Few disease can compete with herpes simplex in the abundance of myths and delusions among patients. Starting with seemingly innocuous mistakes in the name (for example, many believe that herpes, as a disease, can be of type 1 and 2, although viruses are divided into types, but not disease) and ending with serious misconceptions about the possibility of treating an illness by means of which not only useless, but also dangerous to health.
In many ways, this situation is due to the fact that herpes simplex viruses 1 and 2 types are very widespread throughout the world (according to various estimates, at least one of them have from 70 to 92% of the world’s population), but it has not yet been developed. treatment that would completely rid the body of the DNA of the virus. Therefore, people sometimes try different treatment options several times a year, often resorting to the use of useless and expensive dummies and unconventional therapies (which are at least trying to burn herpes sores with a match, cigarette or hot spoon).
And not only the treatment, but also the results of diagnosis because of ignorance of some nuances sometimes give rise to incorrect interpretations. Only one entry in the results of a blood test for herpes IgG positive is worth it – often people are frightened by this, believing that this result means the presence of a virus in the blood and the beginning of some particularly serious illness. In fact, IgG antibodies (class G immunoglobulins) in the blood are only a sign of the presence of immunity to herpes.
To avoid such mistakes, unnecessary financial costs and the risk of serious side effects from individual funds, it is enough to know basic information about herpes simplex viruses and the key points of their interaction with the human body. About this we will continue to talk …
What you need to know about the causative agents of herpes 1 and 2 types
The so-called herpes simplex (herpes simplex) is a disease that is caused by the herpes simplex viruses of the first and second types (HSV-1 and HSV-2).
It is the viruses that are divided into types – there are also other types of herpes viruses (type 3 virus, for example, causes everyone to know chickenpox). Herpes itself, as a disease, is classified not by type, but by the forms of manifestation and localization on the body.
To the note: in medicine the international abbreviated name of herpes simplex virus – HSV (Herpes simplex virus) is often used. In particular, it can be found in decoding the results of analyzes.
Herpes simplex viruses are microscopically small particles (virions) whose size is hundreds of times smaller than the size of cells in the body or the size of, for example, most bacteria. Each viral particle is a capsule of protein molecules, inside which contains viral DNA.
Below is an electron microscope photograph showing herpes simplex virus particles:
An important detail that needs to be understood: there are no exchange reactions in the virus particle, it is, in fact, lifeless. Including it is not able to eat, in itself move, multiply and produce any metabolic products. All processes necessary for it to produce its own similar virions are performed by the infected cell.
This is interesting: experts still have not come to a common opinion whether the viruses should be considered alive. By their many characteristics, they are more like substances than beings.
The herpes simplex virus initially enters the body of a healthy person from the carrier, and such an infection can occur even in the absence of signs of the disease in an infected person. Often, the infection occurs through microdamages of the skin – cracks, scratches, wounds – because the virus cannot pass through the intact horny layer of the skin.
Infection can also occur through biological fluids and mucous membranes of the body. This is exactly how cold lips and genital herpes arise (it is useful to keep in mind that viruses of both 1 and 2 types are easily transmitted when kissing).
Then the virus particle penetrates into the cell of the organism, and when passing through the cell membrane, the protein capsid opens, and only DNA gets inside. Viral genetic information is transferred to the nucleus, inserted into the DNA of the host cell and remains here until the cell itself is killed. By reading information from viral DNA, the cell will continue to produce for the rest of its life with proteins and nucleic acids of the virus along with its own organic substances. They will assemble into new virus particles, leave the mother cell and infect the neighboring ones.
After some time, the infected cell will die, because the number of viral particles in it becomes so large that it interferes with the normal flow of intracellular processes. After the death of the cell, all the virions from it will fall into the intercellular space and begin to spread here, infecting the neighboring cells.
According to customary measures, it happens very quickly – the first infected cells die within 15-24 hours after infection, and massive infection of neighboring cells leads to the manifestation of the main symptoms of the disease and marks the end of the incubation period and the beginning of the acute phase of the disease.
Part of the virions leaving the mother cells are in contact with various agents of the immune system, thereby triggering the mechanism for the formation of immunity. In particular, at this time, antibodies to herpes viruses 1 and 2 types are already being formed, which in the future allow you to quickly detect virus particles, destroy them and prevent the development of subsequent episodes.
Note: these antibodies are called immunoglobulins and are referred to as Ig. There are different classes of immunoglobulins that are produced at different stages of the formation of immunity. By keeping them in the blood, a specialist can understand at what stage the infection is at this particular moment. For example, immunoglobulins of class G (IgG) in the blood indicate that immunity to the virus has been formed long ago.
By the way, it is also useful to read:
The high rate of increase in the number of herpes virus particles in the tissues is directly related to the high rate of development of the symptoms of the disease itself. Very quickly, the virus infects a certain area on the skin or mucous membranes, where characteristic bubbles and inflammation foci form from the dead cells. Around the same time, the immune system begins to actively destroy viral particles, and at some point the spread of the virus in the body stops. Completes the primary episode of the disease.
During the initial infection (in the case of colds on the lips – usually in childhood, and in the case of genital herpes – in adulthood) some viral particles infect nerve cell processes and they fall into the nuclei of the cells themselves located in the ganglia of the trigeminal nerve or spinal cord . Since the lifespan of nerve cells practically coincides with the lifespan of the organism itself, the virus here persists for the whole life of a person.
Infected cells will continuously release a certain amount of viral particles into the extracellular space, where they will immediately be destroyed by agents of the immune system. And only in the case of a sharp weakening of the immunity, certain particles will bypass such protection and will be able to infect cells in those places through which the virus has entered the body. In such a situation, a relapse will develop – a re-outbreak of the disease, in its manifestations in many respects similar to the primary disease.
Thus, it is important to understand that it is impossible to remove viral DNA from nerve cells. That is, if an infection once struck the body, then it will remain in it until death. Therefore, herpes from a certain point of view can be considered an incurable disease until the end.
Herpes caused by viruses 1 and 2 types, and its common manifestations
Herpes simplex, caused by herpes viruses 1 and 2 types, has characteristic manifestations: redness appears on the skin surface first, and behind it are small transparent bubbles. These affected areas are quite painful, stabbing pain in them is easily recognizable, and most patients already after 2-3 relapses know well when the disease begins again.
The photo below shows typical rashes at herpes simplex at the initial stage of the disease:
The contents of the bubbles become cloudy over time, and for 3-4 days of illness, the bubbles massively break through. In their place are ulcers, covered with crusts, which heal quickly and without a trace.
The total duration of such an outbreak of the disease is approximately 7-10 days, the healing of the sores can last as long as a week.
In most cases, repeated relapses occur no more than 1-2 times a year, usually in winter or after suffering other diseases, when the immune system weakens. Sometimes such repeated episodes occur with blurred symptoms or asymptomatic, which is especially dangerous (especially with genital herpes) – the person representing the epidemiological danger does not know that he is sick and communicates with other people.
In some patients, relapses do not occur at all. For others, on the contrary, repeated reactivation of herpesvirus type 1 or 2 can occur many times over the course of a year, which creates many problems for the patient.
Diseases caused by these pathogens
In most cases, the herpes simplex virus type 1, when infecting the body, causes the labial form of the disease (cold on the lips), and the herpes simplex virus type 2 causes genital herpes. However, this is not a strict rule: both pathogens can cause illness with rashes on different parts of the body, although most often they are specifically tropne to the tissues in these places.
With labial herpes, rashes usually appear either on the outside of the lips, or on the skin under the nose, or on the inside of the lips.
In genital herpes, the lesions usually cover the outer parts of the genitals, perineum, anus, and in some cases the inner side of the thighs and pubis.
Note: the weaker the immune system, the more extensive the rash can be and the longer the disease can last.
The photo below shows an example of extensive herpes lesions not only on the lips, but also on the chin:
In addition to the labial and genital forms of the disease, the herpes viruses 1 and 2 types can also cause the following diseases:
- Ophthalmic herpes with damage to the cornea of the eyes, eyelids, eyeball. The disease is very dangerous and can lead to deterioration and even complete loss of vision;
- Herpetic felon – development of lesions on the fingers;
- Herpetic stomatitis – as a rule, children’s pathology with characteristic ulcers in the form of white dots on the gums, tongue and palate;
- Herpetic encephalitis and meningitis are serious and deadly diseases that occur when immunity is severely weakened.
In general, immunodeficiency may cause the herpes simplex viruses of any organs and tissues. In some cases, such an infection is fatal in AIDS patients. In people with a normal immune status, such pathologies almost never develop.
The difference in the symptoms of herpes in women and men
According to statistics, recurrences of herpes occur in women 1.5 times more often than in men. This applies to herpes on the lips, and the genital form of the disease. However, if labial herpes occurs approximately equally in both sexes, then for obvious reasons, the clinical manifestations of genital herpes may differ.
Here are some differences:
- In women, herpetic ulcers can develop both on the external genital organs and in the vagina. This greatly worsens the condition of the patient, who will suffer from constant severe itching and pain;
- In women, the rash often spreads to the anus, is more pronounced;
- The duration of episodes of genital herpes in women is slightly longer than in men – by 1-2 days.
In addition, such pathology as Herpes gladiatorum is known. It is distributed almost exclusively in men involved in contact sports (wrestling, rugby, American football) and is associated with the transfer of the pathogen to the skin of the neck, head and face. It is here that rashes appear, and sometimes outbreaks of the disease are accompanied by generalized symptoms – fever, malaise.
In women, this disease is extremely rare.
Understanding the test results: what does Igg mean positive
As a rule, the diagnosis of herpes simplex is carried out by physical methods. It is enough for the doctor to examine the patient in order to understand that he has herpes. Only in some cases, the inspection is not enough – for example, with ophthalmic herpes, or with herpetic stomatitis (manifestations of the latter are similar to stomatitis of a different nature). An understanding of the immune status of a sick woman during pregnancy is also required – if at this time she reactivates the disease, for the safety of the fetus or newborn it is necessary to understand whether the mother has immunity.
For an accurate diagnosis of herpes, it is sufficient to determine the presence of antibodies to the virus herpes simplex 1 or 2 types in the blood. To do this, a blood sample is taken from a vein, and the results of the study are interpreted as follows:
- Positive results on Ig mean that the patient has had herpes and has developed immunity;
- Exceeding the norm of the amount of immunoglobulin classes M and A means the primary immune response to infection. Simply put, a large number of them indicate that the patient has had a disease or has had herpes for the first time;
- A positive result and a high IgG content means that the primary episode of the disease ended long ago (more than a few months ago) and the patient has specific immunity to herpes simplex viruses.
The presence of antibodies does not mean that viral particles are specifically detected in the blood. The corresponding inscription in the test results may look frightening, but in fact it only means that the patient is immune to the infection. Such carriers are called seropositive, as opposed to seronegative – those who have antibodies (and therefore no immunity) to the virus.
Danger of herpes of the first and second types, including during pregnancy
For most relatively healthy people, herpes simplex is not a serious danger. From time to time, developing relapses only lead to temporary pain in areas of rash and undesirable cosmetic consequences. Unlike some other herpes viruses, herpes simplex viruses of types 1 and 2 are not oncogenic and do not lead to the development of cancer.
However, there are a number of undesirable effects that can be considered quite serious. Among them:
- Psychological trauma, especially in adolescents, caused not only by constantly recurring rash, but also by the reaction of others. The psychological consequences of genital herpes are even more serious and can lead to depression, suicidal impulses, the development of complexes and the general social exclusion of the patient;
- The risk of neonatal infection of a newborn baby, if it was at the time of birth the mother first became infected with herpes. In this case, she does not have immunity yet, she does not transmit antibodies to the child, and therefore infection is very likely. Herpes in a newborn can occur in a very severe form with a threat to the life of the baby. At the same time, if during pregnancy the mother developed only a recurrence of herpes (no matter what type of virus caused it), it does not threaten the fetus or newborn – the developing organism is largely protected by maternal antibodies;
- Viremia and generalized infection in patients with immunodeficiency. They due to the inability of the immune system to control the infection may damage the internal organs and death.
Therefore, for a person with a fairly stable psyche and without immunodeficiency, herpes simplex is not a significant danger. However, the primary activation of the virus of the first or second type and the recurrence of the disease must be treated to reduce the duration of the disease and alleviate the patient’s condition. Moreover, with proper treatment, the appearance of the main symptoms in the form of herpetic vesicles and ulcers can be avoided altogether.
The main approaches to the treatment of the disease
The gold standard for the treatment of herpes infection caused by viruses herpes simplex type 1 and 2, today are considered drugs based on acyclovir. They are quite effective, inexpensive, rarely cause side effects (even in children) and are easy to use. As a rule, it is ointments and creams that are applied to the rash sites. The active substance (actually, acyclovir), entering the cells, disrupts the synthesis of proteins necessary for the virus, because of which new virus particles are not formed, and the infection does not develop.
If such ointment smears the area of future eruptions before the bubbles appear, in many cases they do not appear at all. This is the main rule of applying ointments based on acyclovir: they need to be applied to the skin at the moment when the characteristic tingling has just appeared, but there are no herpes papules yet. If this moment is caught, then the bubbles do not develop, and in the place of the tingles, an inconspicuous dry peel is formed that quickly peels off.
To the note: a similar result can be achieved using tablet preparations (based on acyclovir, valacyclovir, famciclovir). Their main advantage is effectiveness in such forms of herpes, in which the lesions cannot be smeared with ointment (for example, in ophthalmic herpes). The main drawback is side effects in the form of intoxication, headaches, allergies, although they develop relatively infrequently.
Penciclovir is effective against herpes in the form of the ointment Fenistil Penzivir and its oral form, famciclovir (Famvir). In addition, ganciclovir and foscarnet are effective against herpes simplex, however, they are almost never used for treatment in normal situations, since they are quite toxic and cause severe side effects, sometimes more dangerous than herpes itself.
Since severe generalized symptoms of herpes usually do not cause, the treatment does not require a special diet and bed rest. However, the patient must limit the number of contacts, because until full recovery he remains infectious.
It is important to understand that all the above mentioned drugs only allow to stop the symptoms of herpes recurrence. They are not able to completely rid the body of herpes infection. The very concept of cure herpes means only getting rid of the recurrence of the disease, but not the complete elimination of HSV-1 or HSV-2 viruses from the body.
Note: traditional medicine, which would be more effective than acyclovir, is not known today. Vaccines, which would provide complete and reliable protection against the infection of the herpes viruses or against the recurrence of infection, have not yet been created. However, new types of such vaccines are being actively tested, and some of them already allow for reducing the frequency and strength of relapses. There is reason to believe that some success will be achieved in this area in the near future.
Finally, the most obvious and, as practice shows, the most effective way to prevent the regular development of recurrent herpes is to strengthen the immune system. Moreover, strengthening is not immunostimulating pills (they turn out to be practically useless), but tempering procedures, healthy eating, physical activity and avoiding bad habits. People who lead such a healthy lifestyle, even as carriers of the virus, very rarely suffer from its recurrence, and the episodes themselves endure quickly and easily.
Herpes simplex is a typical example of the disease, when prevention is the most effective option for its “treatment”.