There are some kinds of clinical implications of a genital herpes:
primary genital herpetic infection (in a blood there are no antibodies to virus);
secondary genital herpetic infection (in the presence of antibodies to virus of one type — virus superinfection of other type and absence in the anamnesis of episodes of a genital herpes);
relapsing herpetic infection (presence of antibodies to virus and episodes of a genital herpes in the anamnesis);
an asymptomatic herpetic infection.
At the majority of the adult people initially infected by virus with a sexual way develops the local form of a herpetic infection limited to genitals.
The first episode of a primary genital herpes begins without presence of circulating antibodies to herpes virus-1 or herpes virus-2. Both types of viruses can cause the primary herpes of mucosas shown by vulvovaginitis, a keratitis, and the herpetic infection can have a various current — from a lung to serious with a fatal outcome.
In the beginning of disease patients can feel an itch, a burning sensation and a pain in the field of genitals. At the typical form of illness the amazed place swells up a little, reddens, then on mucosas of genitals and adjacent sites of a skin there is a group of vesicles in the size of 2-3 mm on an erythematic background. Blisters in 1-2 days are opened, formed soaked erosions or wounds which further proceed under a crust or without its formation, without leaving cicatrixes. Patients are disturbed by an itch and a pain in the field of a lesion.
Duration of the acute period at a primary genital herpes can reach to 3—5 weeks and more. Before occurrence of visible damages patients can feel paresthesia and a burning sensation, sometimes the pains giving to a back and the bottom extremities. Replication of herpes virus in sensory ganglions can cause a neuritis which is at the bottom of the severe pains tested by patients with a genital herpes. The urodynia can take place very much, as a result of an infection of urethra and a bladder mucosa delay is often observed.
Considering variety of clinical implications oh herpes, a long relapsing current of disease and lifelong paresthesia of a virus in an organism, its treatment remains difficult and not always effective. It is necessary to underline that any of antiviral preparations known now isn’t capable eliminate virus from an organism and it is essential to affect a latent current of disease.
Treatment tactics is in many respects defined by frequency and severity level of exacerbations, presence of psychosocial problems at the patient, and also degree of risk of a transmission of infection to the sexual partner.
Possibility of carrying out of antiviral therapy should be surveyed in all cases of diagnostics of a genital herpes in which the dominant role is played by laboratory methods.
Quite often at relapses of the herpes proceeding in the atypical form (without the expressed clinical signs), the candidiasis is wrongly diagnosed, on the contrary, at the diseases proceeding with cankers (a syphilis etc.) is a herpes.
The treatment purpose is suppression of reproduction ВПГ in an exacerbation, formation of the adequate immune answer and its long conservation for the purpose of blocking of reactivation ВПГ in the centers персистенции.
Now there are two basic directions in treatment of a simple herp:
* этиопатогенетическая antiviral therapy;
* the complex method of treatment including an immunotherapy (specific and nonspecific) in a combination to antiviral therapy.
One of preparations most often applied in antiviral therapy is the acyclovir. It is proved that it possesses an excellent profile of safety without the significant phenomena of toxicity both at short-term, and at long use. Medical and preventive efficiency of antiviral therapy makes 75—90 %. Safety and shipping have been thus established and repeatedly confirmed absolutely unique for such high efficiency.
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