Genital, or sex Herpes - this is a disease of the genitals caused by the viruses of simple herpes (HPV or Herpes Simplex Virus, HSV). It is now known 8 types of herpes virus, of which genital herpes cause the first 2 types (HPV-1 and HPV-2). In 80% of cases, genital herpes was caused by WSV-2, 20% - HPV-1 or a combination of them.
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What is sex herpes
The virus of the first type more often causes the very first episode of genital herpes. Repeated manifestations of genital herpes are almost always associated with HPV-2. Genital herpes usually strikes outdoor genitals, crotch and rear area and (less often) vagina and cervical neck (vaginal and cervical herpes). In severe cases, the infection can switch to the body of the uterus and its appendages (uterine pipes and ovaries).
How often is sex herpes in women
Viruses of a simple herpes 1 and 2 types are infected to 90% of the adult population of the Earth. After infection, the herpes simplex virus penetrates into nervous nodes located near the spinal cord, and remains in them for life. However, the manifestations of genital herpes appear only in a small part of infected people.
In the US, 3% of the population reported the presence of episodes of genital herpes at least once in life, however, the tests have shown that more than 20% of the population has been infected with WSV-2. The total frequency of transfer of herpes during pregnancy - 2 per 100,000 genera (data in Europe).
The main way to transfer genital herpes - sex. Herpes virus is transmitted both with conventional genital contacts (usually HPS-2) and oral (WSV-1) and anal sex (WSV-2). Infection is possible in the absence of a sexual partner of any manifestations of the disease more than 50% of cases. Household path of infection (for example, through personal hygiene objects) with genital herpes, it is rare. The probability of infection is higher, if there are manifestations of herpes or damage to the skin and mucous membrane (wounds, cracks). The common likelihood of infected from a man's infected partner for a woman is about 17%. Using a condom reduces this probability almost 2 times.
Who more often sick genital herpes
Genital herpes more often people are sick, subject to one or several risk factors:
- Reducing immunity (for example, after hypothermia, in the treatment of corticosteroid hormones or chemotherapy). Reducing immunity causes the virus dormant in nerve nodes and the appearance of symptoms of the disease.
- Several sexual partners. This increases the probability of primary or re-infection with a virus. Re-infection can also cause infection activation
- Unprotected sex (without a condom). Using a condom reduces the likelihood of infection
How the genital herpes is manifested in women
The main manifestations of genital herpes are:
- The formation of small filled bubbles filled with turbid liquid. They may appear on the inner surface of the thighs, around the rear pass, in the perineum, on the surface of the outer genitals, in the urethra, the vagina and the cervix. The appearance of bubbles is preceded by redness and itching of the skin. In 5-7 days bubbles burst. Erosions or ulcers are formed on the site of burstings, which are gradually listed and replaced with healthy skin within 1-2 weeks
- Itching, burning and pain in the appearance of bubbles
- Itching and tingling when urination (happens with the defeat of the urethra)
- Increase in inguinal lymph nodes
- Raising temperature, muscle pain, general malaise
These signs appear only with exacerbations of genital herpes, which are usually 1-2 weeks. Throughout the rest of the time there is no infection.
How to diagnose genital herpes in women
Consultation of an experienced gynecologist and careful inspection are very important, because the similar signs and symptoms may be observed in other infections of the genital organs or their combination, as well as some non-infectious diseases of the skin and mucous membranes. In addition to the complaints of the patient and gynecological inspection, various laboratory methods are used to diagnose genital herpes.
The most reliable methods are virological research and environmentality. With a virological study, the contents of bubbles are placed on special cellular media or chicken embryos in which the virus reproduction occurs. However, the problems of virological laboratory diagnostics and the low quality of cell cultures often cast doubt on the results of such studies during herpes offered in Russia now.
In generality, PCR is usually used, polymerase chain reaction) determine the presence of a DNA of the virus in the discharge from the patient. PCR is distinguished by almost 100% sensitivity (the ability to identify the virus) and specificity (the ability to distinguish the east herpes virus from other viruses). In modern laboratories, it is possible to distinguish between the viruses of simple herpes of the 1st and 2nd types. It is important to determine the forecast of the disease, since VVG-2 is much more commonly gives re-exacerbations.
As auxiliary methods, the definition of antibodies to the blood virus using an immunoferment analysis (ELISA) and immunofluorescence reactions (reef). Antibodies to WSG-1 There are many people, their detection does not indicate the presence of sex herpes or the fact of sexual transmission of the virus.
One detection of antibodies to HPV in the blood is not enough to diagnose genital herpes, which doctors sometimes forget about. It should not be misleading the patient, especially since the women find antibodies to HPV-2 are more likely (with an average frequency of 25% in Europe). Only the presence / absence of antibodies against HPV-2 (and even more so - against HPV-1) cannot unambiguously confirm or refute the infection of a woman with sex herpes without PCR data or virus allocation. From the moment of infection before the appearance of antibodies in the blood, 6-12 weeks can pass. Different tests have their own sensitivity and specificity indicators.
At the same time, the definition of antibodies is very important in certain difficult cases of diagnosis, during pregnancy periods, to clarify the features of the disease.
The direct immunofluorescent method (FIF) on the detection of virus antigens in a smear is less sensitive and specific, and today it is used less often, usually with inaccessibility PCR.
Why treat herpes genital organs? Risks for women
All cases of genital herpes require mandatory treatment. Otherwise, the development of complications, the main of which are:
- Saving symptoms for a long time (from several weeks to several months)
- Acute urine delay due to dysuria or neuropathy
- Infection of the sexual partner (probability from 4%)
- The spread of infection by the body with penetration into the brain and massive damage in the internal organs. It rarely happens, with immunodeficiency. Extragolyteal herpes of leather on different parts of the body (brushes, buttocks, dairy glands), mucous membranes of the eyes, with oral sex - herpetic pharyngitis, stomatitis, Haylitis.
- Together with the human papilloma virus, a simple herpes virus increases the likelihood of cervical cancer.
The long-term complication of genital herpes in women can be psychological and psychosexual problems - more than 70% of women in Europe celebrated various experiences and inclined to depression after the first episodes of genital herpes. Therefore, the psychological support for the sick woman, her training and positive motivation, which emphasizes all modern studies of herpes problems.
Genital herpes and pregnancy
Fetal infection with herpes virus from an infected mother can occur during pregnancy, although the probability of transmission as a whole is rather low. However, with primary genital herpes, this probability can reach 50%. Most often, infection occurs during childbirth (perinatal), when passing the fetus through herpes affected by herpes. However, Cesarean section does not exclude the transfer of herpes newborns.
Future infection can cause severe damage to the nervous system (35% of cases of infection), eyes and skin (45%) and lead to disability and even death.
The total frequency of transfer of herpes newborns from infected mothers reaches 5%. The presence of antibodies to HPV-2 is associated with a lower risk of herpes infection during pregnancy.
Approach to maintaining pregnant women with infection due to herpes viruses should be very careful. The active antiviral therapy of herpes during pregnancy is not always possible and is carried out only by appointing the attending physician and under its control.
Treatment of genital herpes
Treatment of sexher herpes does not lead to the complete disappearance of the virus in the body, but allows you to quickly eliminate the manifestations of the disease and can reduce the frequency of new exacerbations.
The main method of treating genital herpes and in men, and in women is the use of special antheherpety drugs: antiviral chemotherapy.
Proven efficacy with herpes 4 drugs: acyclovir (zovirax and its analogs), Valacyclovir (Valtrex), Famatikovir (Famvir) and Penciclovir (Denavir). Of these, only the first 3 drugs are registered in Russia. Most often used acyclovir. The earlier drugs are prescribed, the greater the effectiveness of treatment. Maximum efficiency is achieved at the beginning of treatment in the first day after the appearance of rashes or immediately before their appearance.
With frequent exacerbations (more than 6 times a year), long-term preventive (supportive) treatment for several months. This treatment reduces the frequency of recurrences by 75% and reduce the severity of re-exacerbations. Since treatment has a challenging and long-term treatment, the decision on the choice and appointment of drugs for the prevention of relapses is taken by the attending physician, including various factors, including pshilogical aspects and patient motivation.
The choice of any healing means in addition to specific antiviral therapy should be strictly justified.
The appointment of other drugs (immunomodulators, adaptogen, inductors of interferon and others) is widely practiced in our country, and there is no scientific basis. We urge you with caution to treat proposals to increase immunity or fully clean the body from herpes - at least ask how the effect can be expected from them, and how they studied at herpes.
Herpes vaccines, which have proven efficacy and safety in a genital infection, also does not exist.
In herpes of genital organs, symptomatic therapy is possible: local treatment, allowing to reduce herpes symptoms (pain, burning, itching), it is possible to use soft analgesics.
Remember that a 100% guarantee of complete and one-time cure of genital herpes is unresolved, and its proposals can talk about a incompetent or unscrupulous approach to treatment.
