Clinical and epidemiological features, diagnosis, treatment
- At what age is primary skin herpes detected?
- What are the clinical manifestations of herpes simplex?
- What studies are needed to confirm herpetic infection?
- How can the effectiveness of antiherpetic therapy be evaluated?
- Herpes simplex is one of the most common viral diseases in humans, whose agent is the herpes simplex virus (Herpes simplex).
There are two main antigenic groups of herpes: type I and type II (HPG-I, HPG-II). Strains of HPG-I are more often identified in lesions of the face skin, upper extremities, and HPG-II – in the genital localization of foci, although there is no direct link between the antigenic specificity and the localization of clinical manifestations of herpes.
The source of GHB infection is a patient or a virus carrier. The virus is transmitted by airborne, contact, transfusion and organ transplantation routes. During pregnancy, infection of the fetus may occur through the transplacental and transcervical routes.
It has been established that in 40% of cases, primary infection with VPH occurs by airborne droplets in early childhood, and the source of infection is usually family members with recurrent herpes of the lips.
Clinical manifestations of herpes simplex in humans are characterized by diversity and depend on the localization of the lesion site, the age of the patient, the state of his immune and nervous system – factors that determine the severity and prevalence of the disease, the risk of developing complex forms of disease.
The most common form of primary herpes, herpetic stomatitis, is found in children between six months and three years of age, which is explained by the disappearance of maternal antibodies by the age of six months, the lack of development of local immunity in the oral cavity, and the frequent natural disturbance of mucous membrane integrity through teething.
Primary herpes of the skin appears in older children. Typical areas of its localization are the red edging of the lips and the skin around the mouth.
In adults not previously infected with VPH, primary infection of VPH-I usually manifests itself as an acute upper respiratory tract infection: VPH pharyngitis or VPH-tonzillite.
Genital herpes (GH), a clinical variant of herpes simplex, is one of the most common sexually transmitted infections (STIs) and differs from other diseases in this group in that it is carried in the human body for life.
Today, there are 86 million people in the world who are infected with Type II HBV, traditionally associated with GH. The incidence of genital herpes in Russia increased two and a half times between 1994 and 2000 (from 7.4 to 18.4 cases per 100,000 population). At the same time, women aged 18 to 39 years are in the risk group, where the incidence of GH is 135.7 cases per 100,000 population of this sex and age.
Infection of genitalia occurs through close physical contact with a patient or a virus carrier in case of genital, oral, genital-rectal and oral-anal contacts. Women are sicker than men. Individuals with early sexual debut and multiple sexual partners are at increased risk of developing GH.
Clinical manifestations of primary GH are more pronounced in seronegative than in seropositive individuals, which indicates the impact of the immune response formed on herpetic infection (HI) of GH-I in childhood, on the severity of clinical manifestations of herpes when infected with GH-II genitals.
If antibodies to GI are present, a person is twice as likely to develop asymptomatic form of GI-II infection. In most cases, primary infection of the genitals is asymptomatic, with the subsequent formation of the latent carrier of VPH or a recurrent form of genital herpes. Only 10% of those infected develop clinical symptoms of primary HG.