HSV-1 and HSV-2.

HSV-1 usually causes cold sores around the mouth, but the genital area can become infected during oral sex.

HSV-2 is usually the cause of genital herpes. HSV-2 is highly contagious, especially if you have an open wound, but it is also possible for the virus to spread even when there is no visible damage to the skin or mucous membranes.

HSV-2 is very common. According to experts, 45 million people in Russia over the age of 12 have HSV-2 infection, although for many it does not manifest itself in any way.

What to do if you have genital herpes

If you suspect you have genital herpes, see your doctor. He can diagnose herpes using various testing methods. Because people with herpes may also have other sexually transmitted diseases, your doctor will test you for other infections. If you suspect you have had a flare-up of herpes, a blood test can confirm this. A blood test can determine whether you have HSV-1 or HSV-2 in your body. But if you have HSV-1, a blood test cannot determine whether the infection is oral or sexual.

Complications of genital herpes

In the body of healthy adults, genital herpes does not cause any other serious complications other than rashes. People with weakened immune systems may experience more severe and prolonged periods of exacerbation.

If childbirth occurs during an exacerbation period, the baby may become infected while passing through the birth canal. Genital herpes in newborns can cause pathologies such as brain damage, blindness, or even cause death. The infection is more common among infants born to mothers who have had an exacerbation of the disease during pregnancy.

Treatment of genital herpes

There is no definitive cure for genital herpes. However, there are a number of drugs that help to quickly get rid of the manifestations of infection, which will be discussed during the consultation.

If treatment is started promptly and carried out daily, it reduces the likelihood of infecting your partner.

Prevention of genital herpes

Prevention measures for HSV are the same as for other STDs. Particular care should be taken during periods of exacerbation of the disease so as not to become a source of infection for other people. Having genital herpes increases the risk of transmitting other STDs, including the AIDS virus. Prevention of HSV consists of abstaining from promiscuous sex and having a single sexual partner who is not a carrier of the infection.

You can also:

use a condom during every sexual intercourse;
limit the number of sexual partners.

If you are pregnant, make sure you tell your doctor if you have HSV. He or she may recommend that you start treatment at around 36 weeks of pregnancy to avoid complications during childbirth. If the period of exacerbation coincides with the onset of labor, your doctor will probably suggest you have a cesarean section to prevent infection of the newborn at the time of birth.

Personal hygiene for genital herpes

If you are experiencing an exacerbation of infection:

avoid sex;
keep ulcers clean and dry;
Avoid touching the ulcers with your hands and be sure to wash your hands after touching them;
remember that the virus can become active even in the absence of external signs of illness;
wait until the ulcerations are completely healed before resuming sexual relations;
Always use latex condoms to reduce the chance of infecting your partner.

– a viral infection of the genital mucosa, characterized by the appearance of a group of blisters, and then erosions and ulcers. Accompanied by a local burning sensation, swelling, hyperemia, enlarged inguinal lymph nodes and symptoms of intoxication. It is prone to relapses and can subsequently lead to serious complications: a decrease in local and general immunity, the development of bacterial infections of the genitals, damage to the nervous system, the development of cervical and prostate cancer. It is especially dangerous in pregnant women, as it increases the likelihood of spontaneous miscarriage, pathology and even death of the newborn. It is included in the group of sexually transmitted diseases (STDs).

General information

The causative agent of genital herpes is a type of herpes simplex virus (HSV). The incidence of herpes infection among the world's population is about 90%.

There are several types of herpes virus that cause damage to the skin, mucous membranes, central nervous system and other organs (herpes simplex viruses types 1 and 2, cytomegalovirus, varicella zoster virus, Epstein-Barr virus, herpes zoster, etc.). Herpes simplex viruses types 1 and 2 cause oral and genital forms of the disease, with HSV type 1 affecting mainly the face, lips, and wings of the nose, and HSV type 2 most often causes genital herpes. HSV is often detected in association with ureaplasma and cytomegalovirus.

Genital herpes has a sexual transmission route; with various forms of sexual contact, it easily penetrates through damaged skin and mucosal epithelium. After infection, HSV migrates to the nerve ganglia, remaining there for life. Reproduction of HSV in epithelial cells of the skin and mucous membranes leads to their degeneration and death. The infection is characterized by a chronic course and manifests itself cyclically: periods of activity or relapses (2-21 days), accompanied by the appearance of rashes in the form of blisters, alternate with periods of remission, when clinical symptoms disappear. Often, genital herpes is asymptomatic, but patients are still a source of infection.

Causes of genital herpes

Primary infection with HSV usually occurs by airborne droplets in childhood (in the population of children 6-7 years of age, the incidence rate is already 50%). The reasons for this are high population density, low socio-economic standard of living, and non-compliance with hygiene rules.

Secondary infection usually occurs as a result of sexual contact. A high incidence of genital herpes is observed among people aged 20-30 years. This is due to the early onset of sexual activity, promiscuity, frequent changes or the presence of several partners, and unprotected sexual intercourse. Venereology also includes internal causes as risk factors for genital herpes:

decreased immune defense of the body;
presence of STDs;
gender of the person (it has been noticed that women suffer from genital herpes much more often than men);
surgical termination of pregnancy, use of intrauterine devices.

The human immune system reacts to the penetration of HSV by producing specific antibodies, and with a normal level of immune reactions, clinical manifestations of infection are not observed. Under the influence of a number of unfavorable factors that reduce the body’s immune reactivity, HSV is activated, which is manifested by rashes on the skin and mucous membranes, and neuralgic pain. Episodes of relapse of genital herpes often occur against the background of chronic stress, lack of vitamins, hypothermia, overheating, climate change, and colds.

Ways of transmission of genital herpes

Infection with genital herpes most often occurs through the mucous membranes of the genitals, rectum, urethra or damage to the skin during genital, oral-genital and anal-genital contact.

HSV transmission is also possible:

airborne droplets;
vertically from a sick mother to the fetus (during childbirth in contact with the mother’s birth canal, transplacentally, ascending from the mother’s external genitalia through the cervical canal into the uterine cavity);
in case of self-infection - autoinoculation (a sick person himself transfers the infection from infected areas of the body to uninfected areas - from the face to the genitals);
by household means - rarely (through wet hygiene items).

Typically, infection with genital herpes occurs when the infected partner does not even know about the disease, since he does not have clinical manifestations of the disease (in the case of asymptomatic virus carriers).

Forms and manifestations of genital herpes

According to the clinical course, a distinction is made between primary genital herpes (the first episode of the disease) and recurrent (all subsequent episodes of the disease).

Recurrent genital herpes can occur in typical, atypical clinical forms and the form of asymptomatic virus carriage.

Primary genital herpes

The earliest symptoms of primary genital herpes include swelling, redness, pain, and burning in the area at the entrance gate of the infection. Local manifestations of genital herpes are often accompanied by fever, malaise, headache and muscle pain. After a few days, herpetic rashes appear - small blisters with transparent contents. The rupture of the vesicles is accompanied by the formation of painful erosive and ulcerative elements. When ulcers are localized on the genitals, painful urination is noted. Healing of the rash occurs within two weeks.

Recurrent genital herpes

The development of relapses of genital herpes occurs in 50-70% of patients who have suffered a primary infection. Depending on the frequency of repeated episodes, several forms of recurrent genital herpes are distinguished:

mild form (exacerbations no more than 3 times a year)
moderate form (exacerbations 4 to 6 times a year)
severe form (monthly exacerbations)

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

The arrhythmic course of genital herpes is characterized by alternating remissions from 2 weeks to 5 months. Moreover, the longer the periods of remission, the more intense and prolonged the relapses of genital herpes, and vice versa.

With a monotonous course of genital herpes, frequent episodes of the disease are observed after slightly changing periods of remission. This type includes menstrual herpes, which has a persistent course and is difficult to treat.

Genital herpes of the subsiding type has a more favorable course. It is characterized by a decrease in the intensity of relapses and an increase in periods of remission.

The development of relapses of genital herpes occurs under the influence of various factors: hypothermia, sexual intercourse, stressful situations, overwork, and the occurrence of other pathologies (influenza, ARVI).

Symptomatically, relapses of genital herpes are milder than the primary disease, however, their consequences can be much more serious.

Rashes with genital herpes are accompanied by extreme pain, making it difficult for the patient to move, go to the toilet, and disrupt sleep. The psychological state of a person often changes: irritability, fear of new rashes, fear for the health of loved ones, suicidal thoughts, etc. appear.

Atypical forms of genital herpes

Atypical forms of genital herpes occur gradually, in the form of chronic inflammation of the external and internal genital organs (vulvovaginitis, colpitis, endocervicitis, urethritis, cystitis, prostatitis, etc.). The diagnosis of genital herpes is based on laboratory confirmation of the presence of herpes infection. Atypical forms of genital herpes account for more than half of clinical cases - 65%.

The atypical form of genital herpes is characterized by mild swelling, areas of erythema, pinpoint blisters, persistent burning and itching, and profuse leucorrhoea that cannot be treated. With a long course of genital herpes, enlargement and soreness of the inguinal lymph nodes are noted.

Based on the localization of herpetic eruptions, there are 3 stages:

Stage I - genital herpes affects the external genitalia;
Stage II - genital herpes affects the vagina, cervix, urethra;
Stage III - genital herpes affects the uterus, appendages, bladder, prostate.

The higher the herpetic infection penetrates the genitourinary tract, the more serious the prognosis. An advanced form of genital herpes can lead to a state of immunodeficiency, and in women it increases the risk of developing infertility and cervical cancer. HSV is dangerous for people with weakened immune systems (HIV-infected) and those who have undergone organ transplantation.

Genital herpes and pregnancy

During pregnancy, genital herpes poses the greatest danger in the case of a primary infection, if no manifestations of the disease have previously been observed. There is a possibility of developmental defects if the mother’s illness occurs in the early stages of pregnancy, when the fetus is developing all the organs and tissues. HSV can be transmitted through the placenta, affecting mainly the nervous tissue of the fetus. Genital herpes increases the risk of spontaneous miscarriage, premature birth, fetal deformities and death.

Pregnant women with atypical forms of genital herpes are examined twice for HSV in the last 6 weeks of pregnancy. If a herpes virus is detected, a cesarean section is performed routinely to exclude possible infection of the fetus during passage through the birth canal.

The best option is to screen women for HSV at the stage of preparation for pregnancy, as well as during pregnancy during each trimester.

Genital herpes in newborns

Most often, infection of the fetus occurs in the first 4-6 hours of labor after rupture of the membranes, or during the passage of the fetus through the birth canal of an infected mother. Typically, HSV in newborns affects the eyes, oral mucosa, skin, and respiratory tract. After primary infection of a newborn, HSV spreads in the body through hematogenous or contact routes. The likelihood of infection in newborns increases when the mother is infected with genital herpes in the last trimester of pregnancy.

With a localized form of herpetic infection in newborns, redness, vesicles, hemorrhages of the skin and oral mucosa may appear, meningoencephalitis, keratoconjunctivitis and chorioretinitis (inflammation of the blood vessels and retina), and clouding of the lens may develop. Children infected with genital herpes often suffer from permanent neurological disorders.

Genital herpes can cause a generalized infection in newborns. Signs of a generalized herpetic infection appear 1-2 weeks after the birth of the child. Local symptoms include refusal to eat, vomiting, fever, jaundice, respiratory distress, bleeding, and shock. The death of a child can occur from acute blood loss and vascular insufficiency.

Diagnosis of genital herpes

When diagnosing genital herpes, the venereologist takes into account complaints, medical history and objective examination. Diagnosis of typical cases of genital herpes is usually not difficult and is based on clinical manifestations. Herpetic ulcers that exist for a long time should be distinguished from syphilitic ones.

Laboratory methods for diagnosing genital herpes include:

methods for detecting HSV in material from affected organs (scrapings from the vagina and cervix, smear from the urethra, histological material from the fallopian tubes, etc.). For this purpose, the method of growing HSV in tissue culture and subsequent study of its properties is used; the method of recognizing the virus under an electron microscope is used;
methods for detecting antibodies to HSV in blood serum (immunoglobulins M and G). They allow you to detect genital herpes even in asymptomatic cases and determine antibodies to HSV types 1 or 2. These include ELISA - a method of enzyme immunoassay.

Treatment of genital herpes

Current medications for HSV can reduce the severity and duration of genital herpes, but are not able to completely get rid of the disease.

To avoid the development of HSV resistance to classical antiviral drugs, including those intended for the treatment of genital herpes (acyclic nucleosides - Valacyclovir, Acyclovir, Famciclovir), it is recommended that they be used alternately, as well as in combination with interferon drugs. Interferon has a powerful antiviral effect, and its deficiency is one of the main causes of relapses of genital herpes.

A ready-made medicinal product containing both acyclovir and interferon is Gerpferon ointment. It also contains lidocaine, which provides a local anesthetic effect, which is extremely important for painful manifestations of genital herpes. The use of Herpferon in patients with genital herpes ensures healing of rashes already on the 5th day and significant relief of local symptoms.

Prevention of genital herpes

A way to prevent primary infection with genital herpes is to use condoms during casual sexual contact. However, even in this case, the likelihood of HSV infection through microcracks and damage to mucous membranes and skin not covered by a condom remains high. It is possible to use antiseptic agents (Miramistin, etc.) to treat areas where the virus may enter.

The recurrent course of genital herpes is observed when the body’s defense reactions decrease: illness, overheating, hypothermia, the onset of menstruation, pregnancy, taking hormonal drugs, stress. Therefore, to prevent relapses of genital herpes, a healthy lifestyle, good nutrition and rest, and taking vitamin supplements are important. Measures to prevent genital herpes also include maintaining intimate and sexual hygiene, and timely detection and treatment of sexually transmitted diseases.

A patient infected with HSV must warn his sexual partner about this, even if he does not currently have symptoms of genital herpes. Since infection through sexual contact is possible even in the absence of herpetic eruptions, in this case the use of a condom is also necessary.

After questionable unprotected sexual contact, you can resort to the method of emergency prevention of genital herpes with a locally active antiviral drug in the first 1-2 hours after intimacy.

To prevent self-infection, when the genital herpes virus is transferred by dirty hands from the lips to the genitals, it is necessary to fulfill basic hygiene requirements: thorough and frequent hand washing (especially in the presence of fever on the lips), using separate towels for the hands, face and body, as well as every family member.

In order to reduce the risk of HSV infection in newborns, surgical delivery (cesarean section) is recommended for pregnant women with genital herpes. When planning a natural birth, women with recurrent genital herpes are prescribed a prophylactic course of taking acyclovir.

After unprotected sexual intercourse, when planning pregnancy, as well as during sexual relations with an HSV carrier, it is recommended to be examined for genital herpes and other STDs.

Genital herpes is a very common disease, which is a viral infection of the mucous membranes of the genital organs, in which groups of characteristic blisters first appear, and then ulcers and erosions.

In the vast majority of cases, this disease is transmitted through sexual contact.

It is prone to frequent relapses and, with the wrong approach to treatment or lack of therapy, can provoke the occurrence of very serious complications: a decrease in general immunity, bacterial infection of the genital organs, and the occurrence of malignant diseases of the uterine cervix in women.

Genital herpes is considered the most dangerous during pregnancy, but only when there is a primary infection, since in such a situation there is always a considerable risk of miscarriage, as well as the occurrence of various malformations and pathologies in the fetus.

Causes

According to statistics, the highest percentage of infection with the virus is observed among young people aged approximately 20-30 years. This can be explained by a fairly early onset of sexual life, promiscuity in sexual relations, frequent changes of partners, and the lack of barrier contraception when having sex.

There are also a number of specific factors contributing to the development of the disease:

decreased general or local immunity;
presence of sexually transmitted infections;
long-term wearing of an intrauterine device;
previous artificial termination of pregnancy;
presence of colds;
overheating or hypothermia of the body;
frequent stress;
bad habits, etc.

The human immune system is designed in such a way that when an infection enters the body, special antibodies immediately begin to be produced, therefore, with adequate functioning of the immune system, no clinical manifestations of diseases occur.

But under the influence of one or more of the above factors, the herpes virus begins to become more active: characteristic rashes appear on the skin and mucous membranes, and neuralgic pain is noted.

As already mentioned, genital herpes has a sexual transmission route, that is, infection occurs through the mucous membranes located on the genitals, in rectum, urethra.

Let's look at other ways genital herpes is transmitted:

airborne;
from mother to child during childbirth, transplacentally or ascendingly, when the infection enters the uterine cavity from the woman’s external genitalia;
a person can become infected on their own, transferring the infection to the genitals, for example, from the face;
The virus is extremely rarely transmitted through household contact.

Most often, infection through sexual contact occurs when one of the partners (the carrier of the virus) may not even know his illness.

Forms and symptoms of genital herpes

According to its clinical course, genital herpes can be primary (the very first episode of the disease) and recurrent (subsequent episodes).

In the first case, the earliest symptoms of genital herpes in women are usually the following:

swelling and hyperemia of the genital organs;
burning, pain and visible redness of the mucous membranes;
temperature increase;
general malaise;
characteristic herpetic rashes similar to blisters filled with clear liquid;
after the vesicles rupture, erosive ulcers form.

In women, the pathology most often affects the area of the external genitalia, the urethra, the perineum and anus, and the inner thighs.

The recurrent form develops in more than half of people who have had a primary infection. This type of disease can develop in both typical and atypical forms; in addition, it is sometimes characterized by an asymptomatic course.

Doctors also identify several forms of recurrent herpes, depending on the frequency of exacerbations:

mild form (repeated episodes occur no more than three times a year);
moderate form (the number of exacerbations ranges from four to six per year);
severe form (relapses occur monthly).

Many factors can cause a relapse of the disease, such as hypothermia, stress, overwork or sexual contact. The clinical manifestations of each subsequent episode of genital herpes may be mild, but their consequences are usually very severe.

As for the atypical form of the disease, it is characterized by a somewhat blurred course with chronic inflammation of the genital organs.

This type of genital herpes manifests itself as follows:

mild swelling of the external genitalia appears;
areas of erythema are present;
small bubbles;
constant itching and burning sensation;
profuse, persistent leucorrhoea.

The long course of the disease is also characterized by enlargement and pain of the lymph nodes.

Diagnosis and treatment methods for genital herpes

If you notice symptoms characteristic of genital herpes, you must immediately visit a venereologist who will prescribe a number of diagnostic measures:

scraping of the vagina and cervix;
urethral smear;
analysis of histological material of the fallopian tubes;
blood serum analysis for antibodies (allows you to detect even an asymptomatic type of disease).

Treatment of genital herpes is usually carried out with the use of antiviral drugs.

Most often, doctors prescribe the following drugs:

acyclovir;
valacyclovir;
famciclovir;
foscarnet and others.

Antiherpetic drugs can be produced in the form of ointments, suspensions, tablets or solutions for intravenous administration. It is important to understand that the sooner you start treating herpes, the more effective the therapy will be.

Classic drugs against herpes can be used alternately, as well as in combination with interferon, the deficiency of which can be called one of the most common causes of relapses of genital herpes. Quite often, doctors recommend combining antiviral treatment with therapy aimed at strengthening the immune system. Among other things, with genital herpes, personal hygiene, healthy eating and abstinence from sexual intercourse throughout the entire course of treatment are of no small importance.

Prevention measures

The main preventive measure for primary infection with the genital herpes virus is the use of barrier contraception (condoms) during casual sexual contacts. In this case, existing microcracks in the mucous membranes can act as a method of transmission of genital herpes.

We are well aware of such sexually transmitted diseases as AIDS, syphilis, gonorrhea. As for genital herpes, it is usually given a secondary role, but, in fact, it is no less dangerous. Just like AIDS, herpes cannot be completely cured and, once infected with this virus, a person becomes its carrier for the rest of his life. Although, unlike HIV infection, the herpes virus itself cannot cause death, nevertheless, neglected genital herpes can lead to an immunodeficiency state and cause cancer of the genital organs.

Genital herpes is a sexually transmitted disease caused by one of the many members of the herpesvirus family. This virus is a close relative of herpes simplex, which causes the well-known “lip fever.”

In terms of its prevalence, this disease ranks second among all sexually transmitted infections. According to experts, approximately every tenth Russian is infected with genital herpes.

Transmission of genital herpes occurs through sexual contact in the vagina, mouth and rectum. It is most possible to infect a partner during an exacerbation of the disease, however, even in the absence of rashes, the risk of transmitting herpes remains. In addition, in approximately 80% of patients, genital herpes occurs without visible manifestations. These people do not even know that they are infected, while being the source of infection.

A typical picture of the disease looks like this: bubbles appear in the genital area, which then grow, unite with each other and, bursting, form painful ulcers. In women, the vagina itself and its vestibule, labia and cervix are most often affected. Less commonly, rashes are located on the pubis, thighs, buttocks and perineal area.

Manifestations of genital herpes are very painful. Sometimes a person gets away with an asymptomatic form, but in other cases, ulcers do not allow the patient to walk, sit, or go to the toilet calmly. Some, due to severe pain, cannot even sleep at night; in simple terms, they “climb the wall in pain.”

Psychological experiences are often added to physical suffering: irritability, fear of new rashes, thoughts about the impossibility of having healthy children, fear of infecting a loved one, a feeling of uselessness, loneliness... Suicidal thoughts may even arise.

Genital herpes not only causes physical and mental pain, but also causes weakened immunity, causes chronic diseases of the internal genital organs and can ultimately cause both female and male infertility. Genital herpes is especially dangerous for pregnant women, who may develop pregnancy pathology and become infected with the fetus and newborn.

Treatment

Unfortunately, the herpes virus tends to persist in the body throughout life. And, having declared itself publicly once, the disease can appear again and again. Therefore, we must keep in mind that modern medications can only shorten the duration of the disease and reduce its severity, but cannot “get rid of the virus once and for all.”

Classic drugs for the treatment of genital herpes are acyclic nucleosides (acyclovir, valacyclovir, famciclovir). However, recently an increasing number of viruses resistant to acyclovir (and similar drugs) have appeared. Therefore, it is recommended to alternate acyclic nucleosides with each other (for example, acyclovir with valacyclovir) or use them together with interferon drugs. Interferon is one of the most powerful antiviral proteins in the body. It recognizes the infectious agent that has entered the cell and prevents its reproduction. It is believed that it is the lack of interferon in the body that causes relapses of herpes.

It is better to use drugs that simultaneously contain interferon and acyclovir. The only product in the world that contains both acyclovir and interferon is herpferon ointment. Considering the painfulness of genital herpes, lidocaine was also included in the ointment, which provides an analgesic effect.

According to clinical studies, the use of herpferon for genital herpes in 85% of patients led to complete recovery on the 5th day. This figure was 3.5 times higher than that of the group receiving classical treatment with acyclovir. In patients who used herpferon, general malaise and headache stopped much earlier, and itching, pain and fever at the site of the rash disappeared faster.

Prevention

Prevention of recurrent infections

Repeated episodes of genital herpes appear under the influence of factors unfavorable to the immune system. These include: illness, prolonged exposure to the sun, hypothermia, the onset of menstruation, pregnancy, and taking hormonal medications. Herpes can also worsen due to stress.

Therefore, you should not neglect a healthy lifestyle, proper nutrition and taking vitamins. Existing diseases should be detected in time and treated under the supervision of a doctor. You need to avoid prolonged exposure to the sun and hypothermia, and protect yourself from stress. And, of course, maintain intimate hygiene and promptly identify and treat concomitant sexually transmitted diseases.

In any case, if you have rashes characteristic of genital herpes, you should not postpone a visit to a specialist.

Prevention for a healthy person

How to protect yourself from genital herpes? First of all, we must remember that absolutely safe sex does not exist. Even a condom, while greatly reducing the risk of infection, does not provide a complete, one hundred percent guarantee of protection against genital herpes.

A healthy person should avoid “casual” relationships, be sure to use barrier contraception methods, and preferably in combination with emergency prevention measures. After suspected unprotected contacts, it is recommended to conduct an examination to identify genital herpes and other sexually transmitted diseases.

We also must not forget about the rules of hygiene. No wonder everyone has their own personal towel. After all, for example, if you use a towel after a person with genital herpes, you can easily become infected yourself.

It must be borne in mind that during oral contact, herpes from the lips easily spreads to the genitals. Therefore, you need to engage in oral sex using special latex wipes. And when rashes appear on the face and lips, you should abstain from this pleasure altogether.

There may be cases of self-infection with genital herpes, when the virus is transferred from the lips by dirty hands to the genitals. And here again the banal rules of personal hygiene come to our rescue. Thorough hand washing (especially during the onset of fever on the lips), having separate towels for the face, hands and body will protect you from such trouble.

Emergency prevention

The use of barrier contraceptives, especially during an exacerbation of genital herpes, does not exclude the possibility of infection. Therefore, after suspicious sexual contact or contact with a carrier of the herpes virus, in addition to a condom, special means should be used for emergency prevention of the disease. One of these drugs is the drug herpferon. If you use herpferon ointment within 1-2 hours after intimacy, the likelihood of avoiding infection with genital herpes will increase significantly.

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.

How is genital herpes transmitted?

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.

Classification

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:

genital herpes in women;
genital herpes in men;

Infection of the rectum and skin around the anus.

The mechanism of development (pathogenesis) of genital herpes

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.

Symptoms 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:

permanent or temporary decrease in immunity, including HIV infection;
hypothermia or overheating;
concomitant diseases, for example, diabetes mellitus, acute respiratory infection;
medical interventions, including abortion and insertion of an intrauterine contraceptive device ().

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.

What does genital herpes look like?

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.

Recurrent genital herpes

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.

Diagnostics

Diagnosis of genital herpes is carried out using the following laboratory tests:

virological methods (isolation of the pathogen using a chicken embryo or cell culture, the result can be obtained within two days);
polymerase chain reaction (PCR), which detects the genetic material of the virus;
detection of pathogen antigens (its particles) using enzyme immunoassay and immunofluorescence assay;
detection in the blood of antibodies produced by the human body in response to the influence of HSV using enzyme immunoassay;
cytomorphological methods assessing cell damage during HSV infection (formation of giant cells with many nuclei and intranuclear inclusions).

It is recommended to take a test for genital herpes 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).

Treatment

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:

systemic antiviral drugs;
antiviral agents for topical use;
immunostimulating substances, analogues of interferons, which also have an antiviral effect;
symptomatic drugs (antipyretics, painkillers).

Acyclovir therapy

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.

Alternative drugs

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.

Local preparations

Some antiviral medications used to treat rashes come in the form of an ointment. Among them the following can be noted:

Foscarnet, applied to the skin and mucous membranes;
Alpizarin, the drug is also available in tablet form;
Tromantadine is most effective at the first signs of herpes;
Helepin; also exists in oral form;
Oksolin;
Tebrofen;
Riodoxol;
Bonafton.

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.

Therapy of genital herpes with interferon drugs

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:

Allokin-alpha;
Amiksin;
Wobe-Mugos E;
Galavit;
Giaferon;
Groprinosin;
Isoprinosine;
Imunofan;
Polyoxidonium;
Cycloferon and many others.

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.

Prevention

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.

Infection and pregnancy

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.

How dangerous is genital herpes for a newborn?

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.