Herpes
The content of the article:
- Causes and risk factors
- Forms of the disease
- Symptoms
- Diagnostics
- Treatment
- Possible complications and consequences
- Forecast
- Prevention
Herpes is a collective designation of a group of diseases caused by a virus of the Herpesviridae family.
According to some reports, up to 90% of the world's population is infected with the herpes virus, although no more than 5% of them develop clinical manifestations. With this pathology, the virus persists in the body throughout life; infection occurs more often in childhood. Despite the lifelong nature of the disease, symptoms appear only when exposed to provoking factors and weakening of the immune defense; in most patients, the disease is asymptomatic or with rare exacerbations.
The defeat of the border of the lips with the herpes virus
The herpes virus can infect almost any organ, the disease is more difficult to carry with the primary infection, when immunity has not yet been formed in relation to the pathogen. Subsequently, relapses of herpes infection are less pronounced or hidden.
The penetration of viruses into the host cells occurs in steps: the virus connects with the subordinate cell, merges with its membranes, its DNA is introduced into the cell nucleus, as a result of which the assembly of viral particles by the affected cells begins; the synthesis of their own proteins is sharply inhibited.
Viral proteins begin to be synthesized by infected host cells 2 hours after infection, within 10 hours new viral particles appear in the blood, collected by the cells of the host organism. The maximum concentration of the herpes virus is reached 15 hours after the first particles enter the body.
Synonym: herpes infection.
Causes and risk factors
The causative agents of herpes infection are the corresponding viruses of the Herpesviridae family. In total, there are more than 70 representatives of this family and 8 antigenic serotypes of the herpes virus:
- herpes simplex virus type 1 (HSV-1, HSV-1, herpes simplex);
- herpes simplex virus type 2 (HSV-2, HSV-2, herpes simplex);
- herpes virus type 3 (herpes zoster);
- type 4 virus - Epstein-Barr virus;
- type 5 virus - cytomegalovirus.
The importance of herpes viruses of types 6, 7 and 8 for the development of the pathological process has not been fully understood.
Infection occurs, as a rule, by contact, household (through household items) or by airborne droplets; genital herpes is spread through unprotected sex. Intrauterine transmission from mother to child is possible, as well as at the time the child passes through the mother's birth canal during childbirth.
Herpes is caused by the Herpesviridae virus. There are more than 70 of its types
In the external environment at room temperature and normal humidity, the herpes simplex virus persists for a day, at a temperature of + 50 … 52 ° С it is inactivated after 30 minutes, and at low temperatures (from −70 ° С) it is able to remain viable for 5 days. On metal surfaces (coins, doorknobs, water taps), the virus survives for 2 hours, on wet sterile medical cotton wool and gauze - during their drying time (up to 6 hours).
Risk factors provoking an exacerbation of herpes infection:
- taking drugs that suppress the immune system (cytostatics, glucocorticosteroids, etc.);
- secondary immunodeficiency;
- exacerbation of chronic diseases;
- acute diseases (infectious and non-infectious);
- acute stressful effects;
- persistent psycho-emotional overstrain;
- inadequate physical activity leading to a breakdown of adaptive mechanisms; etc.
Forms of the disease
Various types of herpes viruses cause the following diseases:
- HSV-1 causes herpes of the skin and mucous membranes, orofacial lesions (lesions of the border of the lips, wings of the nose, skin of the face), herpetic inflammation of internal organs;
- HSV-2 causes genital herpes, congenital herpes lesions (intrauterine infection);
- herpes zoster - the cause of herpes zoster (synonym - herpes zoster) and chickenpox (synonym - chickenpox);
- Epstein-Barr virus causes infectious mononucleosis, nasopharyngeal carcinoma, Burkitt's lymphoma;
- cytomegalovirus provokes the development of cytomegaly, congenital CNS pathologies (cerebral calcification), pathology of the retina, lungs, large intestine, esophagus, liver (hepatitis).
Symptoms
Symptoms of a herpes infection vary depending on the type of pathogen.
Herpes simplex and genital herpes have similar symptoms:
- local redness, itching and burning of the skin;
- painful small vesicles with transparent contents containing viral particles, increasing in size and merging into large foci, which are located in the place of preliminary redness and itching of the skin;
- opening of the vesicles with the formation of ulcers, covered with crusts, with deep lesions, it is possible to form skin defects after the reverse development of the process.
Genital herpes affects the genitals
In addition to the skin, the virus sometimes infects the cornea of the eye and the conjunctiva (herpetic keratitis, keratoconjunctivitis), the mucous membrane of the oral cavity and pharynx (herpetic gingivostomatitis, herpetic sore throat), phalanges of the fingers with the involvement of the nail fold and brain tissue in the brain (herpetic brain tissue) membranes (herpetic encephalitis, meningitis), internal organs.
Herpetic infection in this case proceeds in waves: during the period of exacerbation, specific skin manifestations are formed, after the resolution of which a period of remission begins. Remission can be arbitrarily long, the frequency of exacerbations of the disease is purely individual, the seasonality of exacerbations for herpes is uncharacteristic. In some cases, after the debut, herpes infection is asymptomatic, without obvious manifestations.
Herpes zoster (chickenpox) infection is characterized by a papulovesicular rash and the following accompanying symptoms:
- during the period of harbingers - headache, deterioration in general well-being, drowsiness, feeling of weakness. They develop 1-2 days before the appearance of the rash;
- a sharp increase in temperature, coinciding in time with the development of skin manifestations;
- eruptions of a jerky (wavy) nature;
- intense itching.
Chickenpox - a type of herpes virus (zoster)
The rash with chickenpox is specific: initially small red spots (1-3 mm) appear, transforming first into papules, and then into vesicles filled with transparent contents. The bubbles are surrounded by a rim of a more intense red color. After 2-3 days from the appearance of the first skin manifestations, the bubbles dry out and become covered with crusts, which are subsequently rejected. With chickenpox, the growth layer of the skin is not damaged, therefore, there are no defects in the place of the bubbles, however, if the vesicles are damaged or the crusts formed, small punctate scars may form.
In parallel with the rash on the skin, several (usually 1-3) bubbles (enanthema) appear in the oral cavity, which open within 1-2 days, exposing small ulcers or erosions with a grayish bottom, surrounded by a hyperemic corolla.
The incubation period of chickenpox is from 11 days to 3 weeks, depending on age (in patients under 30 years old, it is somewhat shorter, on average - 2 weeks). Skin manifestations persist for 2-9 days, which is determined by the severity of the disease. The disease proceeds, as a rule, benign, after the cure, stable lifelong immunity is formed.
The symptoms of shingles are similar to those of chickenpox. The main difference is the localization of the rash: in the place where the nerve endings of the affected nerve trunk exit to the surface of the skin it innervates. Vesicles with herpes zoster are located in a group, skin manifestations are combined with intense soreness, itching, and an increase in regional lymph nodes. Uncomplicated infection lasts 10 days to 1 month.
It is characteristic that the herpes zoster virus, which infects a person in childhood and provokes the development of chickenpox, for a long time after recovery, latently persists in the nerve cells, causing herpes zoster in adulthood (under conditions favorable for exacerbation of infection).
Diagnostics
The diagnosis of herpes simplex or herpes zoster, chickenpox is not difficult and is established on the basis of a characteristic clinical picture.
Laboratory diagnostics is indicated for atypical form of the disease, blurred course, in newborns, patients with immunodeficiency:
- immuno-point glycoprotein G-specific HSV test;
- scraping of the affected area of the epithelium with subsequent staining of the preparation according to Romanovsky - Giemsa;
- culturing viruses on the chorionallantoic membrane of chicken embryos;
- immunofluorescence method;
- biological research method (infection of experimental animals).
Treatment
There is no therapy that would completely remove fragments of viral DNA from nerve cells. Local and systemic antiviral drugs currently used reduce the frequency, duration and severity of relapses.
Antiviral agents are prescribed to treat herpes. Acyclovir is the most common drug
To eliminate the accompanying symptoms, the following groups of drugs are prescribed:
- analgesics;
- antipyretics;
- detoxifying agents;
- local anesthetics;
- immunostimulants.
Possible complications and consequences
Complications of herpes can be:
- intrauterine infection of the fetus (TORCH infection);
- violation of reproductive function (infertility) with damage to the cervix;
- neuritis, ganglionitis;
- weakening of immunity (development of secondary immunodeficiency);
- gangrenous and ulcerative necrotic lesions of soft tissues.
According to some reports, HSV stimulates the development of Alzheimer's disease.
Forecast
The DNA of herpes simplex viruses, herpes zoster is transported along the processes of nerve endings to the bodies of nerve cells, where it is forever embedded in the genetic apparatus, concentrating in an unproductive state for life. Under the influence of some triggering factors, the virus is activated and moves along the processes of the peripheral nerves to epithelial cells, where it provokes specific symptoms of the disease (exacerbation of herpes infection).
Prevention
In order to prevent herpes, it is recommended:
- use barrier contraception during intercourse, especially with an unfamiliar partner, refuse sexual relations in the presence of manifestations of genital herpes;
- use local antiseptics;
- observe personal hygiene measures (wash hands);
- when using public bathrooms - use individual disposable toilet seat covers (the virus lasts up to 4 hours on plastic);
- for pregnant women who have had genital herpes, it is imperative to inform medical professionals about this.
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Olesya Smolnyakova Therapy, clinical pharmacology and pharmacotherapy About the author
Education: higher, 2004 (GOU VPO "Kursk State Medical University"), specialty "General Medicine", qualification "Doctor". 2008-2012 - Postgraduate student of the Department of Clinical Pharmacology, KSMU, Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
