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Herpes (from Greek – “creeping”) is a group of widespread diseases caused by viruses of the Herpesvirales order of the Herpesviridae family. The disease is manifested by lesions of the skin, mucous membranes, nervous tissue, and sometimes internal organs. The clinical picture develops in states of unstable homeostasis. Basically, herpes is a dormant infection, which is characterized by persistence (hidden or latent carriage).
The danger of herpes is proved at:
Pregnancy – provokes pathologies of the fetus and newborns, secondary infertility, premature birth, neonatal fetal death;
Immunodeficiency states of the body – activates the mechanism of replication of the immunodeficiency virus, herpes – an indicator of HIV infection (aggravates immunosuppression), causes autoimmune diseases;
Neoplastic (oncological) diseases – herpes simplex virus of the second type in association with mycoplasmas, chlamydia and other pathogens – a provocateur of the development of malignant pathologies;
Atherosclerosis induction – negatively affects the neuropsychic health of a person.
Herpes simplex type 1
The herpes simplex virus combines the first and second serotypes of the herpes virus. Herpes simplex virus type 1 is referred to as HSV-1 or HSV-1 (Herpes simplex virus XNUMX). It is also referred to in the clinical literature as oral (oral) or labial (labial) herpes.
HSV-1 is the most common type of herpes of all those with clinical significance for medicine. Infection usually occurs in the first years of a person’s life. The most typical localization of oral or labial herpes is the lips and nasolabial triangle.
Under certain circumstances (immunodeficiency), the virus can also infect:
The mucous membrane of the genital organs, oral, nasal cavity and eyes;
The skin of the fingers and toes (most often the area of the nail fold of the fingers);
Tissues of the nervous system.
Herpes simplex viruses types 1 and 2 are characterized by:
Neurotropism is a predominant lesion of the cells of the nervous system due to the presence or formation in them of receptors complementary to viruses;
Neurovirulence is the ability to cause diseases of the nervous system;
Suppression of phagocytosis (immunity link) to an incomplete level.
Tropism for nervous tissue and the ability of HSV to inhibit phagocytosis are factors indicating the ability of herpes simplex viruses to avoid exposure to the immune system, which makes latent carriage in nervous tissue possible. Persistence in the cells of the nervous system is an important protective and adaptive mechanism of herpes viruses, which allowed HSV-1 to become as widespread as possible in the human population.
For viruses of a simple type, two phases of being in the body are characteristic – latent and manifest:
The clinical manifestation of HSV appears 1-3 times a year, the pathogenesis on the lips develops and ends within seven to ten days. The frequency of relapses depends on the immune status of a person; people with immunodeficiency conditions are more likely to get sick;
The latent (hidden) phase, invisible to the immune system, lasts the rest of the virus’s existence.
Symptoms of herpes type 1
The most common clinical form of HSV-1 in children is vesicular lesions of the lips, sometimes acute respiratory disease. In adults, in addition, lesions of the skin, conjunctiva and cornea of the eyes are observed. With oral-genital contact, HSV-1 manifests itself as a lesion of the genital organs. Women become infected with the genital form of HSV-1 much more often than men.
General clinical sign of HSV-1 – intoxication syndrome:
Fever;
General weakness;
Headache;
Muscle and joint pain.
igg (IgG) positive
For the differential diagnosis of HSV-1 and HSV-2, laboratory methods are used, the purpose of their use is to:
Establishing the type of pathogen based on affinity with the corresponding immunoglobulin;
Differentiation of the pathogen, for example, HSV-1 from HSV-2;
Determining the stage of the disease (acute, chronic, latent).
An approximate interpretation of the results of the study in the detection of IgM and IgG immunoglobulins:
IgM is determined by laboratory methods, starting from the fifth day of the disease, and IgG is determined only from the second week from the onset of the disease;
IgM circulates in the peripheral blood for up to three months, and IgG is present in the blood for many years, in the chronic course of the disease – for life;
IgM does not penetrate the placenta during pregnancy, and IgG penetrates the placenta in large quantities, that is, its detection in a pregnant woman who does not have a clinical manifestation of herpes means the body is ready to protect itself in case of accidental infection during pregnancy;
IgM is unable to neutralize the virus and is only a factor in triggering immune processes in the body, while IgG is able to neutralize the virus, therefore it is a factor in protecting the body.
The detection of IgG specific for HSV-1 in peripheral blood in high titers during the clinical course of the disease using the PCR technique indicates the development of intense immunity to this disease.
The detection of IgG in low titers with a negative PCR reaction indicates a previously transferred disease and that the herpes virus in the body is in a latent state.
Herpes simplex type 1 during pregnancy
Women are generally more susceptible to the herpes simplex virus. It has been proven that the herpes clinic is provoked by conditions that weaken the body’s immune system. Pregnancy and its manifestations (intoxication, hormonal changes) are certainly factors that disrupt homeostasis. Herpes during pregnancy in the form of a clinical manifestation can occur with a high degree of probability.
Herpes simplex virus type XNUMX is very dangerous for pregnant women because:
In the normal state of the body, it does not affect the organs of the genital area, meanwhile, during pregnancy, the development of pathogenesis can result in damage to the nervous tissues of the fetus (the virus penetrates the placental barrier);
During pregnancy, HSV-1 is highly undesirable, especially with the initial development of clinical manifestations against the background of the absence of protective antibodies (specific immunoglobulins) in the blood, which are formed in response to the disease. Moreover, antibodies to HSV-1 do not protect a pregnant woman from HSV-2 (genital herpes);
The herpes simplex virus that enters the body in the first half of pregnancy can cause deformities in the fetus;
HSV-1 or HSV-2, introduced into the body of a pregnant woman in late gestation, can cause infection of the fetus during childbirth.
Herpes type 1 treatment
Treatment of viruses of this group has important features:
Total destruction of the virus is impossible;
There are no preventive drugs;
Viruses are not susceptible to antibiotics;
With a short course of HSV-1, drug treatment is inappropriate.
The only direct acting drug is acyclovir. The pharmaceutical industry produces acyclovir in three formulations (tablets, ointment and solution).
The use of acyclovir in accordance with the instructions can significantly reduce:
The duration of the clinical course of the disease;
The frequency of relapses of the disease in clinical form.
Herpes simplex virus type 2
Herpes simplex virus type 2 is briefly called HSV-2 or HSV-2 (Herpes simplex virus 2). In the clinical literature, it is referred to as genital or anogenital (localization of lesions in the anus and genitals). Under certain conditions, genital herpes can affect other parts of the body, even systemic lesions have been established with PVH-2. HSV-XNUMX is usually transmitted sexually.
Distinctive signs of the clinical course of the disease caused by the herpes simplex virus of the second type:
The number of HSV-2 seropositive persons increases with the onset of puberty and is directly proportional to the number of sexual partners;
Women are six times more likely to become infected with HSV-2 than men;
Antibodies to HSV-1 do not prevent HSV-2 infection;
Genital symptoms (skin lesions in the genital area, perineum, anus, lower extremities and buttocks) in about 80% of cases are a consequence of HSV-2 infection;
Asymptomatic or atypical HSV-2 occurs in approximately 70% of cases of IgG detection;
For HSV-2, unlike HSV-1, frequent relapses of clinical manifestations are characteristic (up to 75% of patients with genital herpes suffer from it constantly);
HSV-2 in 15% of cases causes malignancy (malignant degeneration) of the tissues of the cervix in women and the prostate gland in men. Therefore, persons seropositive for VLR-2 are recommended to be regularly screened for tumor markers;
HSV-2 in women is accompanied by a high incidence of gynecological diseases, leading to a decrease in reproductive function.
IgG antibodies to herpes type 2
The principles of immunological diagnostics are identical to the methods used in the study of HSV-1. Examination of a woman planning a pregnancy for the presence of IgG to herpes of the second type helps to identify gynecological diseases and conduct timely treatment, which increases the likelihood of a normal gestational period and the birth of a healthy child. A similar serological study to determine IgG must be passed to the father of the unborn child. Moreover, if IgG is detected in the blood, it is recommended to use PCR to make sure that there is no HSV-2 in the sperm of the man being examined.
Herpes type 2 during pregnancy
According to information published in available sources intended for neonatologists, a comparative description of two types of herpes simplex during pregnancy is given. The second type virus in pregnant women provokes miscarriages and polyhydramnios, increases the likelihood of miscarriage, and in men is a common cause of infertility. The most formidable consequence of HSV-2 infection during pregnancy is neonatal herpes (NG).
Neonatal herpes is a disease of newborns caused by infection of the fetus with HSV-2 or HSV-1, with an unfavorable prognosis for the newborn. This disease occurs with a frequency of approximately one case per two thousand births. The lethality of newborns, according to some reports, reaches 70%. Timely detection and active therapy reduces mortality by up to 20%. The prognosis of the negative development of neonatal herpes is higher in children infected with HSV-2.
Treatment of herpes virus type 2
Treatment for HSV-2 is similar to that for herpes simplex type XNUMX. In view of the more severe course of the disease, the treatment regimen, according to indications, includes immunocorrectors of various types, agents that strengthen the body’s defenses (vitamins, biostimulants), as well as physiological solutions to reduce the concentration of the pathogen in the blood. It is possible to use other drugs of different pharmacological groups.
Herpes 3 types
The third type of herpes virus is the varicella-zoster virus or herpes zoster (VBO-OG, Human herpesvirus 3, HHV-3, Varicella-zoster (VZV). Herpes Zoster virus enters the body of a susceptible person by airborne droplets or household contact. Infection causes chickenpox in childhood.After recovering from chickenpox, the child remains a lifelong carrier of VZV.The virus is localized in the tissues of the nervous system.Relapses of herpes zoster in adults cause a disease called herpes zoster (SH).
Symptoms of VVO-OH in childhood are pronounced. Usually the disease has a benign course (mostly complete recovery). The acute phase lasts up to two months.
The main symptoms of chickenpox:
Severe skin itching;
High body temperature;
Extensive skin eruptions (vesicles).
The localization of the rash coincides with the projection of the nerve trunks on the skin. After the disappearance of clinical symptoms, the virus passes into an inactive state and is localized in the nervous tissue. The herpes zoster virus carrier lasts for life. Relapses can occur in people with a decrease in the protective (protective) properties of immunity. In the classical view of epidemiology, zoster recurs and manifests clinically in people over fifty years of age. In recent years, this pattern has been broken. The recurrence of the disease caused by herpes zoster is called “shingles (herpetic) lichen”.
The main symptoms of shingles are:
Severe pain along the nerve trunks for 3-12 days;
Hyperthermia (increased overall body temperature);
Swelling and redness of the skin, after 1-3 days – encircling rashes in the form of vesicles;
After 2-3 weeks, the disease ends with recovery after scarring of the crusts at the site of the vesicles.
Complications of herpetic lichen are ganglionitis (inflammation of the nerve node) or ganglioneuritis (inflammation of several nerve nodes). Diseases are manifested by allergies, skin ulcers, conjunctivitis and eczema. Regular relapses of herpetic lichen are characteristic of immunodeficiencies.
Treatment of diseases caused by type 3 herpes (chicken pox in children and herpes zoster in adults) is carried out in a hospital or on an outpatient basis after differential diagnosis and determination of the individual characteristics of pathogenesis in a patient.
Herpes 4 types
Herpes virus type 4 – Epstein-Barr virus (EBV) or Epstein-Barr virus, Human Herpes Virus type XNUMX. Epstein-Barr virus causes infectious mononucleosis. The clinical picture develops in individuals with immunodeficiencies.
Infectious mononucleosis is a lesion of the mucous membranes of the oropharynx and lymph nodes, which is characterized by high fever, possible damage to the liver and spleen, and changes in the morphology of blood cells (atypical mononuclear cells). People usually get mononucleosis during adolescence or young age. Infection is airborne or contact (including oral-genital). The incubation period is from 5 to 50 days.
The main symptoms of mononucleosis:
A sharp increase in body temperature up to 38-40 ° C;
Pain syndrome (headache, muscle, joint pain);
Feeling of chronic fatigue and drowsiness (remains up to several months after the disappearance of other symptoms);
Puffiness and swelling of the mucous membrane of the oropharynx (laryngitis and pharyngitis);
Gray or white-yellow coating on the tonsils;
Papular rash on the skin and mucous membranes, which lasts from one to three days, and then disappears without a trace;
An increase in the number of lymphocytes in the peripheral blood and the presence of specific (atypical) lymphocytes – mononuclear cells.
Diagnosis is supplemented by the detection of Epstein-Barr virus DNA by PCR. Treatment is carried out under the supervision of doctors of different specialties. The Epstein-Barr virus sometimes provokes the development of a malignant disease – Burkitt’s lymphoma.
Herpes 5 types
Herpes virus type 5 – cytomegalovirus (CMV) or HHV-5 (Human herpesvirus 5). Clinical symptoms of cytomegalovirus infection rarely develop. Basically, there is a sluggish virus carrier. Infection – airborne, contact (kissing, sexual intercourse, blood transfusion, in utero, through breast milk). Infection is confirmed by the detection of giant cells, cytomegals, in human blood. The clinical picture develops with a weakening of the immune system. The incubation period is up to 60 days.
Symptoms of cytomegalovirus infection resemble a cold:
High temperature, rapid fatigue;
Pain syndrome (head, joints, throat);
Unlike mononucleosis, there is no inflammation of the tonsils and an increase in regional lymph nodes;
Damage to the kidneys, liver, spleen, pancreas, central nervous system, eyes.
Cytomegalovirus can have a significant negative impact on the course of pregnancy. It crosses the placental barrier, causing infection and deformities in the fetus. Currently, this is the most common cause of neonatal pathologies, and sometimes the death of newborns.
A child with congenital cytomegalovirus infection may suffer from:
Underdevelopment of the brain;
Damage to the organs of hearing and vision;
Delayed general development;
Inflammatory phenomena in the respiratory and digestive organs;
Skin rashes.
Diagnosis of herpes type 5
CMV is diagnosed based on:
Instrumental methods – ultrasound study of blood flow in the vessels of the umbilical cord and uterus, measurement of heart rate (heart rate), determination of oligohydramnios, delays in the development of the fetus, pathologies of its internal organs;
Laboratory methods – cell detection by electron microscopy, PCR analysis, serological studies to detect antibodies to CMV.
The treatment of a pregnant woman and the feasibility of maintaining pregnancy is determined by the doctor based on a set of examinations. Primary infection after conception is a direct indication for artificial termination of pregnancy. General tonic drugs, immunocorrection and symptomatic therapy are prescribed as the main therapy.
Herpes type 6 in adults
Herpesvirus type 6 is referred to as HHV-6 or HHV-6. This is the common name for the human herpes virus of two homologous subtypes. In adults, the HCG-6A subtype shows activity in the form of one of the provocateurs of the development of multiple sclerosis.
The most important facts about the herpes virus type 6:
The presence of this particular type of herpes virus in the etiopathogenesis of multiple sclerosis has been proven;
The clinical picture of MS is a chronic inflammation of the nervous tissues, including the myelin layer of the brain – demyelination, which is accompanied by degenerative processes in the nervous tissues;
Without treatment, multiple sclerosis inevitably leads to disability, social and psychological isolation of the patient.
There are four types of multiple sclerosis:
Primary progressive multiple sclerosis. A steady deterioration in the patient’s condition is characteristic, a short-term remission of the process is possible, and then a rapid relapse;
Secondary progressive multiple sclerosis. Periods of exacerbation after the first wave of the disease are characteristic;
Remitting progressive multiple sclerosis (lat. remitto – weaken). At a certain point, the signs of the disease disappear, and then there is a sharp return and an increase in symptoms;
Relapsing-relapsing multiple sclerosis. Characterized by periods of disappearance and recovery of symptoms, there is a long-term stable condition of the patient without visible signs of deterioration in well-being.
Symptoms of herpes type 6
Early symptoms of multiple sclerosis:
Rapid fatigue, depression;
Unsteady gait, impaired coordination of movement;
Change in sensitivity (temperature, vibration and tactile).
The main symptoms of MS, which characterize significant changes in the body, in addition to the early signs, which usually persist and worsen:
Cognitive disorders, rapid mood swings;
Visual disturbances (defocusing in the form of doubling, decreased visual acuity);
Difficulties with articulation when speaking (unusual pronunciation of words);
Dysphagia (violation of the act of swallowing);
Spasms and convulsions;
Deterioration of sensitivity (lack of pain reaction);
Incontinence of feces and urine, constipation and diarrhea;
Erectile disfunction.
The nature and degree of manifestation of symptoms of multiple sclerosis are diverse, which is associated with the unpredictability of foci of damage to the nervous tissue.
Herpes type 6 treatment
Used to treat multiple sclerosis:
corticosteroids;
Antioxidants, antiaggregants, angioprotectors;
proteolysis inhibitors;
Plasmapheresis with drugs;
Immunomodulators, for example, Copaxone;
Stimulators for the production of interferon;
Immunoglobulins intravenously.
Drugs of other groups may be indicated, depending on the stage and form of the disease. Symptomatic therapy and medical and social rehabilitation of patients with multiple sclerosis prevents the development of complications.
Herpes 7 types
Herpesvirus type 7 is referred to as HHV-7 or HHV-7. Often this type of virus is combined with the herpes virus of the sixth type. HCG-7 is a possible cause of chronic fatigue syndrome and oncological diseases of the lymphoid tissue.
Symptoms of herpes type 7
There are the following main symptoms of herpes type 7:
Weakness against the background of lack of physical tension, increased nervousness;
Light physical activity is accompanied by rapid fatigue;
Excessive increase in suspiciousness;
Chronic depressive conditions;
Sleep disorders (insomnia);
Prolonged (up to 6 months in a row) subfebrile body temperature;
Swollen lymph nodes.
History taking and physical research methods are supplemented by laboratory tests:
Polymerase chain reaction (PCR) – detection of the genetic material of the virus,
Enzyme immunoassay (ELISA) – determination of IgG titers;
Immunogram with the definition of subpopulations of T- and B-lymphocytes (decrease in the content of natural killers and an increase in circulating immune complexes).
Treatment of the herpes virus type 7 consists in antiviral therapy aimed at strengthening the immune system. Preventive measures have not been developed.
Herpes 8 types
The herpes virus type eight is designated as HHV-8 or HHV-8. This pathogen affects lymphocytes, moreover, it can be in the body of healthy people in a latent state for a long time. The herpes virus type 8 is transmitted by contact, during organ transplantation, through the placenta from mother to fetus, during pregnancy and during childbirth, when the fetus moves along the birth canal. The disease is activated due to radiation therapy.
Symptoms of herpes type 8
Symptoms of herpes type 8 should be considered, given that HCG-8 causes a number of cancers:
Kaposi’s sarcoma;
primary lymphoma;
Castleman disease.
Kaposi’s sarcoma
Kaposi’s sarcoma is an oncological disease characterized by the formation of multiple tumors due to malignant degeneration of blood vessels.
Kaposi’s sarcoma is localized to:
Skins;
mucous membranes;
Lymph nodes;
Internal organs.
There are four types of Kaposi’s sarcoma:
Classic type. It occurs in men of advanced and senile age. The disease manifests itself on the skin of the hands, on the auricles and cheeks, on the forehead and oral mucosa, as well as on the genitals in the form of multiple symmetrical spots, nodules and plaques;
endemic type. Widely distributed only in Africa;
immunosuppressive type. Develops against the background of taking immunosuppressants;
epidemic type. It develops as a complication in AIDS patients. It is characterized by a very rapid course of pathogenesis with damage to the lymph nodes and internal organs.
Treatment of Kaposi’s sarcoma: surgical method, medication (introduction of interferon, cytostatics, antitumor and antiviral drugs), radiation therapy.
Primary lymphoma
Lymphoma (cancer of the lymph nodes) is an oncological disease with a predominant lesion of the serous membranes, which is characterized by the accumulation of fluids containing tumor cells in the body cavities. Primary lymphoma is treated with chemotherapy alone.
Castleman disease
It is manifested by an increase in lymph nodes (subclavian and mesenteric, as well as in the lungs and on the neck). There are three types of Castleman’s disease: hyaline vascular, plasma cell, and multifocal. Treatment of the disease is surgical or with radiation therapy.