Almost all of us have heard about such a common problem as herpes. It is generally accepted that it looks like itchy blisters on the lips. But many people do not know about genital herpes, which causes no less trouble.

We will talk about the main signs of the disease, what needs to be done and what the consequences may be.

This is a viral disease caused by herpes simplex virus (HSV) type 2, less commonly type 1, and is transmitted primarily through sexual contact. Its characteristic symptom is the presence of rashes and blisters in the genital area.

In everyday life, its other name is very often found, like vesicular lichen.

It is one of the most common diseases transmitted through sexual contact. Approximately 10-30% of men and women worldwide are infected with HSV type 2, which is mainly responsible for the development of the disease.

About 90% of the population are carriers of HSV type 1, which is mainly responsible for rashes on the lips (labial), and very rarely spreads to the groin area.

About 16 percent of people between the ages of 14 and 49 have genital herpes. However, up to 90 percent of people who get sick do not know they have the virus. This is because many people have very mild symptoms that go unnoticed by them or are mistaken for another condition. Or no symptoms are noticeable at all. But sooner or later they will still have an outbreak.

Women are more likely to get the herpes virus than men, but the risk of transmission from man to woman is 5 times higher than vice versa. Once it reaches you, it remains in the human body for life, periodically making itself felt.

Genital herpes is a very unpleasant phenomenon, accompanied by a rash and itching in the genital area. By the way, a rash on the genitals is not necessarily him. You can find a complete overview of other reasons here.

Its causative agent is HSV, usually type II. It refers to infections transmitted through sexual contact. Type I, which usually causes rashes on the lips, can also lead to genital symptoms, but after oral sex.

How does infection occur?

We're dealing with two sneaky enemies here: HSV-1 (which usually causes common herpes) and HSV-2 (which usually causes genital herpes).

Viruses enter your body through mucous membranes. Your mucous membranes are thin layers of tissue that line the openings of your body. Mucous membranes are found in the nose, mouth and genitals.

Once the virus gets inside your body, it invades your cells and then stays there. It lies dormant (sleeping) in a bundle of nerves at the base of the spine. It reproduces or adapts to different environments very easily, making treatment difficult.

Methods of infection vary depending on the type of pathogen:

— Type 1 virus is transmitted by droplets and contact. Infection most often occurs in childhood through close contact with sick parents, brothers and sisters, and friends.

— type 2 pathogen is transmitted through unprotected sexual contact. Infection occurs during puberty or later when the virus enters through cracks and abrasions in the mucous membranes of the genital organs. In addition, oral infection is possible when lips come into contact with virus bubbles on the genitals. Or vice versa - by contact of these organs with bubbles on the lips.

The fluid in the blisters is highly contagious. This probability is especially high when the bubbles open and the liquid in them gets out.

But even if the blisters have healed, infection can occur through contact, for example, with saliva, semen, vaginal secretions or prostate secretions, since viruses may still remain there.

Before the first symptoms appeared, the virus could have been in the human body for quite a long time. This is because primary infection with HSV type 1 or 2 often goes unnoticed.

When it enters the body through the mucous membrane of the mouth or genitals, it enters the blood and lymph and, along with them, is carried to organs and tissues.

The nerves in the groin area, upper thigh and buttocks are very connected; therefore, a person can get a herpes outbreak in any of these areas. Primary areas of occurrence include the vagina or vulva, penis, scrotum or testicles, buttocks, anus or thighs.

Genital herpes, whether HSV-1 or HSV-2, does not cause symptoms in the mouth or face.

HSV-1 or HSV-2 can be found in the body fluids of infected people, including:

• saliva
• sperm
• vaginal discharge.

During the first week of infection, the immune system tries to eliminate the enemy by forming antibodies against it, which inactivate viral particles in the blood. But nevertheless, part of its DNA is hidden in the nuclei of sensitive nerve cells located in the dorsal horns of the spinal cord.

This is the reason that the immune system does not recognize the DNA of the virus and cannot thus attack it. Therefore, its DNA remains throughout its life in the nerve roots of the spinal cord and cannot be completely cured.

Once the immune system weakens, the DNA begins to reactivate itself. Numerous new viruses arise in infected cells. All this leads further to the development of characteristic symptoms of the disease.

Main features.

The disease can occur without any clinical manifestations. Or they are so mildly expressed that the disease goes unnoticed.

But for most people, when the immune system is weakened, symptoms appear that can affect the genitals, anal area, the entire perineum and neighboring tissues, particularly the buttocks and inner thighs. Sometimes the process reaches all the way to the toes.

Typical symptoms of genital herpes:

• -small, painful blisters with clear liquid containing many pathogens,
• -swelling and inflammation of the tissues where the blisters are located,
• - itching and burning in areas of the rash,
• - sometimes there is swelling and inflammation of the inguinal lymph nodes.

In addition to the main symptoms, there may also be the following signs:

• - increased body temperature,
• - pain when urinating,
• - vulva and vagina (vulvovaginitis),
• - general weakness and headache,
• -back pain and muscle pain.

Gradually, the blisters burst and their contents flow out, and in their place ulcers and skin erosions form, which become crusty. The blisters will heal within about 2-3 weeks.

People who are currently in the active phase of the disease have an increased risk of contracting other infectious diseases that are transmitted through sex.

The first signs may appear within two days after infection, or after 30 days or even later.

Symptoms for men include blisters on the penis, scrotum, or buttocks (near or around the anus).

Symptoms for women include blisters around or near the vagina, anus and buttocks.

Common symptoms for men and women include the following:

• rashes and blisters may appear in the mouth and on the lips, face, and anywhere else that has come into contact with infected areas
• the infected area often begins to itch or tingle before blistering.
• blisters can turn into ulcers.
• After a week, the ulcers usually become covered with a thin crust.
• your lymph nodes may become enlarged, especially in the groin area.
• you experience headaches, body aches and fever.

The severity of the disease can vary from mild to extremely severe.

In these photos you can see the symptoms of genital herpes.

The first symptoms are often so mild that you can mistake them for insect bites, abrasions, normal itching, a pimple, an ingrown hair, razor irritation, etc. For example, a tiny crack may first appear around the anus, which can easily be mistaken for hemorrhoids.

After 2-7 days from the moment of infection, itchy irritation occurs on a small area of ​​the skin of the external genitalia or near them. Over the next 12 hours, small reddish spots appear on this limited area, which quickly turn into small blisters. The latter soon open up, forming many painful ulcers that can become covered with scabs.

With further development of the disease, the inguinal lymph nodes become enlarged. Your lymph nodes may become inflamed and slightly swollen. Lymph glands always suffer from infection and inflammation in the body.

The general condition of the patient who experiences flu-like symptoms also suffers. The manifestations of the first attack of infection (primary herpes) can last up to three weeks.

How to determine?

Very often, the disease does not reveal itself for a very long time, because it occurs without noticeable symptoms or is so mild that patients simply do not notice it.

If the disease still makes itself felt, the doctor can confirm its presence using the following sequence of actions:

1.Patient survey: the doctor finds out:

• when complaints arose
• How long has a person been sick?
• Have there been similar manifestations before and how many times,
• whether there were sexual contacts during this period,
• Have you made any attempts at self-treatment?
• what other diseases are there?
• does the person take any medications?
• does he have any allergic reactions?

Depending on the frequency of relapses, the doctor determines the forms of the disease:

• mild - exacerbations 3 times a year or less,
• average - exacerbations 4-6 times a year,
• severe - exacerbations occur every month.

2. Examination of the patient: the disease manifests itself with typical changes in the form of itchy watery blisters in intimate places, swelling and inflammatory changes. Be sure to conduct an examination of the vagina and cervix in women, and a digital examination of the prostate in men.

Depending on the results of the examination, the following stages can also be distinguished in the development of genital herpes:

• Stage 1 - observed only on the genitals,
• Stage 2 - the vagina, cervix, urethra are affected,
• Stage 3 - spreads to the uterus, ovaries, prostate gland, bladder.

It should be noted that the further up the body the disease spreads, the more severe its consequences can be. The process that affects the internal organs can cause infertility, cervical cancer and severe immunodeficiency.

3. Laboratory diagnostic methods:

• general blood test: in the mild stage of the disease no changes are visible; sometimes there may be an increase in the number of leukocytes, band neutrophils and ESR as a sign of an inflammatory process. In severe cases, along with an increase in ESR, the number of leukocytes may be reduced, which indicates an immunodeficiency state.
• general urinalysis: in mild cases, no changes are detected; if the urethra is damaged, the urine may be cloudy with the presence of leukocytes.
• biochemical blood test: no changes are usually visible either; C-reactive protein may be elevated as a sign of inflammation.
• growing HSV in tissue culture from material obtained by scraping from the lesion site, vagina, cervix, urethral smear, followed by electron microscopy.
• enzyme-linked immunosorbent assay (ELISA) - detects virus antibodies (IgM and IgG) in blood serum even in asymptomatic cases of the disease. IgM increases in the first week of the disease and indicates an active process. Then their level decreases and is replaced by IgG, which is present in the blood throughout life.
• polymerase chain reaction (PCR) - determines whether HSV DNA is in the blood and is considered the most accurate method.

How to treat?

As we already said, genital herpes is incurable, and HSV remains in a person's body for life. Antiviral drugs used in medicine inhibit its reproduction, but do not destroy it. But at the same time, they alleviate the course of the disease and reduce the frequency of relapses.

The most widely used in this case are drugs from the group of acyclic nucleosides:

• Acyclovir is used in several forms: tablets are prescribed in a dosage of 0.2 g (1 tablet) 5 times a day, except at night, for prophylactic purposes, 1 tablet 4 times a day. Creams are applied 5 times a day by applying to the affected surface. The standard course of treatment for tablets is on average 5 days, for ointments - 5-10 days.
• Valacyclovir - prescribed 1 g 2 times a day for 3-5 days, in more severe cases the course of treatment is increased to 5-10 days.
• Famciclovir - for primary infection is prescribed at a dosage of 250 mg 3 times a day for 5 days. For relapses - 125 mg 3 times a day for 5 days or 1000 mg in two doses for one day. They can also prescribe 500 mg once, and then 250 mg three times every 12 hours.
• Also quite effective is the drug Tromantadine, which comes in the form of an ointment and is applied to the affected area 3-5 times a day for 5 days.

During the initial attack of a herpes infection, the duration of skin manifestations can be reduced by antiviral drugs such as acyclovir or famciclovir. These remedies, however, will not be able to limit the duration of relapse if treatment is started after the appearance of rashes and skin sores.

We must not forget about drugs from the group of interferons, which have an immunomodulatory effect and, due to this, have antiviral activity. The most famous drug from this group is Viferon, which can be prescribed rectally in the form of suppositories at a dosage of 1,000,000 IU (1 suppository) 2 times a day for 10 days. It can also be in the form of an ointment, which is applied to the affected area 3-4 times a day for 5-7 days.

There are combination drugs based on acyclovir and interferon. They are highly effective and reduce treatment time, achieving the desired result already on the 5th day from the start of treatment. The most famous of them is Herpferon, which is applied as an ointment to the affected area 4-5 times a day for 5-10 days.

It should be noted that all of these drugs are most effective within the first 48 hours from the moment the first symptoms of the disease appear. You can combine the simultaneous use of antiviral drugs and interferon.

And remember, give up sex during the treatment period!

Of the additional methods, ultraviolet blood irradiation (UVR) helps to significantly improve the healing process and achieve stable remission.

In case of severe illness with severe pain when urinating in women, in order to alleviate suffering, it is recommended to take a warm bath.

Antibiotics are powerless in the treatment of genital herpes - they fight bacteria, not viruses.

A patient with genital herpes is a source of infection for life, so during sexual intercourse he must use condoms, especially if the partner has not yet encountered the infection.

As we have already said, the herpes virus will remain in your body forever. But mostly it will be in an inactive state. Our task is not to provoke him into outbreaks of the disease.

Why might the disease return again?

Reactivation of the virus can occur for various reasons, for example:

• skin diseases,
• burns,
• inflammatory process, dental treatment,
• psycho-emotional stress,
• hormonal disorders (pregnancy, menstrual cycle),
• elevated temperature,
• ARVI and a number of bacterial infections,
• oncological process,
• physical stress,
• immunodeficiency conditions, such as HIV and AIDS.

The causative agent of the disease can lie dormant in the human body for months and years without making itself felt. As long as it is at rest, infecting another person is impossible.

Genital herpes and pregnancy.

In rare cases, the disease can be transmitted by contact from mother to child during childbirth in the presence of blistering rashes on the genitals.

Also, a child can become infected during the mother’s pregnancy if her first infection occurred during this period.

It is necessary to understand that classic intrauterine infection of the child is caused by primary infection of the mother during pregnancy, which happens quite rarely. And if this happens, the child’s illness may not manifest itself in any way. If a woman has already suffered from this disease before pregnancy, then the infection, in most cases, does not pose a danger to the intrauterine development of the child. It is dangerous only at the time of birth, if the woman in labor is in the active phase of the disease.

The herpes virus can be very dangerous for newborns, so in most cases, when the mother’s disease worsens, a caesarean section is resorted to. If it so happens that the birth took place naturally, then the mother and child are treated with antiviral drugs.

During pregnancy, the virus can cause intrauterine growth retardation, miscarriage and premature birth. Very rare, but still leads to abnormalities in the development of the child.

Common symptoms for a baby born with herpes (acquired through vaginal contact) may include sores on the face, body and genitals. Recurrent attacks or primary herpes in early pregnancy do not pose a high risk of complications for the child. But in the later stages of pregnancy it is very dangerous for the child, since there is a high risk of infection during childbirth.

Children born with genital herpes can develop very serious complications:

• blindness
• brain damage
• death.

Moreover, if infection occurs, the mortality rate among newborns is about 50%. Some surviving children may have ocular and neurological manifestations.

Herpes of the lips (labial), as a rule, does not pose a danger to the fetus and newborn child.

What absolutely needs to be done?

It is very important that you tell your doctor that you have a rash on your genitals. Especially if you are pregnant. Doctors will then take every precaution to prevent infection from being passed on to your baby during delivery. Activation of the pathogen and the appearance of ulcers at the end of pregnancy can cause serious harm to the baby. Therefore, delivery in such cases is carried out by caesarean section.

Antiviral medications can help speed up the healing process of ulcers and reduce pain. Medicines may be taken at the first sign of infection (tingling, itching, and other symptoms) to reduce these symptoms.

Use mild products in the shower or bath. Keep the infected area clean and dry. Wear loose cotton clothing to avoid further injury to the sores.

You should practice safe sex and use condoms every time you have sex.

What complications can you expect?

Despite its apparent harmlessness, genital herpes can cause a number of serious complications:

1.Local complications:

• dryness of the mucous membranes of the vagina and cervix,
• dryness of the mucous membrane of the urethra,
• formation of cracks and erosions followed by scarring,
• addition of a bacterial infection.

2.General complications:

• decreased immunity - you will get sick more often,
• damage to the nervous system, from neuralgia to inflammation of the brain (encephalitis) and soft meninges (meningitis). Newborn children are very susceptible to this when infected from their mother.
• damage to internal organs (liver, kidneys, lungs, intestines).

What's the prognosis?

A third of patients forget about these problems soon after the first attack; another third occasionally experience mild exacerbations; for others, relapses occur at least once a year, although they are milder than the first attack and usually resolve within a week.

There is no reliable treatment for genital herpes yet, but you can live with this disease. The virus remains dormant in your body until something causes it to flare up. Outbreaks can occur when you are under stress, another illness, or fatigue.

What should you do to avoid the recurrence of genital herpes?

“Triggers” (determining exactly what leads to an outbreak of a disease) are very individual. But over time, many people learn to recognize and sometimes avoid the factors that seem to revive the virus in their own bodies.

Illness, poor nutrition, emotional or physical stress, friction in the genital area, prolonged exposure to ultraviolet light (common for oral herpes, such as a trip to the beach or ski weekend), surgical trauma, and steroid medications (such as asthma treatment) can cause flare-ups. diseases.

The frequency of outbreaks can often be controlled through effective stress management and getting adequate rest, nutrition, and exercise.

For people with frequent outbreaks, suppressive (daily) therapy with either antiviral drug can reduce the number of outbreaks by 80%.

If relapses occur more than five times a year, it is advisable to carry out suppressive therapy, which involves prescribing antiviral drugs for a period of at least six months. In particularly severe cases, suppressive therapy can continue for years.

If you have type 2 HSV in your body, then by following a number of simple rules, you can prevent a relapse:

• strengthening the immune system,
• full sleep,
• healthy lifestyle,
• avoid stressful situations,
• washing hands after going outside and when touching contaminated areas,

– 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. Prone to relapses and can subsequently lead to serious complications: decreased local and general immunity, development of bacterial infections of the genitals, damage to the nervous system, 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. Included in the group of sexually transmitted diseases (STDs).

General information

– 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. Prone to relapses and can subsequently lead to serious complications: decreased local and general immunity, development of bacterial infections of the genitals, damage to the nervous system, 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. Included in the group of sexually transmitted diseases (STDs).

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 genital organs, 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 with 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 hygiene and hygiene of sexual life, 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.

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Genital herpes is an infectious disease caused by simplex viruses herpes Types 1 or 2 and manifested by multiple blistering rashes in the genital area. It is because of the localization of the lesion in the genital area that genital herpes is also called sexual or genital herpes.

Despite the high prevalence of this infection (according to the World Health Organization, about 90% of the world's population is infected), genital herpes is a fairly safe disease, in the vast majority of cases not causing serious complications. However, during the period of active course, genital herpes significantly reduces the quality of life and creates inconvenience for a person.

Genital herpes is transmitted from an infected person to a healthy person through any type of sexual contact - vaginal, oral and anal. Moreover, a person can be a source of infection, even if he does not have any manifestations of the disease. In addition, in rare cases, a baby may become infected with genital herpes during childbirth, if the mother's infection at that moment was in an active stage.

General characteristics of the disease

Genital herpes belongs to the group of sexually transmitted infections (STIs). Moreover, genital herpes is the most common infection of this group in the adult population in all countries of the world. According to various estimates, from 60 to 90% of the adult population in various countries are currently infected with genital herpes. This spread of genital herpes is due to the peculiarities of its transmission and the course of the disease.

The fact is that the infection is sexually transmitted, but is not life-threatening, and once a person has had genital herpes, he becomes a lifelong carrier of the herpes virus. Occasionally, in an infected person, the herpes virus is activated and released into the secretion of the genital organs, and most often this occurs without any accompanying clinical manifestations. Accordingly, a person does not know that the genital herpes virus is present in the secretions of his genital organs and leads a normal sex life. As a result, during sexual intercourse the virus is transmitted to a partner. Moreover, transmission of the genital herpes virus occurs during any type of sexual contact - vaginal, oral and anal. Thus, many carriers of the genital herpes virus periodically become a source of infection for other people, without even knowing it. Accordingly, the spread of infection occurs very quickly and on a wide scale. But, due to the non-life-threatening nature of genital herpes, they are not actively detecting the infection.

Genital herpes is caused herpes simplex virus (HSV) type 1 or 2. HSV-1 is the cause of genital herpes in 20% of cases, and HSV-2 - respectively, in 80%. At the same time, the “true” provocateur of genital herpes is traditionally considered to be type 2 virus, since type 1 herpes virus is the cause of herpetic rashes on the lips and face. However, during oral sexual contact, a person infected with herpes simplex virus type 1 can transmit it to a partner in whom the pathogenic microbe will provoke genital herpes, since it was, figuratively speaking, “transferred” to the genitals. In principle, the type of HSV that causes genital herpes is completely unimportant, since the infection proceeds and is treated in exactly the same way. The only category of people for whom it is important to know the type of HSV virus that causes genital herpes are pregnant women, because based on this information they will be able to guess when and how the infection occurred.

The virus that causes genital herpes enters the human body through intact mucous membranes and damaged areas of the skin during sexual intercourse. Therefore, the only effective way to prevent genital herpes infection is to use a male condom for all types of sexual intercourse (vaginal, oral and anal). In addition, in rare cases, genital herpes can be transmitted from mother to newborn or fetus if a woman is first infected during pregnancy.

Once the herpes virus enters the body, it does not always cause an active infection; in at least half of the cases, the person does not get sick at all, but only becomes a latent carrier. Such latent carriage does not cause harm to a person and does not reduce the quality of his life, but occasionally leads to the release of the virus into the secretions of the genital organs, as a result of which it can become a source of infection for other people without knowing it.

But still, in half of the cases, after the virus enters the body, a person develops symptoms of genital herpes, and the infection proceeds actively. In such situations, a person is bothered by multiple small blistering rashes on the skin in the genital area, as well as on the mucous membranes of the genitourinary tract (urethra, vagina, etc.), which are very itchy and very painful. After some time, the blisters pass, and the infection passes into latent carriage, in which the virus is also occasionally released into the secretions of the genital organs without any symptoms and can infect other people during sexual intercourse without using a condom.

With latent carriage, regardless of whether there were active manifestations of genital herpes during the initial infection, so-called relapses can develop in any infected person. During relapses, genital herpes manifests itself with clinical symptoms, that is, a person develops itchy, painful, fluid-filled blisters on the skin or mucous membranes of the genitals. Such relapses usually go away on their own, and the person again becomes only a latent carrier of the infection. Recurrences of genital herpes are usually caused by a sharp decrease in immunity, for example, under stress, after overwork, serious illness, etc.

The peculiarity of herpes simplex viruses types 1 and 2 is that, once they enter the human body, they remain in the tissues for life, never being completely removed. This is what causes asymptomatic lifelong carriage of the virus and occasional relapses of genital herpes. Having entered the body through the mucous membranes, the herpes simplex virus penetrates through the blood and lymph into the nerve nodes, where it remains in a latent inactive state throughout the subsequent life of a person. And when situations arise that cause a decrease in immunity (stress, hormonal imbalance, exposure to radiation, strong ultraviolet irradiation, etc.), the virus is activated, leaves the nerve nodes, penetrates the skin and mucous membranes of the genital organs and causes a relapse of the infection.

Attempts to completely remove the herpes simplex virus from the body are futile, so they are not necessary. This means that in the absence of relapses of genital herpes, asymptomatic virus carriers do not need to be treated. Moreover, there is also no need to be afraid of such virus carriage, since it is not dangerous to human life.

Treatment of genital herpes is carried out only in the presence of an active infection, that is, with rashes on the skin and mucous membranes of the genital organs. Typically, treatment is aimed at eliminating painful symptoms - pain and itching, as well as at quickly transferring the virus into a latent, inactive state, in which it will not bother a person.

Genital herpes - causes

The cause of genital herpes is the herpes simplex virus (HSV) type 1 or type 2. Moreover, in 20% of cases, genital herpes is provoked by HSV type 1, and in the remaining 80% - by HSV type 2. It should be noted that the herpes simplex virus is typical for the genitals type 2, and therefore most cases of infection are caused by it. And HSV type 1 is usually localized in the area of ​​the mucous membranes and skin of the face, and it is this that provokes the widespread and almost universally known “herpes” on the lips. But if HSV type 1 gets on the mucous membranes or skin of the genital organs, it will provoke not labial (labial) but genital herpes. This usually occurs through oral sex when HSV type 1 is transmitted from a partner who has herpes labialis.

It is also necessary to know that infection of the genital tract with HSV type 1 often causes an active course of the infection. And when infected with HSV type 2, genital herpes in a large number of cases does not develop, and the virus immediately goes into a latent state. But, as a rule, after the end of the active phase of genital herpes caused by HSV type 1, the virus goes into a latent state for a long time, and a person very rarely suffers from relapses of the infection. If an infection with HSV type 2 occurs, then a person is much more likely to develop relapses of genital herpes, even if after the initial infection clinical symptoms did not appear and the virus immediately went into an inactive state. That is why, to predict relapses, it is important to know the type of herpes virus that a given person is infected with.

Infection with genital herpes

Infection with genital herpes can occur in two ways:

• Sexual tract;
• Vertical path (through the placenta from mother to fetus or during the passage of the baby through the birth canal).

The most common and significant in the epidemiological aspect is sexual transmission of genital herpes. Herpes simplex virus type 1 or type 2 is transmitted through vaginal, oral or anal intercourse without using a condom from one partner to another. Since the active release of the herpes virus into the secretions of the genital organs of both women and men can occur without any visible clinical signs, a person simply does not know that he can be a source of infection for his sexual partner.

However, if a person has herpetic rashes, but the condom does not cover them completely, then during sexual intercourse the likelihood of transmitting the virus is also very high. That is why it is recommended to abstain from sexual activity during the period when herpetic eruptions appear on the genitals until they disappear completely.

The entry point for infection is the intact mucous membrane or damaged skin in the genital area, groin, anus and oral cavity. That is, the virus, entering the mucous membranes of the vagina, rectum or oral cavity along with genital secretions, quickly penetrates into cells, as a result of which infection occurs.

A person becomes a source of infection for other people a few days after becoming infected himself. This period of infectivity lasts 10–14 days. If a person periodically develops herpetic eruptions in the genital area, then he becomes infectious to others immediately after the formation of blisters and remains so for 8 to 9 days. After 8 to 9 days, even if the rash has not yet gone away, the person ceases to be a source of infection for others.

In addition, against the background of asymptomatic carriage, periodically, throughout life, the virus is released into the secretions of the genital organs for 1–2 days, which are not accompanied by any clinical manifestations. During these periods, a person also becomes infectious to sexual partners. Unfortunately, it is impossible to identify such periods, since they do not differ in any symptoms.

Infection with genital herpes of a fetus during pregnancy or an infant during childbirth(when passing through the birth canal) is very rare. As a rule, intrauterine infection of the fetus occurs only in cases where a woman is first infected with herpes during pregnancy. If, before pregnancy, a woman was already infected with genital herpes, then the infection is transmitted to the fetus in extremely rare cases, even if the expectant mother periodically develops exacerbations of genital herpes during pregnancy. Indeed, during exacerbations of genital herpes, the virus is effectively destroyed by the woman’s immune system, and therefore does not penetrate the placenta to the fetus.

Infection of a baby with herpes during childbirth occurs only in two cases. Firstly, if the woman herself became infected for the first time in her life during the last 2 to 3 weeks of pregnancy. Secondly, if at the time of childbirth a woman had herpetic eruptions on her genitals, that is, there was a relapse of the infection.

Genital herpes: causative virus, types, routes of transmission, virus carriage, risk groups, incubation period - video

Test for genital herpes

Currently, to clarify the type of virus that caused genital herpes, as well as to identify the form of the infection, the following types of tests are performed:

• Sowing a smear from the rash onto a culture;
• Determination of the presence of antibodies to herpes virus types 1 or 2 (IgM, IgG);
• Determination of the presence of active viral particles in the blood using PCR.

Smear culture, taken from the rash on a cell culture, is produced only in the presence of herpetic blisters on the genitals. In this case, a smear should be taken within 2 days from the moment the rash appears. A smear taken at a later period is not informative. This test allows you to accurately determine the type of virus that causes genital herpes, and also determine whether the rash is indeed a suspected infection. Today, culture of a smear from a rash is the most accurate method for confirming genital herpes and establishing the type of virus that caused the infection.

Determination of antibodies to the herpes virus in the blood or genital secretions is a common analysis and allows you to determine whether the infection occurred long ago or recently. Also, the determination of antibodies makes it possible to determine whether a person is actually infected with the herpes simplex virus. Accordingly, for this analysis you need to donate blood from a vein or genital secretions (the collection is usually carried out by medical personnel).

Typically, these tests are used in preparation for pregnancy, since the doctor needs to know whether the woman has antibodies to the herpes virus in her blood. After all, if antibodies are present, then the woman is already “familiar” with the virus and, therefore, throughout pregnancy she may not be afraid of infection and relapses of genital herpes, since her own, already formed immunity will reliably protect the fetus from infection. If there are no antibodies in a woman’s blood, then throughout pregnancy she will have to be careful not to become infected with the virus, since primary infection during pregnancy can lead to infection and serious complications, including fetal death.

Currently, the presence of two types of antibodies in the blood is determined - IgM and IgG. Moreover, for each type of herpes simplex virus, antibodies of both types are determined separately, that is, there are antibodies of the type IgM for HSV-1 and IgM for HSV-2, as well as IgG for HSV-1 and IgG for HSV-2. Accordingly, if antibodies to a certain type of virus are detected, then the person is infected with it. If there are antibodies to both types of the virus, this means that it is infected with both.

If only IgG is detected in the blood or genital secretions, this means that infection with the herpes virus occurred quite a long time ago (more than 1 month ago), and the person is reliably protected from re-infection. Women who have IgG against the herpes virus in their blood and genital secretions can safely plan a pregnancy, since the infection occurred long ago and their immune system will not allow the virus to penetrate the placenta and infect the fetus.

If there are IgM or IgM + IgG antibodies in the blood or genital secretions, this means that the infection with the virus occurred no more than 1 month ago. In this case, the body is actively developing immunity against infection. In this case, nothing threatens an adult, but women planning a pregnancy are advised to postpone this for 1 month so that the immune system is fully formed and reliably protects the unborn baby from infection with the herpes virus.

However, it should be remembered that detecting antibodies to the herpes virus is not a very accurate analysis.

Detection of viral particles in blood, genital secretions or fluid from rashes using the method PCR is a fairly accurate method, which, however, has limited information content. The fact is that this method allows you to accurately determine the type of virus that causes genital herpes. PCR does not provide information about the stage or activity of the infectious process, as well as the risk of relapse. Moreover, if a person has a positive PCR test result for the herpes virus, but there are no clinical manifestations, then this is the norm and does not require treatment, since it only indicates asymptomatic carriage, which is present in more than 80% of people. If the herpes virus is detected by PCR in a pregnant woman who was already infected before conception, then this is also normal for her and no treatment is necessary if there are no rashes on the genitals. If a pregnant woman was not infected with the herpes virus before conception, and at some point during pregnancy, viral particles are detected by PCR, then this is an alarming signal, since in this case she should receive antiviral treatment that will prevent infection of the child.

Genital herpes - symptoms

General symptoms

According to various statistics, infection with the herpes virus does not cause the development of genital herpes infection in 75 - 80% of cases, but simply turns into asymptomatic carriage. In the remaining 20–25% of cases, the virus that has entered the human body causes the development of genital herpes. The incubation period (the time from entry of the virus into the body until the onset of symptoms of the disease) is usually 4 days, but can last from 1 to 26 days.

Additionally, in rare cases, genital herpes can lead to difficulty urinating, decreased sensitivity, and severe pain in the genital skin. In very rare cases, herpes infection can cause destruction of the brain, lungs, liver, or joints, as well as bleeding disorders that often lead to death.

Signs of the development of complications of genital herpes, which should promptly consult a doctor, are:

• Strong headache ;
• Tension of the neck muscles, as a result of which it is painful and difficult to press the chin to the chest;
• Severe weakness;
• High body temperature;
• Feeling of strange, non-existent smells and tastes;
• Loss of the ability to smell;
• Weakness of the arm and leg muscles on one side;
• Restlessness and confusion;

Genital herpes: symptoms in men and women, where herpes occurs - video

Relapse (exacerbation of genital herpes)

Recurrences of genital herpes can occur sporadically in a person throughout his life if he is infected with PVG-1 or HSV-2. The theoretical probability of relapse is due to the lifelong presence of the virus in the body and its periodic activation when favorable conditions occur. That is, the herpes simplex virus is normally in a dormant state in the body, which is maintained by the human immune system, as if suppressing the activity of the pathogenic microorganism. But if for some reason the immune system weakens and ceases to effectively suppress the herpes simplex virus, it will become activated and provoke a relapse of genital herpes.

As a rule, activation of the herpes virus in the body occurs during periods of weakened immunity, which are provoked by stress, hypothermia, hormonal disruptions or changes, overwork, serious illness, etc. This means that if any event occurs that negatively affects immune system, the risk of developing a relapse of genital herpes in a person who is a carrier of the virus increases significantly.

Recurrences of genital herpes usually present with the same symptoms as the initial episode of infection. That is, a person develops characteristic multiple, small, itchy, painful, fluid-filled blisters on the skin of the genitals. If bubbles, in addition to the skin, are also present on the mucous membrane of the urethra, then the person suffers from pain when urinating. If bubbles are present in the vagina of women, then they may experience abundant, mucous, whitish discharge. Additionally, a relapse of herpes may be accompanied by symptoms of general ill-being, such as:

• Enlarged inguinal lymph nodes;
• Increased body temperature;
• General weakness.

Depending on the number of rashes, a recurrence of herpes can last from a week to a month. A few days after the appearance, the rash bursts and becomes covered with a crust, under which complete healing occurs within 2 to 3 weeks. After healing, the crusts disappear, and no traces of rashes remain on the skin.

In addition to the typical form described, recurrence of herpes can occur in the so-called atypical form, most typical for women. An atypical form of recurrent herpes is characterized by the appearance of only one stage of blisters. That is, a person may experience redness and itching of the genitals, but bubbles will not form. Or bubbles will form, but quickly collapse and dry out without forming crusts, etc.

Relapses of genital herpes develop more often the closer the current moment is to the time of infection. That is, people who have recently become infected with genital herpes may experience relapses of the infection more often than those infected several years ago. The more time has passed since infection with genital herpes, the less often a person experiences relapses. It should also be noted that relapses are milder than the initial episode.

Chronic genital herpes

The diagnosis of chronic genital herpes is given to people who suffer from recurrent infections at least 3 to 4 times a year. If relapses of genital herpes occur less than 3 times a year, then we are talking about episodic exacerbations, but not a chronic process.

With chronic genital herpes, periods of remission, when a person is not bothered by the symptoms of infection, alternate with relapses. During relapses, a person develops characteristic rashes on the genitals and a whole range of accompanying symptoms. Chronic genital herpes usually develops in people whose immune system, for one reason or another, is unable to keep the virus in an inactive state for a long time. As a rule, this is typical for people suffering from severe chronic diseases, under the influence of progressive constant stress, poor nutrition, etc.

Depending on the number of relapses of genital herpes during the year, the following degrees of severity of the chronic process are distinguished:

• Mild severity of chronic genital herpes– relapses develop 3–4 times a year with periods of remission no shorter than 4 months;
• Moderate severity– relapses develop 4–6 times a year with periods of remission no shorter than 2–3 months;
• Severe degree– relapses develop monthly with periods of remission from several days to 6 weeks.

Chronic genital herpes requires serious treatment, since its development indicates a failure of the immune system, which is not capable of introducing the virus into an inactive state for a long time and keeping it there, thereby preventing relapses of the disease.

Genital herpes during pregnancy

The problem of genital herpes is often faced by women who are just planning a pregnancy and undergoing examination, during which they are diagnosed with certain infections that could potentially be dangerous to the fetus. In addition, another category of those facing the problem of genital herpes are already pregnant women who first developed symptoms of infection or developed a relapse. Let us consider the problem of genital herpes for each category of women separately, so as not to confuse different aspects of the problem.

At the stage of pregnancy planning Many women have “traces” or the herpes virus itself in their blood. Traces of the herpes virus are detected by testing for the presence of antibodies (IgM and IgG), and the virus itself is detected by PCR. Due to the discovery of the virus or traces of it, many women become frightened and postpone planning a pregnancy because they believe that this may pose a danger to the fetus. However, such an opinion is incorrect and the fears associated with it are completely unfounded.

The fact is that the presence of the virus or its traces in the blood not only does not pose a threat to pregnancy, but on the contrary, indicates a low risk of infection of the fetus with a herpes infection. After all, if a woman became infected with the herpes virus before pregnancy, then her immune system has already developed antibodies to it and therefore reliably protects her and the fetus from attacks by the pathogenic microorganism itself. That is why, if there are antibodies (traces) in the blood or the herpes virus itself, you can safely become pregnant and be calm, since the immune system is already in a state of “combat readiness”, destroying viral particles when trying to penetrate through the placenta to the developing fetus. Antibodies to the herpes virus circulating in the blood throughout life protect the woman herself from the spread of infection to various organs, and during pregnancy, from the entry of viral particles into the fetus.

But the absence of antibodies or the herpes virus itself in a woman’s blood before pregnancy is a signal of potential danger. The fact is that in such a situation, the woman’s body is not yet familiar with the virus, and the immune system does not produce antibodies that destroy it and protect her and the future fetus. In this case, if a woman becomes infected herpes during pregnancy, then there will be a very high risk of infection of the fetus with dire consequences, since the virus may have time to penetrate the placenta while the immune system has not yet developed antibodies against it. Infection of the fetus with herpes can provoke its death or the development of various deformities. This means that a woman who does not have traces or the herpes virus itself in her blood must be very careful throughout her pregnancy and take all preventive measures to avoid contracting the infection.

Therefore, women who do not have traces of the herpes virus in their bodies or the virus itself are at greater hypothetical risk during pregnancy compared to those who have either traces or the virus itself in their blood. That is, women who have antibodies or the herpes virus itself in the blood can plan a pregnancy and not worry about the negative impact of the microorganism on the fetus. And women who do not have antibodies or the herpes virus in their blood must be careful throughout pregnancy so as not to become infected.

The second category of those facing the problem of genital herpes is already pregnant women suffering from recurrent infections. Since immunity decreases during pregnancy, women may develop relapses of genital herpes. However, if a woman was already infected with the herpes virus before pregnancy, then relapses of the infection during pregnancy are not dangerous, since the antibodies in her blood reliably protect the child, preventing viral particles from passing through the placenta. That is, if relapses of genital herpes occur during pregnancy, you just need to carry out symptomatic treatment and not worry about the health and development of the fetus. Even if a recurrence of genital herpes occurred at the expected time of conception, this does not indicate any danger to the fetus, since the existing antibodies reliably protect it from infection.

The only situation in which the risk of infection of the fetus against the background of a relapse of genital herpes is high is childbirth a few days after the onset of the next exacerbation of the infection. That is, if a woman developed a relapse of herpes and within a few days after that she gave birth to a child, then it could become infected when passing through the genital tract. In other cases, relapses of genital herpes in a pregnant woman who was already infected with the infection before conceiving a child are not dangerous to the fetus.

The herpes virus poses the greatest danger, paradoxically, to those women who were not infected with it before pregnancy. That is, if infection with herpes first occurred during pregnancy, then this is very dangerous, since the risk of infection of the fetus is high. In this case, if the infection occurred in the first 13 weeks of pregnancy, the herpes virus can cause fetal death or developmental defects. If a woman first becomes infected with genital herpes in the second half of pregnancy, the virus can cause delayed fetal development, premature birth and herpes infection in the newborn. Herpes in newborns is very dangerous, since in 60% of cases it leads to death.

Genital herpes in children

Genital herpes is much less common in children than in adults, since they have not yet had sexual intercourse. Unlike adults, genital herpes infections in children are usually caused by the herpes simplex virus type 1, which usually causes rashes on the lips and face. Infection occurs, naturally, not through sexual contact, but through contact. Children touching herpetic rashes on the face with their hands can transfer the virus to the genitals, where it penetrates the tissue and causes genital herpes. The course of infection in children is usually the same as in adults. But in some cases, rashes can be localized not only in the genital area, but over the entire surface of the body. Genital herpes in children must be treated to prevent the spread of the virus and damage to internal organs.

Genital herpes: diagnostic methods - video

Genital herpes in children and women during pregnancy (opinion of a dermatovenerologist): what is the danger of genital herpes at various stages of pregnancy, complications, treatment, risks of infection of a newborn - video

Genital herpes - treatment

Principles of therapy

The herpes virus cannot be completely removed from the body using currently available methods, therefore, once it gets into it, the microorganism remains in the cells of the human body for life. Due to this feature, treatment of genital herpes is aimed at suppressing the activity of the virus and its “leaving” into a dormant state, in which a person does not develop periodic relapses. Treatment consists of using antiviral drugs internally and externally. Externally, antiviral agents (ointments, gels, creams, etc.) are applied to the rash areas to speed up their healing and relieve associated pain and itching. Antiviral drugs are taken internally to suppress the activity of the virus and ensure the maximum duration of the remission stage.

If genital herpes is not chronic, and relapses occur no more than 3 times a year, then it is recommended to use only external antiviral agents to treat occasional rashes. If relapses occur 3-6 times a year, then during exacerbations it is recommended not only to treat the rash with external agents, but also to take antiviral drugs internally in short courses. In this case, the drugs are taken orally only during relapses. If relapses of herpes develop more than 6 times a year, it is necessary to take long-term courses of antiviral drugs orally in order to achieve a stable transition of the virus into an inactive state. In this case, the drugs are taken for a long time, regardless of the presence or absence of relapses.

• Acyclovir (Acyclostad, Acyclovir, Vivorax, Virolex, Herperax, Gerpetad, Zovirax, Provirsan);
• Valacyclovir (Valacyclovir, Valtrex, Vacirex, Vayrova, Virdel, Valvir, Valcicon, Valavir, Valogard, Valmik);
• Famciclovir (Minaker, Famvir, Famacivir, Famciclovir, Familar).

Episodic administration of antiviral drugs for rare relapses (3–6 times a year) is carried out according to the following schemes:

• Acyclovir – 200 mg 5 times a day for 5 days;
• Valaciclovir – 500 mg 2 times a day for 5 days;
• Famciclovir – 250 mg 3 times a day for 5 days.

At the same time, if a relapse develops, medication should be started as early as possible. Even if a person has only the precursors of a relapse (itching and redness of the skin), and the rash has not yet formed, you can start taking antiviral drugs. In this case, the relapse will pass very quickly.

Antiviral drugs for the treatment of frequently recurring genital herpes (more than 6 times a year) are taken over a long period of time, for several weeks in a row. In this case, use Acyclovir 200 mg 4 times a day, and Valacyclovir 500 mg 2 times a day. The duration of therapy is determined by the doctor.

External antiviral agents are used only during periods of exacerbation, applying them to the area of ​​the rash. The most effective external agents are those containing the following antiviral active ingredients:

• Acyclovir (Acigerpin, Acyclovir, Acyclostad, Vivorax, Virolex, Gervirax, Herperax, Gerpetad, Zovirax);
• Penciclovir (Fenistil Pencivir).

All of the listed ointments, creams and gels are applied to the area of ​​the rash several times a day (optimally every 3 hours) for 3 to 5 days. If the condition does not improve within 7 days of use, you should consult a doctor.

In addition to antiviral ointments, herpetic rashes can be treated externally with 4% Propolis ointment and gel with 0.5% Aloe Vera, which accelerate the healing of blisters.

Ointment for genital herpes

Currently on the pharmaceutical market there are the following drugs in the form of ointments, creams or gels that effectively dry out herpetic rashes, relieve itching and pain and promote their rapid disappearance:

• Acyclovir;
• Acigerpin;
• Acyclostad;
• Biopin;
• Vivorax;
• Virolex;
• Viru-Merz serol;
• Gervirax;
• Herpetad;
• Hyporamine;
• Zovirax;
• Lomagerpan;
• Tromantadine;
• Fenistil Pentsivir;
• Khelepin D.

All of the listed drugs can be used for the external treatment of herpetic eruptions during periods of exacerbation, both separately and in combination with the ingestion of specialized antiviral agents.

Genital herpes: duration of treatment with antiviral drugs, which antiviral drugs are the best in the treatment of genital herpes, the best ointments, interferon drugs (opinion of a dermatovenerologist) - video

Treatment of genital herpes (primary and recurrent, virus types 1 and 2): antibiotics, immunomodulators for herpes on the lip and genital herpes, homeopathy, folk remedies (garlic, tea tree) - video

Prevention of infection

Prevention of genital herpes involves using condoms, limiting the number of partners and avoiding sex with people who have suspicious rashes in the genital area.

Types of genital herpes: symptoms and characteristics of acute and chronic, primary and recurrent genital herpes, complications (herpetic keratitis, etc.), preventive measures, herpes vaccination - video

Before use, you should consult a specialist.

Among diseases that are transmitted through sexual intercourse, the most difficult are viral infections, which are difficult to treat. A striking example of this is genital herpes, the treatment of which can last for many months if the help of a doctor is not sought in a timely manner. The herpes virus can be transmitted by partners during sexual intercourse if condoms are not used.

The manifestation of herpes can occur long after infection with the virus, which makes treatment of the disease difficult in most cases. Only if the immune system has fallen can a person detect a herpetic rash, which tends to recur and hide in the latent stage. Treatment of herpes requires an integrated approach, as well as medical care from an experienced specialist.

What is herpes?

In medicine, the concept of herpes is usually understood as an infection caused by the virus of the same name. After the virus enters the human body, it invades the cells of the immune system, disrupting its functioning and reducing the resistance to other pathogens and pathogenic agents. In order for herpes to manifest itself with characteristic symptoms, certain conditions are necessary.

At the moment, medical theory officially recognizes 8 types of herpes pathogen - HSV. Genital herpes can be caused by only two of them - HSV-1 and HSV-2; the second type accounts for almost 80% of patients with this disease. A person can become infected with herpes only if they show signs of herpes, that is, a herpetic rash on the external genitalia.

Is there a cure for genital herpes?

For many people faced with such a serious virus, the burning issue is how to treat genital herpes and whether its complete cure is possible. In fact, it is impossible to completely get rid of the virus, since its cells are embedded in the cells of the immune system, the most important system of the human body. From this it becomes clear that recurrent genital herpes is most often treated during its exacerbation.

Treatment is carried out after identifying the following signs of relapse of the virus:

• burning, redness and itching in the genital area;
• enlarged lymph nodes in the groin area;
• burning and tingling during bowel movements;
• at the site of the herpetic rash, bubbles with cloudy liquid appear;
• if such bubbles burst, ulcers and erosions appear in their place, covered with a crust;
• general malaise.

For reference! Signs of herpes appear approximately 8 days after infection, after which they may disappear on their own after about a month.

The entire course of treatment is based on eliminating the symptoms of the viral infection and alleviating the patient’s condition. The more effective the therapy, the faster the disease will go into a latent form.

Diagnosis of the disease

Effective treatment of genital herpes can only be possible after a thorough diagnosis and examination of the patient. The treating doctor must identify the type of HSV, compare the symptoms of the disease, determine the presence of concomitant diseases, and then draw up a set of therapeutic measures.

There are two types of tests for HSV:

1. Detection of herpes cells- a specialist takes a smear from the site of the disease, the resulting biomaterial is grown under special conditions under a microscope. The specialist stains the flora, after which the color indicates the presence or absence of the virus. But there are cases when this technique does not show the presence of the virus in a carrier who has not gone through the exacerbation phase.
2. Detection of antibodies to the virus- ELISA immunoassay involves taking the patient’s blood, after which a specialist identifies specific antibodies in it if there is a virus in the body. The immune system has the ability to “remember” the period of time when the body fought the virus at the stage of its exacerbation.

In addition, the laboratory often uses PCR analysis, a polychain reaction, which can detect fragments of viral DNA. This technique also accurately determines the type of pathogen, which determines the course of treatment of the disease.

Treatment methods

To quickly cure herpes, you need to contact a medical specialist after the first manifestation of the virus. It is impossible to completely defeat genital herpes, but there is every chance to suppress it in the body, thereby preventing its spread between sexual partners. Complex treatment consists of drug and alternative therapy.

Folk remedies

At home, you can fight genital herpes using several traditional medicine recipes. Namely:

• Tea tree oil. To do this, you need to boil 400 ml of water, add 10 drops of pharmaceutical oil, and then wash your genitals with this solution every evening before bed.
• Phytotherapy. It is necessary to mix several plants in equal proportions - flowering meadow clover, birch foliage, flowering calendula, motherwort and dandelion roots. You need to dilute 10 grams in 350 ml of water. such a herbal mixture, boil everything over the fire for 5 minutes, cool and strain to remove any sediment. The resulting decoction should be used to wash the genitals or perform douching procedures. You need to repeat the procedure every evening for 14 days in a row.
• Series. 10 gr. This herb should be brewed in a glass of water, then leave the decoction for an hour and strain. A piece of gauze soaked in the infusion should be applied to the site where herpes appears. You can also drink 100 ml of this decoction twice a day.
• Chamomile. In 200 ml of water you need to brew 5 grams. herbs, leave for 40 minutes, then irrigate the genitals or perform the douching procedure. This infusion is used in treatment twice a day until the rash disappears.
• Sea salt. 50 gr. salts from the sea need to be dissolved in 10 liters of boiling water, after the water has cooled, you need to take salt sitz baths. For two weeks you need to take such baths for 20-30 minutes.

In addition, folk treatment involves taking echinacea tincture, which is sold in pharmacies. Such measures will increase the body's defenses, after which the immune system will be able to independently suppress the virus without medical treatment.

Medical treatment regimens

The symptoms and treatment of herpes can only be indicated and described by a medical specialist. If you self-medicate, HSV will later develop into chronic genital herpes. Drug treatment requires only an integrated approach, which includes several groups of drugs:

1. Immunomodulators. Since herpes is a viral disease, and it is completely impossible to get rid of it, it will be enough to increase the resistance forces to suppress the pathogen. Such drugs destroy the protective shell of the virus cells, after which the body begins to independently produce an immunomodulator - interferon. Interferon is found in several drugs:

• Viferon ointment, which should be applied to the site of the disease. The active component of this drug is recombinant human interferon alpha-2b, the composition is supplemented with vitamin E, petroleum jelly, and lanolin.
• Interferon Beta injections, which contain fibroblast interferon. The effectiveness of this treatment is at least 70%.

1. Antiviral agents. Such drugs are taken for acute genital herpes; they suppress the reproduction of viral cells, stopping their growth. There are several such remedies for HSV:

• Acyclovir - treatment is carried out at any stage of herpes, if its causative agent belongs to types 1 and 2.
• Pharmaciclovir - penciclovir in the composition is acceptable for regular relapses of the virus, as well as when neuralgia is detected against this background.
• Denavir is a cream that contains penciclovir as in the previous version.
• Groprinosine - inosine pranobex, which contains pranobex, destroys DNA cells and also increases resistance forces.
• Valtrex is an acyclovir ester drug that is taken during a relapse.

In addition, relapse prevention and treatment involve the use of antiseptics, for example, Decasan for irrigation of the genitals and douching.

Which doctor treats genital herpes?

Herpes is a common disease of modern society, which is treated by a urologist or andrologist for men, and a gynecologist for women. In addition, specialists at the dermatovenerological dispensary can provide advice and diagnose and treat genital herpes. Also, in some cases, consultation with an immunologist may be required.

Nutrition and diet

The herpes viral infection requires not only medication and home treatment, but also a certain diet. The following products need to be excluded:

• strong brewed coffee and tea;
• strong chocolate;
• peanut;
• flour products;
• sweets;
• alcohol;
• grapes and raisins.

The diet needs to be filled with foods that are good for the skin and immune system. For example, meat and fish products, vegetables and fruits, dairy products, berries and cereals.

How to live with genital herpes?

If a person develops genital herpes, he should immediately see a specialist. In the future, it is important to be regularly monitored by a specialist to prevent periods of relapse. In addition, it is important for the infected person to come to terms with the situation, since most patients with the herpes virus experience severe psycho-emotional stress and discomfort (psychosomatics).

For reference! During the latent form of herpes genius, it is impossible to transmit the virus to another person. Infection can only occur when symptoms of infection appear.

A person with such a diagnosis must understand that any unprotected sexual intercourse during the period of relapse of herpes can lead to the spread of the virus between partners. You can become infected with the virus not only through sexual contact, but also through household contact. It is also important for people with this disease to protect their body from stress, serious illnesses and a decrease in immunity against this background.

Disease Prevention

In addition, which doctor should you consult for a herpetic rash, whether it can be completely cured, and how to live with such a disease, the topic of preventing such a viral infection is no less important. The most important preventive method is routine vaccination of the country's population, which is prescribed in legislation and the healthcare system.

Nonspecific measures to prevent genital herpes are as follows:

• healthy lifestyle;
• playing sports;
• proper nutrition;
• giving up all bad habits;
• protected sexual intercourse;
• compliance with personal hygiene standards.

For virus carriers, it is important to avoid hypothermia, overheating, vitamin deficiency and immunodeficiency. To do this, it is important to take vitamin complexes during the off-season, as well as monitor your health, preventing various diseases.

Genital herpes is a fairly common problem. Statistical studies indicate that almost 20% of the world's population are carriers of the virus of this disease. In most cases, the infection can be cured quite easily, especially if diagnosed early. On the other hand, the development of inflammation of the urinary system and other complications is possible.

In light of such facts, information about this viral disease will be useful for every person. How is it transmitted? Are there effective methods of protecting against the virus? What symptoms should you pay attention to? What treatment can modern medicine offer? How dangerous is this disease? Many readers are looking for answers to these questions.

General information about genital herpes

It's no secret that the herpevirus family is quite large and includes more than 200 different types. And before considering the question of how the herpes virus is transmitted, it is worth learning more about the causative agent of this disease.

By the way, the “culprits” for the development of the disease are two main types, namely: HSV-1 and HVS-2, which are commonly referred to as herpes simplex viruses. Virions of these two types are quite similar - the differences between them are only in the different composition of the glycoproteins of the protein shell. Symptoms of genital herpes can develop when tissue becomes infected with any of these types of herpes. Nevertheless, statistical studies confirm that damage to the mucous membrane of the genital organs more often appears in connection with the activity of herpes simplex type 2.

How is genital herpes transmitted?

Herpes is extremely common among the modern population. So how is genital herpes transmitted? The main route of infection is unprotected sexual contact with infected people. At the same time, the likelihood of catching an infection is greater if your partner’s herpes is in the acute stage. By the way, not only traditional vaginal contacts are potentially dangerous - viral particles can also pass from person to person during oral and anal intercourse.

Many people are interested in questions about whether genital herpes is transmitted through airborne droplets. The answer to this question is no, since virions are destroyed very quickly in the external environment. Household transmission is possible, but the likelihood of contracting the infection by sharing towels or other items with an infected person is much lower.

Is genital herpes transmitted through blood? Absolutely yes. It is also possible that the fetus may become infected during pregnancy if the mother is a carrier of viral particles. By the way, the activation of herpes during this period is quite dangerous, as it can harm the body of the mother and child.

How do diseases develop? Brief description of physiological changes

We have already looked at the question of how genital herpes is transmitted. Regardless of how exactly pathogenic virions entered the human body, their development pattern looks the same. Through the mucous membranes, viral particles “migrate” to the tissues and then penetrate into the cells. The genetic material of the virus is incorporated into the DNA of a human cell, as a result of which they begin to synthesize not only their own, but also viral copies of the genetic material. This is exactly what happens: When the number of infected cells increases sharply, the standard symptoms of herpes develop.

Moreover, viral particles spread to nerve fibers. And if, after treatment, all infected cells are destroyed and replaced by new and healthy ones, viral particles remain in the nerve ganglia. That is why it is completely impossible to cure a person from a herpetic infection - there is always a risk of relapse.

Are there risk factors?

We found out the answer to the question of how the herpes virus is transmitted. But, according to scientific research and statistics, there are groups of people in whom this infection is diagnosed more often than others. For example, it has been proven that homosexuals and people have antibodies to the herpes virus more often. The same can be applied to the fair sex - it is much easier for women to catch such an infection.

Naturally, the risk group includes people who lead a promiscuous sex life, since the virus is most often transmitted through sexual contact. Genital herpes is also quite often diagnosed in combination with others, since a weakened immune system is not able to protect the body from the penetration of pathogenic microorganisms.

It is also worth saying that not all carriers of this pathogen show symptoms of the disease. Many people are unaware of the infection for years. The fact is that a healthy immune system clearly controls the number of viral particles, preventing the infection from multiplying and spreading.

As a rule, the appearance of symptoms of genital herpes is associated with a weakening of the immune defense, which, in turn, can be a consequence of vitamin deficiencies, pregnancy, sudden climate changes, overheating and hypothermia of the body, and smoking. Also, activation of the herpes virus is often observed in the presence of colds, which briefly reduce the activity of the immune system. Do not forget that frequent stress, constant fatigue, emotional stress, nervous breakdowns - all this affects the immune system and can activate a viral herpetic infection.

Main symptoms of the disease

It is immediately worth noting that long-term persistence of symptoms of genital herpes is not at all necessary. Moreover, quite often the primary disease occurs without any symptoms. In such cases, doctors talk about virus carriage - a condition in which a person is a source of infection, but he himself does not have any complications or disorders.

But another clinical picture is also possible. Approximately 1-10 days after infection, itching and a burning sensation appear in the genital area. Sometimes swelling of the mucous membranes is also observed. These are the first signs of genital herpes.

After some time, a characteristic rash begins to appear on the mucous membrane, which looks like blisters with watery contents. The skin around the rash turns red, and the itching often becomes more intense.

As the disease progresses, the lymph nodes in the groin area may become enlarged, which confirms the presence of an infectious inflammatory process. In addition, some patients experience other signs of intoxication of the body, namely: increased body temperature, weakness, chills, fatigue, and muscle aches. After a few days (usually 2-4), the blisters begin to crack, their contents come out, and small ulcers form at the site of the rash.

This stage usually lasts about 2-5 weeks. With proper and timely treatment, the main symptoms of herpes go away after 1-3 weeks. By the way, in some people the exacerbation of the disease goes away on its own, without the use of any drugs.

Approximately 75% of patients experience so-called recurrent genital herpes, which is repeated exacerbations of the disease from time to time. Such relapses pass relatively easily - there is no weakness or fever. The same rash forms on the skin and mucous membranes of the genital organs, although in much smaller quantities. The rashes disappear faster and do not cause as much discomfort.

Features of genital herpes in women

Of course, the characteristics of the disease directly depend on the gender of the patient. For example, in women, a rash appears not only on the labia, but also on the mucous membrane of the vagina, around the anus, and sometimes even on the skin of the buttocks. Added to the woman’s general clinical picture are nagging pains in the lower abdomen, which intensify in the second half of the menstrual cycle. Sometimes the pain is quite noticeable and can radiate to the rectum.

Complications of genital herpes can be dangerous. For example, patients are sometimes diagnosed with the so-called atypical form of the disease. The disease is not accompanied by a standard set of symptoms. There are no rashes, pain or itching. However, there is constant chronic inflammation of the pelvic organs. This affects the state of the reproductive system, and sometimes leads to complete infertility.

Features of the course of the disease in men

Herpes in men is also accompanied by the appearance of rashes, and they are localized mainly on the head of the penis. Quite often, patients complain of pain that spreads to the perineal area.

If left untreated, the infection can lead to inflammation of the urethra. A fairly common complication is urethritis (inflammation of the urethra). Infection of the prostate gland with the herpes virus can lead to the development of acute prostatitis.

Modern diagnostic methods

Diagnosis of genital herpes is a rather lengthy process. If you suspect an infection, you should immediately consult a doctor. As a rule, the first step is to collect a medical history and examine the patient for the presence of the main external symptoms of the disease. For example, characteristic blisters can be found on the skin of the genital organs.

By the way, sometimes the contents of the vesicles are taken for analysis, during which viral particles are planted on a chicken embryo, observing the development and death of cells. Such a study is quite labor-intensive, but makes it possible to accurately determine the type of virus and determine its sensitivity to certain medications.

PCR diagnostics are considered quite accurate. Also in modern medicine, enzyme-linked immunosorbent assays are often used, during which they determine the presence in the blood not of the virus, but of antibodies to it, which indicates a previous illness and, accordingly, the presence of herpes virions in the patient’s body.

What treatment does modern medicine offer?

Of course, the treatment regimen is determined individually and directly depends on the severity of the disease, the age and gender of the patient, the individual characteristics of the body, and the presence or absence of complications. Nevertheless, some common features can be identified.

The basis of therapy is antiviral drugs. The most popular and effective medications include Acyclovir, Valacyclovir, Famciclovir, Foscarnet and many others. Today, these medications are available in various forms, including tablets, solutions for intravenous and external use, ointments and gels, which help relieve itching and burning. According to statistical studies, the effectiveness level of this medicine is 60-70%. In most cases, therapy with antiviral drugs lasts 7-10 days.

Quite often, treatment is supplemented with medications that stimulate the body’s production of its own interferon. Such drugs activate the immune system, accelerating the healing process. The most effective means include “Amiksin”, “Arbidol”, “Poludan”. By the way, these are the drugs prescribed for routine prevention of recurrent genital herpes.

Genital herpes during pregnancy: what is the danger?

Infection with herpes during pregnancy is extremely dangerous, both for the woman and for the growing fetus. The consequences of the disease depend on many factors. For example, if the expectant mother was infected during the first trimester, then the likelihood of spontaneous abortion is high. In addition, viral particles can penetrate the tissues of the fetus, causing disturbances in its further development.

Activation of herpes in the later stages of pregnancy can lead to premature birth, which is also fraught with complications, because we are talking about a premature baby. There is also a possibility of infection of the fetus during childbirth and the development of herpes in a newborn child, whose body tolerates this infection quite hard. The decision on how to treat a genital infection can only be made by the attending physician, since not all antiviral medications are allowed during this period.

Basic preventive measures

Knowing how genital herpes is transmitted and how it occurs, it is quite easy to guess what exactly prevention looks like. Since viral particles are mainly transmitted during sexual intercourse, it is extremely important to use condoms. However, even they cannot guarantee 100% protection, and therefore during an exacerbation of the disease, experts recommend completely abandoning contact with a partner.

From time to time, you can take a course of taking antiviral drugs, which reduce the likelihood of a relapse in an infected person and minimize the possibility of the infection spreading to a healthy person. But, again, such drugs can only be prescribed by the attending physician.

After unprotected sexual intercourse with a carrier of the virus, you can treat the external genitalia with an antiseptic. And of course, it’s worth watching your diet, maintaining physical activity, walking in the fresh air, in a word, strengthening your immune system.