Overview:
Genital herpes is caused by Herpes Simplex Virus (HSV) type I and type II.In recent years, the incidence has increased significantly.In China, it is also a new generation of members in attribute diseases, and people do not know enough about it.Polypense virus can cause skin, mucous membranes and various organs infections.It can cause genital herpes through sexual contact with infection.Genital herpes virus has two serum types; HSV-I and HSV-Ⅱ.Most genital herpes are caused by HSV-Ⅱ. The disease can be chronic recurrence process, and there is currently no good medicine that has not yet been cured.At present, HSV has become the primary cause of genital ulcers in many countries and regions, and it is also related to the infection of the onset and newborn herpes disease.
Cause:
Polymids virus infection
pathology:
The local mucosa has a small damage, and the genital herpes virus enters the local mucosa, causing infection.
symptom:
(1) Primary GH: Men are common in penis, foreskin, glans, coronary grooves, scrotum and perineum; women are common in cervix, vagina, urethra, labia, and vulva skin mucosa.Before the onset of the disease, the local reddishness, burning and tension, then clustered small pimples and quickly became chestnut size blisters, cone -shaped, slightly thicker walls, blisters began to clarify.2. Those with three clusters, the erosion surface is exposed after the blister rupture. After a few days, the crust is dried up. After healing, the temporary pigmentation can be left.Some patients may have burnout, full body discomfort, low fever and scholarship in nearby lymph swelling.If the rash is involved in the urethral opening, symptoms such as dysuria and difficulty in urination may occur.Those who occur in the vagina and cervix may have no symptoms of consciousness because they are relatively not sensitive.A small number of cases can cause scattered infections such as HSV encephalitis.Generally, primary infections can last slowly for 1 to 2 months.
(2) Recurrent GH: The symptoms of recurrence are mild, and the course of disease is short. Generally, there is no symptoms of the whole body.HSV-2 patients are easy to relapse than HSV-1.Before recurrence, there may be symptoms of front -drive, such as local itching, blisters occur from time to time at the initial infection site, and formation of erosion or shallow ulcers, the rash can be removed for 7 to 10 days.
Symptoms can be seen in the good parts of the good parts, and pustules can be formed after 3 to 5 days. After the ulceration, erosion, ulcer, and finally scabbing healing.
diagnosis:
There is a history of unclean sexual intercourse, and a group of blisters occur in the external genitalia. Those who consciously symptoms and pain should do the following examinations:
1. Checked liquid coating method: Use a cotton swab to scrape the specimen coating from the blister base, dye the WRIGHT or GIEMSA, and find the nucleus in -nucleus in the nucleus in the nucleus in the optical microscope of the optical microscope.Essence
2. Blood virus cultivation: Disinfeted with vinegar (without alcohol) blisters when taking materials. Use a dry needle to extract blister liquid into the disinfection test tube and send the laboratory for cultivation. The separation of the virus from the tissue culture can establish diagnosis.The positive rate of this method is more than 80 %, and the price of viruses is currently expensive.
3. Indirect fluorescent antibody examination: Scrape the blister liquid on the glass tablet.Add 2 drops of phosphate buffer physiological saline, the air is dry and fixes, and the antipotalog virus serum and fluorescein are marked with the resistance of the splin protein to see the positive fluorescence.
4. Serum science method: Measure the cost of HSVII antibodies. This method is helpful to the primary type and it is meaningless to the recurrence.
This disease should be identified with the following diseases:
There is a history of unclean sexual intercourse in the soft undercib, and the outer genital skin appears abruptly ulcers. The ulcer is red but soft around the ulcer, accompanied by pain.Half of the patients with ulcer surfaces can find pathogenic bacteria.
There are only one incubation period and hard and painless damage under the hardcores of syphilis. The damage of the exudate can be found to find the pale butterfly spin, and the syphilis serum test is positive.
The vulva skin lesions of Baisai's disease are ulcers, accompanied by fever joint pain, oral mucosal ulcer or keratitis, irisitis and other changes.High blood sinks, acupuncture reaction is positive, and pathological changes in vasculitis.
treat:
This disease has self-limiting, and it can heal at about 1-2 weeks.The purpose of treatment is to prevent the next recurrence.There is currently no special drugs in this disease. The principle of treatment is to shorten the course of the disease, prevent secondary infection, and reduce recurrence.
1.Local therapy: The principle is dry, convergence, and protect the affected parts to prevent secondary infections.It can be applied to 2%dragon purple solution, or 10%non -meal acid (Dermatol), zinc oxide ointment or mud cream, purotic ointment, 0.5%chinomycin ointment, or 0.25%~ 0.1%herpes net (IDU) ointment, 5%herpes net second meta -based solution (for skin herpes), etc.Those who are faces can also use 10%aluminate or zinc and copper agent.
2.Specification: The principle of treatment makes the infected HSV cannot be activated or even eliminated by the virus; the second regulates immunity and prevent reinstatement, you can use Agelovoviri to drip or take orally, Lizhu Weigou, interferon muscle injection, leukoplastin Ⅱ Ⅱ ⅡMuscle note.When treating recurrent genital herpes, we use 3 million units of muscle injection of interferon produced by the Biotechnology Center of Four Medical University. Once once a day, 10 times for one course of treatment, a total of three courses, properly cooperate with leukopenocycin Ⅱ or 利 百 百 百 百Multi -or P. and 95%of patients do not recur.
Here are the method of treating herpes for others for reference:
1. Anti -HSV drug
(1) Circular udosidin is recognized as effective drugs:
1.Origin and first infection: ACV200mg, 5 times a day, 7 days in a row; or ACV 5mg/kg, note according to weight, once every 8 hours, for 5-7 consecutive days.
2.During the recurrence infection, ACV 200mg, 5 times a day, 5 days in a row, or ACV800mg, 2 times a day, 5 days in a row;It may be effective for some patients
3.When the recurrence is frequent: ACV200mg, 3 times a day, can be taken for 6-12 months in a row.Among the frequent recurring patients (each year "6 times), the daily treatment can be reduced by at least 75%of the number of recurrences. People who have been treated for up to 3 years have been determined to be safe and effective.HSV plants that are resistant to ACV have been separated from the crowd of treatment, but those with normal immune function have not seen the failed.After 1 year of treatment, the medicine should be discontinued to re -evaluate the recurrence rate of patients.
4.Immune patients with inhibitory patients: first or recurrence of acute patients: quiet injection ACV (5 mg/kg/8H) or oral ACV400mg × 4 times/day, a total of 7-10 days; inhibitory recurrence: daily restraint ACV (5mg/kg/8H 8H) Or oral ACV (400mg × 3-5 times/day) can prevent recurrence.
5.HSV rectitis, 400mg of ACV, 5 times a day, can shorten the course of disease.Immune -inhibiting or severe illnesses can still note ACV5MG/KG/8H.
6.Newborn HSV: The existing information believes that it should not be used in a routine to be treated with non -symptom babies that pass the infection of the birth canal. The treatment is limited to children with HSV clinical manifestations and postpartum virus culture.All newborn HSV infections should be treated with ACV or Aglycellosine.ACV300mg/Kg/D is often used, and 30mg/kg/d of alcohol adenosine is 10-14 days.
7.Merge HIV infection: Patients need orally oral ACV or daily inhibitory treatment.It is very useful for increasing the ACV dose for merging HIV infection.
ACV400mg, orally, 3-5 times a day, effective treatment, continuous medication should be continued until the clinical symptoms disappear; for intensive patients, apply ACV intravenous administration, the best solution for severe patients caused by suspicious or confirmed ACV drug resistance plants, the best solutionIt may be: ACV400mg/kg, intravenous injection, once every 8 hours until clinical healing.
Skin injury in HIV infection is increasing in large doses of ACV infected with mucosal HSV infection.Large -dose ACV helps some patients to heal, but it cannot prevent the disease of other patients from progressing.For those who have recurred frequently for a long time, ACV cannot stop continuing to detoxify. Therefore, it is still possible to be infected with sexual accompaniment. At this time, antiviral drugs with different mechanisms such as changing the mechanism of action may be effective.
The ACV's antiviral mechanism is that it is easily acidified by thymidinosin kinase encoded by HSV, forms an ACV-MP, and then the ACV-TP is formed by cell kinase.ACV-TP competes with DGTP to inhibit virus DNA synthesis.
When the first clinical seizure of ACV's whole body application or as a inhibitory drug, the symptoms and signs of herpes seizures can be controlled.However, the medicine can neither eradicate the latent virus infection, nor can it affect the number and severity of the future attacks.The effect of local treatment of the drug is worse than that of oral administration, so local drugs are not recommended.
ACV can shorten the course of genital herpes, accelerate healing and relieve symptoms. Long -term applications can reduce recurrence. Some people have been continuously treated for 5 years of Normal GH for 5 years, and the recurrence rate is significantly reduced during this period.
However, long -term oral ACV cannot remove the latent virus of the sacral nerve festival. After the drug is discontinued, the genital herpes can still recur. More and more virus strains have resistance to ACV. Almost all drug resistance occurs in multiple diseases.Immune damage.
The main side effects of ACV intravenous application are temporary renal insufficiency caused by the crystallization of drugs in the substrate of the kidney.This side effect can be avoided if you take a slow administration for more than an hour or a large amount of water.
(2) Virus (triazoolucleoside, Ribavin RBV): A variety of DNA and RNA replication and synthesis.
Dosage: The original GH and AIDS merged HSV infection, 15mg/kg/d, muscle injection; recurrence GH, 0.4g, orally, 4 times a day, 3 days after 3 daysMust be used for drug -resistant virus strains.
(3) Trisodium Phosphonoformate (PFA); DNA polymerase depends on DNA dependencies induced by herpes virus virus, mainly used for infection of ACV virus strains.
Dosage: 40-60mg/kg/d, intravenous injection, once every 8 hours, 4 times in a row, can be used for AIDS with HSV infection.Topical 0.3%-1%PFA cream.The auxiliary use of kidney toxicity and calcium and phosphorus metabolism disorders.
(Four), hydroxydium oxygenylinoside (Ganciclovir, Ganciclovir, DNPG): It is a derivative of ACV. By inhibiting virus DNA replication, RNA synthesis is blocked. Infection cell DNA polymerase is the target position of action.
Dosage: 5-10mg/kg/d, divided into 3 static injections, for 14 consecutive days, side effects include hematopoietic system inhibitory and liver damage.
(V) Fluoroshide iodine (FIAC): It has the same effect on HSV-1 and HSV-2, and selectively acts on cells infected by viruses.Both have antiviral effects.Altaricinoside phosphate inhibits virus DNA synthesis. It has a broad -spectrum antiviral activity. The use of less partial use can not prevent the establishment of latent infection, but preventing the virus from entering the central nervous system has a certain protective effect.Anti-HSV monoclonal antibody has a local external use and has a treatment effect on GH. Some people reported that the total effective rate of HSV-2 was 92.6%, and the basic healing rate was 44.1%.
(6) INDOMETHACIN: The role is to inhibit the synthesis of prostaglandin, help reduce the recurrence of GH, promote the cell proliferation effect of CONA and PHA (plant hemorchin) stimulation, and strengthen the killing ability of NK cells.Can be used for recurrence of GH, dosage: 25mg orally, 3 times a day.
(7) Poly Zic: It is an artificial synthetic interferon induction, which can stimulate phagocytosis, enhance the formation of antibodies, and regulate and use the immune system.Dosage 2mg, muscle injection, 2-3 times/week.
2. Treatment of GH pregnancy
The safety of pregnant women's use of cycloin non -ringless is not yet affirmed, but the study found that the incidence of pregnant women with ACV has not increased compared with normal people, but the danger of ACV on pregnancy and fetus has not reached a reliable conclusion.
HSV infections that threaten the life of the mother, such as encephalitis, pneumonia, and hepatitis, should use ACV intravenous medication, but no HSV infection that threatens life does not need to be treated with ACV.
According to the suggestions of the American Infectious Diseases Society, the GH treatment scheme of recurrence during pregnancy is as follows
(1) If there is no active genital damage during childbirth, there is no need to have a caesarean section;
(2) Within 3 months of pregnancy, the symptomatic recurrence is short. As long as there is no mobility damage during childbirth, it can be delivered through vaginal.
(3) Those who have activity GH during the delivery can be treated as follows: ① The amniotic fluid is not broken, the pregnant woman is not fever, and the fetus is not mature, and the delivery should be delayed;Caesarean section.
prevention
(1) Avoid unclean sexual intercourse and improper sexual relationships, patients with active genital sores are absolutely prohibited from having sexual relationships with anyone;
(2) During the treatment period, intercourse is prohibited, and the spouse must also be checked if necessary;
(3) Care for local damage should be kept clean and dry to prevent secondary infections.
(4) After cure or recurrence, pay attention to preventing cold, cold, tired and other induced factors to reduce recurrence.
At present, there is no specific prevention method. Animal experiments have shown that inoculating HSV dead vaccines or drug reduction vaccines all have immune effects. Therefore, the relationship between viruses and certain cancers is closely related, so it is not conventional prevention.Recently using purified herpes virus envelope sugar protein as vaccine can prevent the carcinogenic risk of herpes virus DNA.
ACV also has a preventive effect.Penile cases may reduce the transmission of diseases, especially during the asymptomatic detoxification period, but when genital damage occurs, the use of the penile cover cannot avoid transmission.
(Editor in charge: Chen Bong)
