In the daily outpatient clinic and personal website Q&A, I encountered many inquiries about genital herpes diagnosis, treatment and prevention, many patients have many misunderstandings in these areas, therefore, based on my many years of experience in the STD clinic, I collected a lot of information, the first draft of patients or Internet users often mentioned the problem and answer one by one, in order to improve the patient’s scientific knowledge in the diagnosis and treatment of genital herpes The first thing you need to do is to avoid wasting your energy and financial resources in the event of an emergency.
1. What is herpes simplex virus?
Humans are the only natural hosts of Herpes simplex virus (HSV), which infects up to 80-90% of the population and 10% of the population is asymptomatic. HSV has a diameter of about 120-150 microns and is composed of three concentric structures: the envelope, the body, and the capsid, in that order. The body is composed of fibrous material and the cell membrane contains lipid components, so the 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. 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 HSV-1 infection. HSV-2 is mainly found 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 more than 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 will cause. The disease is clearly defined as one of the sexually transmitted diseases, both at home 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, genital herpes has shown a rising trend year by year in recent years.
4. How is the herpes simplex virus transmitted?
Herpes simplex virus is present in the herpes fluid, oral and nasal secretions and feces of the infected person, among which herpes type II virus is mainly present 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 the patient.
5.Will herpes simplex virus in pregnant women be fetal?
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. Herpes neonatorum is caused by the delivery of a newborn through the birth canal, resulting in neonatal encephalitis with a high mortality rate (70-80%) and central nervous system sequelae in 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 invasion site. The incubation period of individual patients can also be months long.
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. humoral antibodies do not stop herpes virus recurrence, and weakened cellular immunity has a major impact on recurrence. genital herpes with HSV-1 infection 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, infecting 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 the 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, latent 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 choosing a cesarean section. For testing of sexually active people, it can reduce sexual contact infection. 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?
A: 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 methods for viral infections (mainly WBA and part of ELISA test), using virus type-specific Glycoprotein G (gG-1 and gG-2) as the antigen, can be sensitive and specific detection and differentiation of antivirus type 1 and antivirus type 2 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%. The accuracy of the test is incomparable compared with similar kits in China.