1. What is herpes simplex virus?
HSV is the only natural host of herpes simplex virus (HSV for short), with 80-90% of the population infected and 10% asymptomatic. HSV has a diameter of about 120-150 microns and is composed of three concentric structures in the order of envelope, body and capsid, with the body consisting of fibrous matter and the cell membrane containing lipid components, so herpes simplex virus is particularly sensitive to ether and lipid solvents. It can survive for months at low temperatures, and can be destroyed in 30 minutes at 50°C in humid heat and 90°C in dry conditions.
2. How many types of herpes simplex are there?
Herpes simplex virus can be divided into two types, HSV-1 and HSV-2. HSV-1 is mainly transmitted through close contact with the respiratory tract, skin and mucous membranes, and infects the skin mucous membranes and organs above the waist. If it causes inflammation and herpes in the mucous membrane of the mouth and lips, nasal vestibule, conjunctiva, pharynx, and herpes occurring around the mouth and mouth, 99% is caused by HSV-1 infection. HSV-2 mainly exists in the cervix, vagina, vulvar skin of women and penis and urethra of men, and is the culprit of genital inflammation and herpes. It is estimated that 20% of the world’s population is HSV-2 positive, and the number of cases is increasing by about 25% every year. HSV-1 is one of the most widespread viral infections in the world, with a seropositivity rate of over 85% in adults and even 100% in some countries and regions.
3. Is genital herpes a sexually transmitted disease?
Genital herpes is mainly caused by the herpes simplex virus HSV-2. The disease is clearly defined as one of the sexually transmitted diseases, both domestically and abroad. In foreign countries, the incidence of genital herpes is the third most common STD after gonorrhea and syphilis, and the first among STDs caused by viruses. In China, in recent years, genital herpes has shown a trend of increasing year by year.
4. How is the herpes simplex virus transmitted?
Herpes simplex virus exists in the herpes fluid, oral and nasal secretions and feces of infected people, among which herpes type II virus mainly exists in the cervix, vagina, vulva skin of women and penis and urethra of men, etc. Healthy people are infected through direct close contact and sexual contact with patients.
5.Will herpes simplex virus in pregnant women fetus?
The fetus may be infected through the placenta during pregnancy and through the birth canal during delivery. Occult infection is common, with only 10-20% of first-time infections showing symptoms. Pregnant women who are newly infected with HSV are more likely to transmit the virus to their newborns than those who have been infected for a long time. Intrauterine herpes infection in the fetus can lead to miscarriage, preterm birth, stillbirth and birth defects. Neonatal herpes is caused by infected pregnant women who deliver their newborns through the birth canal, resulting in neonatal encephalitis with a high mortality rate (70-80%) and central nervous system sequelae in the survivors. The current incidence of neonatal herpes in the United States is about 1/1800.
6. What is the incubation period of herpes simplex?
HSV invades mucous membranes or broken skin, and after an incubation period of about 1 to 26 days (average 5 to 7 days), it produces erythema, papules and blistering damage at the site of invasion. The incubation period for individual patients can also be several months.
7. Why is genital herpes prone to recurrence?
Herpes simplex infection produces neutralizing and complement binding antibodies in the body after 1-3 weeks, and the residual virus may be transferred to the peripheral nerves along the nerve axis into the trigeminal ganglion (herpes virus type I) or sacral ganglion (herpes virus type II), where it remains latent for a long time and enters a quiescent state. When some triggering factors such as anxiety, trauma, exposure to cold, sun, wind, trauma, infection, drug allergy, high fever, menstruation, pregnancy, etc. disrupt the body’s physiological balance, specific transcriptase required for virus proliferation appears in the nerve cells, activating the virus and causing recurrence. The recurrence rate of genital herpes with HSV-1 infection is much lower than the recurrence rate of genital herpes with HSV-2 infection.
8. What are the manifestations of HSV infection?
HSV-1 is mainly transmitted through close contact with the respiratory tract, skin and mucous membranes, and infects the skin mucous membranes and organs above the waist. For example, it causes inflammation and herpes in the mucous membrane of the mouth and lips, nasal vestibule, conjunctiva, and throat, and 99% of the herpes occurring in and around the mouth is caused by herpes virus type I infection.
HSV-2 is found in men on the glans, coronal sulcus, urethral opening, penis, scrotum, thighs and arms. In women, it occurs in the labia, mons pubis, clitoris, perianal area or vagina. In about 90% of patients, the virus may also invade the cervix, presenting with increased vaginal discharge or lower abdominal pain, and may be complicated by cervicitis and uterine inflammation. Most patients of both sexes have bilateral enlarged inguinal lymph nodes. In later stages, when the inflammation spreads to the urethra and bladder, there may be difficulty in urination, painful urination, frequent urination, and in severe cases, urinary retention. In addition, there may be other symptoms present at the same time, such as fever, general malaise, headache, cervical tonicity, meningitis, and sacral neurological insufficiency. The disease is more common in women than in men, and the symptoms are more severe than in men. About 10% of the patients have pharyngitis, and 10% of men and 26% of women with primary genital herpes also have lesions outside the genital area, mainly on the arms and fingers, commonly in the second week after the appearance of herpes on the genital area, mostly due to self-inoculation of the virus from the infected genital area.
9. What are the typical manifestations of genital herpes?
When first infected with the genital herpes virus, it usually takes about 2-10 days from the time of contact to the onset of the disease, which is the incubation period. The site of the disease first has a burning sensation, and soon 3-10 red papules occur in clusters on top of the erythema, accompanied by itching, and the papules soon become small blisters, which turn into pustules after 3-5 days, and then break down to form large vesicles and ulcers, which are painful and finally heal with scabs. The entire course of the disease can last about 20 days. Between 50% and 70% of patients with genital herpes do not show any symptoms. Among patients with genital herpes, male homosexuals can develop anorectal infection with rectal herpes virus type II, which is second only to gonococcal anorectitis in men. The clinical manifestations are severe anorectal pain, constipation, pus discharge and urgency, and there may be blisters and ulcers in the anus.
10.What is an asymptomatic HSV infected person?
Not every infected person will show discomfort or clinical manifestations after HSV infection, only 10-20% of patients have symptoms. This is the reason why HSV transmission is increasing year by year and is difficult to control. According to foreign studies 45% of HSV-infected patients never realize they are HSV patients.
11.What is the significance of herpes simplex virus typing test?
Herpes simplex has an epidemic trend of high infection rate, occult infection and transmission that increases year by year and is difficult to control. For pregnant women and perinatal women: testing for herpes simplex can prevent the birth of unhealthy and mentally retarded children; reduce the incidence of herpes in newborns; and provide a reference for the choice of cesarean section. For sexually active people: testing can reduce sexual contact infections. Testing of immunocompromised populations may prevent hepatitis and pediatric encephalitis in immunocompetent children and reduce mortality from acute episodes of herpes simplex in patients using immunosuppressive drugs.
Because of the cross-infection that can occur between HSV1 and HSV2, and the differences in the severity of disease and illness that each causes, it is increasingly important to provide clinical typing for diagnosis. Treatment options and prognosis differ for different types of herpesvirus infections. Approximately 90% of people with first genital herpes HSV-2 infection will experience a recurrence within 12 months (average of 4 recurrences), whereas only 50% of people with first HSV-1 infection experience a similar recurrence (average of less than 1 recurrence). recurrence rates for HSV-2 infection are highly variable, with most recurrences occurring 5-9 times per year, usually within 1-6 months after the primary herpes has subsided.
12.What are the advantages of Trinity products for detecting HSV in herpes simplex?
It is the only product in China that has passed all the certifications of FDA, CE, and SFDA, and has excellent quality. It can provide kits for accurate typing of IgM and IgG type-specific antibodies including HSV-1/HSV-2 (type-specific serological diagnostic method for viral infection (mainly WBA and part of ELISA test), using the virus type-specific glycoprotein G (gG-1 and gG-2) as the antigen, can be sensitive and specific detection and differentiation of anti-1 virus and anti-2 virus antibodies in the serum), is the product recommended by the U.S. CDC, China CDC, etc., the domestic authority test results: sensitivity 100%, specificity 96.4%. The test results of domestic authorities: sensitivity 100%, specificity 96.4%. Compared with similar domestic products kits have incomparable accuracy. (Click the picture to enlarge)
13.What is the clinical significance of HSV-specific serological test?
HSV-specific serological examination can accurately determine the disease. Specific IgM antibodies appear about 2-3 days after the first HSV infection, and peak IgM antibodies reach about one week. The level of IgM antibodies is maintained for a period of time thereafter and decreases rapidly during the healing period, with basically no detectable antibodies after 8 weeks of infection. Thereafter, it declines slowly until the healing period when it maintains equilibrium. Specific IgG antibodies rise rapidly when HSV is reinfected and peak within a week, after which they rapidly return to normal levels. Therefore, the combined use of HSV1 and HSV2 specific serologic tests can accurately determine the stage of progression, severity, and onset cycle of HSV infection and other important information to accurately determine the disease. Type-specific serologic antibody testing is the most feasible means of detecting subclinical asymptomatic infections, and therefore type-specific serologic diagnosis is important for preventing sexual and mother-to-child transmission of genital herpes. Type-specific serologic diagnostic methods will play an important role in clinical research, epidemiologic studies, and surveillance of genital herpes.
14. Can women with genital herpes get pregnant and have children?
Women with genital herpes are able to have a safe pregnancy and normal vaginal delivery. This is especially true in women who have been diagnosed with genital herpes before they become pregnant. In cases where a pregnant woman already has a history of genital herpes infection, antibodies are present in her bloodstream and will protect the fetus during pregnancy and delivery.
The fetus is at risk of herpes infection only in two cases.
(1) In the early stages of pregnancy (within the first 12 weeks of gestation): when a severe first episode occurs, it can lead to miscarriage. This is rare. This risk is also present in the case of many other viral infections, including influenza.
(2) In the second trimester (the last three months of pregnancy): When an initial attack occurs, a large amount of virus is present in the mother and there is not enough time to produce antibodies to protect the fetus. Transmission of the virus to the fetus can result in neonatal herpes in particular, which can lead to neonatal death. However, neonatal herpes is extremely rare in developed countries. Careful monitoring, judicious use of antiviral therapy and/or cesarean section may reduce the risk of this neonatal infection.
15. What should I be aware of during pregnancy in patients with genital herpes?
If a pregnant woman has genital herpes herself or her sexual partner, it is important to inform her doctor of this condition. When the male partner has genital herpes and the woman has no evidence of herpes infection, the following measures may help the woman avoid acquiring the virus during pregnancy.
Having blood tests to determine if the woman has antibodies to HSV.
(1) Using condoms after conception until delivery.
(2) Treatment of her male partner with oral antiviral medication to suppress recurrence of genital herpes during pregnancy.
(3) Avoid oral sex during pregnancy if the sexual partner has facial herpes or oral labial herpes.
Regular check-ups should be performed during the prodromal period, while the pregnant woman and her doctor can discuss the possibility of a cesarean section or the use of antiviral medication. In addition, the pregnant woman should follow the general pregnancy health guidelines as closely as possible. During pregnancy, good nutrition and rest may be even more important.
Recurrent genital herpes attacks pose minimal risk to the pregnant woman, but it may interfere with the pleasure a woman brings with pregnancy.
16. What about frequent recurrence of genital herpes?
Due to the many factors affecting the recurrence of genital herpes, some patients have frequent recurrences despite paying close attention to diet, rest, warmth and other daily life, abstaining from sex and strengthening physical exercise. Such patients are often very distressed and have a heavy psychological burden. In this case, long-term suppressive therapy, i.e., acyclovir and other drugs, can be used for at least 1 year of continuous medication. After 1 year of treatment, depending on the patient’s psychological adaptation to the disease and the frequency of disease recurrence, the discontinuation of the medication is considered. The disease basically does not recur while taking the medication, but it may recur after stopping the medication. These drugs have a good safety profile and long-term use does not adversely affect the body, and there is no need to worry about viral resistance. However, this therapy is expensive. Therefore, for patients with prodromal symptoms of relapse, i.e. local itching, burning, tingling, vague pain, numbness, perineal swelling and other discomfort in the genital or anal area for a few hours to a few days before relapse, you can start taking the medication on your own when the prodromal symptoms appear for 1 to 3 days, which can also eliminate the pain of relapse and save money at the same time. Thankfully, as time goes on, genital herpes recurrence decreases and patients do not have to spend their lives with drugs.
17. How is genital herpes transmitted?
Genital herpes is transmitted by symptomatic patients and asymptomatic infections. Asymptomatic infections and atypical patients are the main source of infection for the disease. Asymptomatic infections are quite common among women in prostitution. Most patients with genital herpes contract the disease during sexual contact with sexual partners who are often unaware that they have genital herpes. It is highly contagious when symptomatic, while asymptomatic infections and the asymptomatic phase of recurrent patients can also be contagious. Genital herpes is transmitted through sexual contact and mother-to-child and mother-to-fetus transmission. Sexual contact transmission is the main route of transmission and includes genital intercourse, oral sex and anal sex. Vertical transmission refers to mother-to-infant and mother-to-fetus transmission, including intrauterine infection and infection through the birth canal. Herpes simplex virus is present in the cervix, vagina, urethra, vulva and anus of female patients and in the penis, urethra, anus and semen of male patients. When the mucous membrane of the skin of the sexual organs is rubbed during sexual intercourse, virus particles can enter the skin mucous membrane cells through tiny fissures that cannot be detected by the naked eye.
Barrier contraceptives such as penis condoms can greatly reduce the risk of transmission of genital herpes (especially asymptomatic genital herpes), but infection can occur during sexual intercourse with skin lesions, even with the use of a penis condom. Herpes simplex virus vaccination is the best way to prevent genital herpes, but at present the herpes simplex virus vaccine is only in clinical trials in a few countries such as the United States, and its actual effectiveness is still under further evaluation, while no research on herpes simplex virus vaccine has been conducted in China. Therefore, as with other STDs, cleanliness and elimination of multiple partners are fundamental measures to prevent genital herpes.
18.Why do I need to treat genital herpes?
Genital herpes is a sexually transmitted disease that can cause spousal transmission, and the high recurrence rate can seriously affect the quality of life, as well as have adverse effects on fertility and may cause additional diseases or sequelae.
19: How is genital herpes treated?
Please see: “Ministry of Health 2000 Genital Treatment Program” , “US CDC 2006 Guidelines Genital Treatment Program” The specific treatment plan needs to be developed by the doctor according to the patient’s condition.
20.How can I prevent recurrence of genital herpes?
Although genital herpes has a high recurrence rate, it is not an incurable disease. After treatment, the number of recurrences will gradually decrease or not recur as the body’s immune system strengthens. What patients need to pay attention to in daily life is not to be overly nervous, regular life, strengthen exercise. Under the guidance of the doctor reasonable condom to have sex, to avoid asymptomatic virus emitters, infected spouses or sexual partners. At the same time should also actively mobilize sexual partners for examination and treatment. Work or recreational fatigue or exertion should be avoided. There are no special dietary contraindications, but alcohol consumption, especially intoxication, should be avoided. If the patient is planning to get married or get pregnant, he/she should first undergo standardized treatment and fully consult the physician doctor.