What Are the Different Treatments for Genital Herpes?

Genital herpes is a sexually transmitted disease caused by the herpes simplex virus (HSV). It is mainly of the HSV-2 type and a few are of the HSV-1 type. Is one of the common STDs. Genital herpes can recur, which has a greater impact on the patient's health and psychology; it can also infect newborns through the placenta and birth canal, causing congenital infections in newborns. Therefore, the disease is also one of the more serious public health problems, and attention should be paid to its effective prevention and treatment.

Basic Information

English name: herpes genitalis
Visiting department: Dermatology
Common causes: Source of infection is HSV-2

Common symptoms: Genital or perianal blister, pain, fever, headache, fatigue, etc.
Contagious: Have
way for spreading: Mainly through sexual contact

Genital herpes epidemiology

Source of infection

Humans are the only natural host for herpes simplex virus. Patients with seizures and convalescence, and those with no obvious symptoms of infection are the source of the disease. It is mainly transmitted through vesicular fluid, local exudate, and the virus on the surface of the skin and mucous membrane. The disease is mainly transmitted through sexual activity, with less indirect transmission through contaminated items. In addition, mothers with genital herpes can directly transmit the virus to the newborn through the birth canal during childbirth or become sick during pregnancy and the virus can be transmitted to the fetus through the placenta.

2. Ways of transmission

Infected people are transmitted to their sexual partners mainly through sexual contact. The risk of transmission among male homosexuals is also high. Sometimes people with herpes on and around the lips can get genital herpes through oral-genital sexual intercourse. Therefore, different ways of heterosexual or homosexual behavior can spread genital herpes. Because infectious viruses can survive in humid environments for several hours, they are also likely to be transmitted indirectly through contaminants in rare cases.

Causes of genital herpes

HSV-2 is the main pathogen (90%) of genital herpes and causes first-generation genital herpes after infection. After the onset of genital herpes has subsided, the residual virus is transferred to the phrenic ganglion via the peripheral nerve along the nerve axis and is latent for a long time. When the body's resistance decreases or certain stimulating factors such as fever, cold, infection, menstruation, gastrointestinal disorders, Under the effects of trauma, the latent virus can be activated, and the virus descends to the surface of the skin and mucous membranes, causing damage and causing recurrence. Humans are the only host of the herpes virus. The virus cannot survive without the human body. It can be inactivated by ultraviolet rays, ether and general disinfectants.

Clinical manifestations of genital herpes

Genital herpes

Primary genital herpes is divided into primary genital herpes and non-primary primary genital herpes. The former is the first genital herpes to develop symptoms of HSV. His condition is relatively serious. Some patients had previous HSV-1 infection (mainly lips or facial herpes) and HSV-2 infection again. The first episode of genital herpes was non-primary genital herpes, and the condition was relatively mild.

(1) The incubation period is 3 to 14 days.

(2) There are clusters or scattered small blisters around the external genitals or anus, and they will rupture to form erosions or ulcers after 2 to 4 days, and they will feel pain.

(3) Inguinal lymph nodes are often enlarged and tender.

(4) Patients may have systemic symptoms such as fever, headache, and fatigue.

(5) The course of disease is 2 to 3 weeks.

2. Recurrent genital herpes

After the primary skin lesions subsided, the rash repeated. The recurrent genital herpes was milder than the primary systemic symptoms and skin lesions, and the course was shorter.

(1) There is a local burning sensation, acupuncture sensation or paresthesia before the onset of rash.

(2) Small blister clusters around the external genitals or anus, quickly ulcerated to form erosions or superficial ulcers, and the symptoms are mild.

(3) The course of disease is 7 to 10 days.

Genital herpes test

1. Cytological examination (Tzanck smear)

A glass slide was used as a print on the bottom of the blister, and Wright staining or Giemsa staining was performed. Under microscope, characteristic multinucleated giant cells or nuclear virus inclusions were found.

2. Detection of viral antigens

Specimens were collected from the lesions and tested for herpes simplex virus antigen by monoclonal antibody direct fluorescence method or enzyme-linked immunosorbent assay (ELISA).

3. Virus culture

Specimens were taken from skin lesions for virus culture, and herpes simplex virus and cytopathies were found.

4. Nucleic acid detection

Detection of HSV-2 nucleic acid by polymerase chain reaction (PCR) and other methods.

Genital herpes diagnosis

Diagnosis can usually be made based on medical history and typical clinical manifestations. If necessary, a comprehensive judgment should be made based on the results of laboratory tests to make a diagnosis.

Genital herpes treatment

Antiviral therapy is mainly used. The main purpose of treatment is to relieve symptoms, reduce pain, shorten the course of disease and prevent secondary infections.

General therapy

(1) It is mainly to keep the area clean and dry. It can be washed with isotonic saline every day. Those who are in pain can take painkillers orally to give them spiritual comfort.

(2) Those with concurrent bacterial infections may use antibiotic ointment topically.

(3) Those with obvious local pain can use topical 5% lidocaine hydrochloride ointment or oral painkillers.

(4) Psychological support, explaining the nature of the disease, the cause of recurrence, and how to treat and deal with it to enhance confidence in fighting the disease.

2. Antiviral treatment

Recommended treatment options include: acyclovir, orally, 5 times a day; or acyclovir, orally, 3 times a day; or valacyclovir, orally, 2 times a day; or famciclovir, orally, 3 times a day Times. If it is first-generation genital herpes, the course of treatment is 7-10 days; for recurrent genital herpes, it is 5 days. Frequent relapses require a longer course of treatment at a lower dose.

Genital herpes prevention

The prevention of genital herpes has its own characteristics, and counselling and health education must be emphasized.

Consulting

(1) Explain the natural course of the disease, and emphasize the possibility of relapse and asymptomatic detoxification. Sexual transmission of HSV can also occur during asymptomatic periods;

(2) Tell patients the common causes of recurrence of this disease, avoid adverse emotions such as psychological tension, depression or anxiety, and reduce recurrence by avoiding recurrent causes;

(3) Inform patients of childbearing age (including male patients) about the risk of fetal and neonatal HSV infection;

(4) Tell the newly diagnosed person that antiviral treatment can shorten the course of disease and antiviral suppression therapy can reduce or prevent recurrence;

(5) Get the patient's active cooperation in treatment to reduce the continued spread of the disease.

2. Health education

(1) Emphasize that patients inform their sexual partners, obtain understanding and cooperation from sexual partners, avoid sexual contact when recurring prodromal symptoms or skin lesions appear, or better use barrier contraceptives to reduce the transmission of HSV to sex Associated risks

(2) Promote barrier-type contraceptive measures such as condoms. Condoms can reduce the risk of genital herpes transmission, but sexual intercourse occurs when skin lesions appear. Even if condoms are used, sexual transmission of HSV may occur;

(3) Changing the way of sexual behavior, avoiding non-marital sexual behavior, and eliminating multiple sexual partners are the fundamental measures to prevent genital herpes.