Genital herpes treatment - m3lwmaat clinic

 Genital herpes causes, symptoms and treatment

Herpes is caused by the HSV-1 and HSV-2 virus. The first type of virus usually gives a "cold" on the lips and nose, it is called "labial". The second type of virus provokes a rash on the genitals and in the anus and refers to genital herpes. However, in about a quarter of cases, the first type of virus can be the cause of genital herpes.

From 70 to 90 percent of the adult population is infected with one of the herpes viruses, but the manifestations of the disease may not manifest themselves in any way. And only a decrease in immunity or other factors are the impetus for the fact that the infected person will show symptoms of herpes.

What is genital herpes

Genital herpes is a chronic viral infection that can be caused by herpes simplex viruses type I and type II. Previously, it was believed that this infectious disease is caused only by the second type of virus, and the “cold” on the lips is the antics of the type 1 virus, but oral sex has changed our lives. Recently, the proportion of cases of genital herpes caused by HSV type I has been increasing, which is especially noticeable among MSM and young women. Genital herpes caused by type II HSV is characterized by a more severe course and frequent relapses.

How is genital herpes transmitted?

Transmission of the virus occurs through sexual contact with all sexes, as well as contact with saliva, semen and other biological fluids that contain the virus.

Genital herpes symptoms

Genital herpes symptoms

In most people who have no symptoms or have mild clinical manifestations, the diagnosis of genital herpes may not be established. Mild symptoms may go unnoticed or may be confused with other skin conditions (pimples or ingrown hairs). This isn't great, because if a person doesn't know they have herpes, they don't follow adequate precautions so as not to pass the virus on to their sexual partner.

With symptomatic genital herpes, one or more blisters / vesicles appear in the genital area. The blisters burst and leave painful sores that may take a week or more to heal. Flu-like symptoms, such as fever, body aches or swollen lymph nodes, may accompany or precede the rash.

Transmission of the virus occurs through sexual contact with all types of sex, as well as contact with saliva, semen and other biological fluids containing the virus.

How is genital herpes diagnosed?

Diagnosis of genital herpes

The diagnosis of genital herpes is established clinically - in the presence of characteristic changes on the lips, wings of the nose or genitals - but requires confirmation by PCR (detection of the genetic material of the virus in the fluid from the vesicles or secretion of ulcers). With a negative PCR result, serological diagnosis can help - the study of whether there are specific antibodies to type 1 and type 2 viruses in the blood.

If there are no rashes and other symptoms (pain, burning), then a routine examination is not recommended. True, there are two exceptions: planning a pregnancy (it is necessary to examine both partners) or the risk of contracting genital herpes (more than 10 sexual partners in a lifetime, HIV infection or earlier detection / treatment of other sexually transmitted diseases).

But if there is even the slightest suspicion that you may have genital herpes, especially when some mild rashes appear, even those that are not very similar to herpes in the description, you should consult a doctor to clarify their cause.

How to treat genital herpes

Genital herpes treatment

What men and women do when rashes appear in intimate areas, what they don’t smear, what candles and where they just don’t insert. In fact, there is nothing more effective than a real antiviral therapy that has been proven to work. This is the basis of the treatment of herpes. The main thing is to understand what and who we are going to treat.

For antiviral treatment, widely known drugs are used: acyclovir, valaciclovir or famciclovir. Further in the article we will focus only on the forms of drugs for oral administration. There is also an ointment of acyclovir, it is even very popular, but in fact, bioavailability, the ability of the active component to penetrate into the site of the fight against the virus, local therapy (ointment) is low. Such therapy will not be effective and may lead to the formation of virus resistance to acyclovir.

In some cases, the treatment is carried out intravenously, but often these are severe cases that require hospitalization, so we only discuss pills.

Different clinical situations require us to have a completely different approach to how to treat herpes on the genitals (labia, penis). Of great importance is whether this is a primary episode or a repeated one, and if it is repeated, then how often do relapses occur?

The initial episode can be quite intense and prolonged, with a large lesion and severe ulcerative defects, so treatment is necessary to reduce the duration of the process and accelerate healing.

Almost all people who have had a symptomatic initial episode of genital herpes experience recurrences later on. Of course, subsequent relapses may be less intense and not as long.

Each episode of exacerbation of genital herpes should be treated with standard courses of antiviral therapy, which in the future can reduce the number of episodes and the intensity of manifestations, and maybe remission will occur for some time.

Taking medications should be started as early as possible, preferably in the first 24 hours from the appearance of rashes or even in the prodromal phase - when discomfort appears: for example, burning / itching, where rashes should appear, but they are not there yet. Some people know their triggers for genital herpes flare-ups and start taking medication early (eg, before menstruation, climate change, stressful situations), but there are no official recommendations for proactive therapy.

According to WHO and European recommendations, as well as CDC recommendations, if a patient has more than six relapses of a herpes infection per year, this is already an indication for the so-called suppressive / suppressive therapy: taking the drug in one dose daily for a long period (usually at least a year or more reassessing the need for further intake every year). Suppressive therapy reduces the recurrence rate by 70-80%! And it is safe - there are studies that confirm the safety of long-term use of drugs (for several years in a row).

But, again, if there are more than six relapses, but less than ten, these are the same dosages, and if there are more than ten relapses, they are completely different.

Genital herpes during pregnancy 

Genital herpes  

in HIV positive

In some cases, daily antiviral drugs are given to men during conception to prevent transmission of the virus to a partner. And in late pregnancy, antiviral drugs can be prescribed to the mother to prevent infection of the fetus.

In the treatment of genital herpes in people with positive and negative HIV status, there are also differences in the doses and duration of the drugs. And, in general, many factors can influence the choice of drug, dose, regimen and duration of administration: age, pregnancy (it all depends on the timing of pregnancy and whether it is a primary infection or a repeated one), the effectiveness of previous therapy and other factors, so here you can not do without a specialist who will help sort everything out. Let's go back to the fact that if you are not sure that it is herpes, only a doctor can correctly assess the situation and choose tactics.

Source: https://h-clini./articles/genitalnyy-gerpes-kak-raspoznat-i-gde-lechit/