Antibodies IgM and IgG to herpes simplex virus types 1 and 2

Manifestations of the virus are characteristic blistering rashes on the mucous membranes and skin. After some time, small ulcers form in their place, then crusts. In the area where the rash should appear, burning and itching first occurs. Herpes is characterized by severe pain in the area of ​​the rash.

The herpes virus spreads along the nerve endings and is not completely removed from the body even after a course of drug therapy. It is able to exist in an active and “sleeping” state.

Herpes simplex viruses types 2 and 1 are transmitted sexually and through contact, even when the symptoms of the disease in the carrier are not yet noticeable. In the early stages of infection, there are usually no symptoms at all, so diagnosis can only be made in the initial stages through laboratory testing. Primary infection with the virus most often occurs in childhood, even in preschool age.

In women, genital herpes usually appears on the labia and cervix, less often in the perineal area. In men, blisters appear on the skin and mucous membrane of the penis, as well as inside the urethra and rectum.

Why do tests for herpes simplex virus types 1 and 2?

Herpes simplex virus types 2 and 1 not only cause cosmetically unpleasant rashes. It also causes severe pain (for example, along the nerve trunks in the area of ​​the rash), general weakness and damage to the central nervous system.

Therefore, it is important to know about the presence of this virus in the body in order to ensure the necessary prevention of exacerbations of infection and timely, comprehensive treatment. These measures will prevent complications associated with the active progression of herpes infection.

The danger of herpes simplex virus types 2 and 1 is that against the background of decreased immunity, from which no person is immune at different periods of life, the infection is activated. The activity of the virus can lead to serious complications such as damage to the facial, auditory and other cranial and spinal nerves.

Herpes simplex virus types 2 and 1 can seriously threaten a pregnant woman and her unborn child. Intrauterine infection occurs with serious consequences for the nervous system. Reactivation of the infection during pregnancy can lead to its pathological course or premature termination.

Detection of herpes simplex virus

As stated earlier, herpes simplex viruses cause disease exclusively in humans. The source of infection is patients with obvious, latent or asymptomatic forms of the disease, as well as virus carriers (asymptomatically releasing the virus into the environment). Human infection follows contact with patients or virus carriers. The entry points for the herpes simplex virus are the mucous membranes of the lips, oral cavity, nasopharynx, genitals, conjunctiva of the eyes, as well as the skin. The risk of infection with the herpes simplex virus increases with trauma to the mucous membranes, for example, with diseases of the urogenital tract, accompanied by disruption of the integrity of the mucous membranes and the development of ulcers, erosions and cracks.

The routes and mechanisms of HSV infection are numerous and varied. The virus is transmitted through horizontal and vertical routes.

Contact path:

• Infection occurs when virus-containing biological fluids come into contact with mucous membranes during intimate contacts: sexual contact (genitogenital, genitogenital, orogenital contacts), kissing, touching.
• Autoinfection is possible - mechanical transfer of the virus from the herpetic focus to other places, for example, the introduction of the virus from the oral cavity with herpetic stomatitis by hand to the conjunctiva of the eye, in the genital area, to any part of the body through microdamages of the skin. Orogenital contacts can lead to auto-infection of the genitals in the presence of herpetic stomatitis or the presence of a virus in saliva without visible stomatitis, and vice versa, infection of the oral mucosa is possible in the presence of genital herpes.
• Infection through household items infected with the virus: sharing the same dishes, personal hygiene items, towels, toys, etc.

Airborne : the presence of the virus in saliva provides the possibility of its transmission by airborne droplets, although this route of infection is not the leading one. transfusion route (after transfusion of blood and its components), Transplantation route (during transplantation of organs and tissues). Blood transfusion and transplantation routes are horizontal transmission routes.

The vertical infection mechanism includes:

• transplacental, transcervical route from the infected birth canal and genitals;
• ascending path (from the infected cervix to the uterine cavity of a pregnant woman);
• transovarial infection of the fetus - from the pelvic cavity through the fallopian tubes;
• intrapartum infection of the fetus (when the fetus passes through the infected birth canal of the mother).

The herpes simplex virus is transmitted from a person who has an active phase of the disease (regardless of whether it is caused by a primary infection or an exacerbation of the latent (latent) form of the disease). The source of infection is people with obvious, latent or asymptomatic forms of the disease, as well as virus carriers (asymptomatically releasing the virus into the environment).

Herpes simplex refers to infections with lifelong carriage of the virus. This means that after the initial infection, complete elimination of the virus from the body does not occur. Currently, herpes simplex is considered a chronic disease that has a cyclical course, when periods of exacerbation alternate with periods of remission of varying duration.

The cause of exacerbation of herpes simplex may be the following factors:

• hypothermia, overheating, hyperinsolation,
• neuro-emotional stress,
• trauma, medical and cosmetic procedures (abortion, surgery, insertion of an intrauterine device, tattooing, piercing, etc.),
• somatic, psychosomatic, endocrine, oncological, infectious diseases,
• decreased immunity, primary or acquired (secondary),
• poor nutrition (strict diet),
• long-term use of medications (hormones, chemotherapy, cytostatics).

Reminder for herpes simplex disease

The herpes simplex virus is highly contagious. Therefore, sick people and those around them must take the necessary precautions. Measures aimed at preventing the spread of infection and infecting other people:

• Do not touch the area where the rash is located with your hands. If you do touch them, wash your hands thoroughly with soap.
• Do not apply medicinal or antiviral agents to lesions (rash elements) with your hands. Use cotton swabs for this.
• Do not comb, squeeze, open blisters, or tear off crusts. This can lead to the spread of infection to adjacent areas of the skin.
• The patient should only have his own separate dishes, towels, and other hygiene items.
• During illness, you should refrain from kissing and sexual intercourse.
• If you have contact lenses, you should never wet them with saliva.

Discuss on the forum

When should you test for antibodies to herpes simplex?

It is advisable to carry out an analysis for antibodies to herpes simplex virus types 1 and 2 (IgG, IgM), as well as an analysis for the DNA of the virus in the following cases:

• If small blisters appear on the skin or mucous membranes;

• With HIV infection or immunodeficiency of unknown origin;

• The appearance of burning, swelling and rashes in the genitourinary area may indicate herpes simplex virus type 2. Determination of antibodies to herpes simplex virus type 2 IgG class and other methods can help in the differential diagnosis of genitourinary tract infections;

• In preparation for pregnancy (it is advisable for both partners to be tested for antibodies to herpes simplex);

• If there are signs of intrauterine infection of the child or feto-placental insufficiency, etc.

Kinds

Herpesviruses of the Herpesviridae family that infect humans:

• Alpha herpes viruses are the most common types: HSV-1 (oral herpes), HSV-2 (genital herpes), and chickenpox. A distinctive feature of the group is the rapid destruction of infected cells.
• Betaherpesviruses are the most pathogenic infectious agents of herpes type 6, type 7 and cytomegalovirus. They cause less pronounced degenerative changes in cells,
• Gammaherpesviruses are herpes type 8 and Epstein-Barr virus. They are capable of infecting the systems of mononuclear macrophages (immune cells), causing processes of cell death.

The virus cannot be removed from the host cells; it remains in the body for life. Treatment is aimed at reducing the manifestations of symptoms, concomitant diseases, and making the patient’s life easier. A vaccine is being developed.

Cytomegalovirus

This type of virus causes cytomegalovirus infection (CMVI, cytomegaly). It has a large DNA genome and relatively low pathogenicity. Develops without damaging the cell. The new viral particles that are formed already inside the body infect macrophages, epithelia, and myeloid cells. In them, the virus enters the latent phase. It is believed that due to cytomegaly, pathological inflammatory processes begin to develop in humans with age.

The source of infection is an infected person. Cytomegalovirus is transmitted by airborne droplets and through all existing fluids: genital secretions, blood, saliva, breast milk.

The virus, slowly spreading throughout the body, provokes changes in infected cells with an increase in size. In healthy people, cytomegaly is mild or asymptomatic. It is particularly dangerous for persons with pathologies of the immune system, young children and pregnant women due to the risk of infection of the fetus. In immunocompromised patients, CMV infection is one of the causes of illness and death.

Acquired cytomegaly has symptoms similar to seasonal colds. Congenital (intrauterine), can cause miscarriage and lead to fetal pathology. In children under 3 months and in adults with pathologies of the immune system or oncology, cytomegalovirus infection can be severe. Complications include lung damage, viral encephalitis, changes in the liver, kidneys, and gastrointestinal tract.

Epstein–Barr virus (EBV)

Belongs to group 4 of herpesvirus (Herpesviridae). Looks like a double-stranded DNA molecule. It is not integrated into the cellular genome of the infected cell, but resides in the nucleus. There are two types of Epstein-Barr virus: EBV-1 and EBV-2. They are equally common and have similar symptoms. They differ in their transformation abilities and latent flow characteristics. The virus replicates in lymphocytes and epithelium and does not cause destruction.

The source of infection is an infected person with a manifest and latent form. The infection is spread by airborne droplets.

The disease with strong immunity almost always occurs without symptoms. In immunocompromised patients, it manifests itself as infectious mononucleosis. In the manifest (active) form of EBV infection, the level of CEC increases, and the activity of leukocytes, on the contrary, decreases. This may lead to adverse immunopathological reactions.

In case of immunodeficiency, the Epstein-Barr virus can provoke the development of lymphoproliferative disorders and trigger oncology. In people with autoimmune diseases, it affects overall well-being, causing chronic fatigue syndrome.

Infectious mononucleosis

Acute disease caused by the Epstein–Barr virus. It develops against a background of weakened immunity, mainly in children and adults under the age of 40. It can occur in mild, moderate and severe forms.

Common symptoms include fever, oral lesions, and lymphadenopathy. Less commonly, significant enlargement of the spleen, leading to rupture. An atypical form of mononucleosis can also cause acute multiple organ failure, myocarditis, and meningitis.

The visceral form of the disease is characterized by serious multiple organ lesions. Pathological processes involve the central and peripheral nervous systems, organs of the cardiovascular system, kidneys, adrenal glands and other vital organs.

Herpes virus type 6 (HHV-6)

The virus mainly replicates in T lymphocytes, but sometimes it is detected in B lymphocytes, the mononuclear macrophage system, hepatocytes and other cells. The source is an infected person. The herpes virus is transmitted by airborne droplets and directly to the child from the mother.

The list of diseases caused by HHV-6 is quite wide. More often, pathologies occur in people with a suppressed immune system. In other cases there are no symptoms.

In newborns, due to infection, exanthems occur, the first fever in life. In adults and older children, the disease occurs as mononucleosis. HHV-6 carriers have an increased risk of developing malignant lymphoma, histiocytic lymphadenitis, T-cell leukemia and B-cell lymphoma. In immunocompromised individuals, infection is more severe. In some cases it leads to pneumonia, hepatitis, and encephalitis.

Herpes virus type 7

HHV-7 is usually found together with HHV-6. They differ slightly from each other - in body weight and the number of base pairs. Herpes virus type 7 is primarily localized to CD4+ T cells. It suppresses CD4, and also affects syncytium, causes unprogrammed cell death, and changes the level of cytokines.

The specific effects of HHV type 7 separately from HHV-6 have not yet been sufficiently studied. However, it is known that this type affects CD4, like HIV infection, and therefore has a negative impact on the course of winter diseases. Capable of maintaining the existence of latent infections.

Herpes virus type 8

The HHV-8 virus, Kaposi's sarcoma herpesvirus (KSHV), stimulates the synthesis of lymphoid, dendritic, epithelial cells and secretion of the prostate epithelium. The presence of HHV-8 in the body increases the risk of developing tumor diseases.

The main methods of infection: sexual, hematogenous (blood transfusion), horizontal (with saliva), transplacental (the fetus becomes infected during pregnancy). The largest number of copies of the virus is found in saliva.

Herpes virus type 8 can stimulate the occurrence of neoplasms:

• Kaposi's sarcoma;
• lymphoma;
• multiple myeloma;
• Castleman's disease.

Pathologies occur due to aging, immunodeficiency and HIV infection. Almost half of people infected with HPV-8 develop Kaposi's sarcoma within 10 years of infection. All HIV-infected patients with Kaposi's sarcoma are diagnosed with herpes virus type 8.

Survival rate is 72% with early diagnosis and therapeutic procedures. However, HHV-8 is more difficult to treat than other types. At the moment, no sufficiently effective medications have been developed.

Diagnostics

Tests for antibodies to herpes simplex virus 2 and 1: IgG, IgM

Given the high frequency of infection, antibodies to the herpes simplex virus are found in the vast majority of people (more than 90%) around the world. However, the antibody titer and its change over a certain period can provide much more information important for the treatment of herpes simplex virus types 2 and 1.

Antibodies to herpes simplex Ig M and Ig A do not remain in the blood for long - approximately 1-2 months. The only type of antibodies to herpes simplex virus 1 and 2 that persist in the blood throughout life is IgG.

Antibodies to herpes simplex Ig M are markers of primary infection. During primary infection with herpes simplex virus types 2 and 1, the IgG titer may increase. If the tests were taken at an interval of 10-12 days, the titer of IgG antibodies to the herpes virus can increase fourfold.

In the case of recurrent infection, antibodies to herpes simplex virus 1 and 2 IgG are very high. This indicates constant antigenic stimulation of the body. The exacerbation of the disease is also indicated by the appearance of IgM in the blood serum.

Treatment of “Herpes Simplex”

Treatment of “Herpes Simplex” includes regimen, diet, etiotropic drugs, symptomatic drugs, immunotherapy and syndromic therapy for the development of complications.

It is necessary to treat herpes simplex differently depending on the pathogenetic features of the disease, the clinical picture (the form, period, severity of the disease), the degree of symptoms, the presence of complications, concomitant diseases, and the age of the patients. Treatment should be comprehensive and include both etiotropic (acting on the infectious agent) and pathogenetic, symptomatic agents (immunomodulators, vitamins, adaptogens, pre-/and probiotics).

Particular attention is paid to restoring the body’s immunological reactivity, restorative therapy, as well as anti-relapse treatment using, for example, an antiherpetic vaccine or a combination of an antiherpetic vaccine with immunomodulators.

Self-medication is not acceptable.

Each case of herpes requires mandatory treatment in order to:

• prevent further development of the pathological process (long-term persistence of symptoms, emergence of new foci of the disease);
• prevent the development of complications;
• prevent the formation of residual effects and disability;
• prevent infection of a sexual partner, etc.

It must be emphasized that herpes simplex can only be treated after consultation with a doctor. At the appointment, the patient should receive information about the disease (the first signs of the disease, symptoms, factors provoking a relapse, prognosis of the disease, the risk of transmission of infection), about the possibilities of various methods of treating the disease, including the prevention of relapses; the scope of the proposed examination and treatment, in accordance with his financial capabilities; reasoned advice on a healthy lifestyle. The necessary knowledge about the disease will allow the patient to strictly follow the doctor’s recommendations in the future, promptly carry out prevention and/or treatment of relapse, and avoid the development of complications.

Is it necessary to talk further about the importance of treatment aimed at reducing the likelihood of a relapse of herpes infection?

In our country such treatment exists. One of a kind, unique in its effectiveness, which has no analogues. This treatment method is called specific immunotherapy and is carried out using the antiherpetic vaccine “Vitagerpavak”.

Vaccine for the prevention of chronic herpes virus infection. 1 package – full course of treatment.

Vaccination course: 5 injections, given at intervals of 7-10 days. Store at a temperature of 2-8 ºС. The drug can be transported at a temperature of 9-18 ºС, but not more than 3 days.

The therapeutic effect develops against the background of stimulation of antiviral immune reactions, restoration of the function of immunocompetent cells and specific desensitization of the body, i.e. relieving hypersensitivity to those antigens of the herpes simplex virus to which the body is sensitized.

In order to prevent relapses of herpes simplex, the Vitagerpavak vaccine is used during the period of clinical and immunological remission of the disease. Vaccination with Vitagerpavak is the third stage in the treatment and prevention of chronic herpes virus infection. It should be noted that this stage often occurs no earlier than 7-10 days after the end of the exacerbation phase of the disease (after the complete disappearance of clinical manifestations). The basic vaccination regimen using the Vitagerpavac vaccine: 0.2 ml of the vaccine is injected intradermally into the flexor surface of the forearm. The vaccination cycle consists of 5 injections, which are carried out at intervals of 7-10 days. For a lasting preventive effect, repeated courses of vaccination are necessary. If herpetic rashes appear, the intervals between injections should be doubled. After 6 months, revaccination is carried out (5 injections).

The results of numerous literature data indicate that the drugs used to treat acute manifestations of herpes simplex, including long-term, many-month, suppressive use of the antiherpetic drug Acyclovir, are not able to prevent relapses of the disease after its discontinuation or exposure to provoking factors (cooling, insolation, concomitant diseases of other etiology, etc.), reducing the activity of immune reactions, against the background of lifelong persistence of the herpes virus and the immunodeficiency state caused by it. The use of the Vitagerpavac vaccine has a number of advantages over antiherpetic drugs, as evidenced by studies conducted in leading medical institutions in Russia.

Thus, according to the results of research conducted by prof. L.A. Marchenko et al., (Scientific Center for Obstetrics, Gynecology and Perinatology of the Russian Academy of Medical Sciences), with the participation of 200 patients with recurrent genital herpes (RGH), 6 months. After vaccine therapy, 31.5% of patients experienced a significant improvement - remission (increase in the interval between relapses by 3 times - up to 7 months), 58% - improvement (remissions increased by 1.5 - 2 times) and only 10% of patients the effect was weak or absent. 77 out of 200 patients at this center were observed 2 years after regular vaccination courses. At the same time, in 40 patients (52%) clinical symptoms of RGG were completely absent. The vast majority of the 200 patients stopped treatment, justifying this by the improvement that had occurred as a result of vaccination.

In another study conducted by Prof. Barinsky I.F. et al. at the Federal State Budgetary Institution "Research Institute of Virology named after. DI. Ivanovsky" Ministry of Health of Russia, Moscow. it was shown that 6 months after vaccine therapy with Vitagerpavak, 19 (31.1%) patients showed significant improvement (increase in the interval between relapses by 3 times), 35 patients (57.3%) showed improvement (remission increased by 1. 5–2 times) and only in 7 (11.6%) the therapeutic effect was weak or absent. The majority of patients (38 people) stopped treatment due to improvement as a result of vaccination. In 52% (20 patients) of them, clinical symptoms of recurrent HH were completely absent.

Dynamics of clinical parameters in patients with recurrent HH during vaccine therapy

Of interest are the results of a study using the Vitagerpavac vaccine conducted by Prof. A.A. Kasparova et al. (Research Institute of Eye Diseases of the Russian Academy of Medical Sciences), with the participation of patients with ophthalmoherpes caused by the herpes simplex virus. Of 114 patients with ophthalmoherpes with frequently recurrent forms, relapses of the disease completely stopped in 71 patients (63%), their frequency became significantly less frequent in 32 (27%) and did not change in only 11 people. (10 %). Analysis of the results revealed a 5-fold reduction in the frequency of relapses and a 3.2-fold reduction in the duration of relapses per 1 patient suffering from herpetic keratitis, keratoiridocyclitis and iridocyclitis. When studying the blood of patients with herpes using PCR and MFA methods, it was revealed that the use of an inactivated vaccine was accompanied by the elimination of viremia.

Briefly about the Vitagerpavac vaccine:

Compound:

— The drug is a lyophilisate for the preparation of a solution for intradermal administration — Contains specific antigens of HSV I and HSV II grown on a continuous cell line VERO, acceptable by WHO as a substrate for the production of vaccines

Indications:

Prevention of relapses of herpetic infection, including: - Preparation of women with a history of relapses of chronic recurrent herpetic infection (CRHI) for conception and pregnancy - Prevention of relapses of CRGI in people regularly exposed to provoking factors.

Vaccination is carried out in medical institutions under the supervision of a doctor.

• The vaccine is used in the remission stage 7-10 days after the complete disappearance of clinical manifestations
• The vaccination course consists of 5 injections with an interval of 7-10 days
• In case of complicated herpetic infection, the 2nd and subsequent injections are carried out at intervals of 10-15 days

Where to get vaccinated Get advice

Detailed information about the Vitagerpavak vaccine and its use can be obtained from the Methodological recommendations MZ3.3.1.0002-10 “Immunization with the Vitagerpavak vaccine (herpetic culture inactivated dry) for the prevention of relapses of infection caused by herpes simplex viruses types 1 and 2”, approved by the Head of the Federal service for supervision in the field of consumer rights protection and human well-being by the Chief State Sanitary Doctor of the Russian Federation G.G. Onishchenko. These recommendations came into force in 2010.

*author of the material - Alimbarova L.M. Associate Professor, Ph.D.

Interpretation of tests for antibodies to herpes simplex virus types 1 and 2

• IgG is elevated in chronic herpes infection. If antibodies to herpes IgG increase by more than 30% when repeated testing after a time interval of 10 days, you can think about activation of the infection. If the titer of IgG antibodies to the herpes virus decreases during repeated studies, this indicates the success of treatment and the “extinction” of the infection.

Elevated IgG antibodies to herpes may indicate an intrauterine infection or the likelihood of its development. If the study was first performed during pregnancy, then it is not worth judging the probability until repeated studies are carried out. If IgG antibodies to herpes simplex virus types 2 and 1 were detected in the blood before pregnancy, then the likelihood of intrauterine infection is low.

• IgA appears in the blood 14 or more days after infection with the herpes virus and is not critical in diagnosis.

• IgM class - the first antibodies that appear after infection with herpes simplex virus types 2 and 1 within two weeks. A positive test result makes one think about an acute herpetic infection or the activation of a chronic one. In the latter case, IgM does not always appear in the blood serum; here the concentration of IgG antibodies to herpes is of greater importance.

A negative test result may indicate no infection. However, the same test result occurs in the first days of herpes infection or with a chronic inactive infection.

Herpes simplex virus, symptoms

Features of local clinical symptoms to a certain extent depend on the localization of herpetic eruptions. The herpes simplex virus can infect any area of ​​the skin and mucous membranes: on the lips (herpes labialis), wings of the nose (herpes nasalis), facial skin (herpes facialis), genitals (herpes genitalis), buttocks (herpes glutaealis), on the mucous membrane of the cavity mouth (herpes buccalis), pharynx (herpes pharyngealis), conjunctiva (herpes conjunctivalis), urethra (herpes urethralis), etc. Typical localization of herpes simplex is the skin of the face: the circumference of the mouth, especially the corners, the red border of the lips (herpes labialis), the wings of the nose (herpes nasalis); The skin of the cheeks, ears, forehead, and eyelids is somewhat less commonly affected. Rashes of elements on the skin of the genitals, buttocks, thighs, lower back, fingers are often observed; Other localization is also possible.

There are 4 periods during the disease:

• premonitory,
• catarrhal,
• period of rashes,
• period of regression.

The prodromal period is the precursor to the rash. 1-2 days before the appearance of erythema and blisters, subjective sensations are usually noted in the form of pain, burning, itching, tingling, and a feeling of discomfort in the same areas of the skin where rashes will appear in the future. During this period, viruses multiply in target cells. It is often asymptomatic.

The catarrhal period is a precursor to local manifestations. In the first days of the disease, especially with primary damage, local manifestations are preceded by signs of general intoxication: increased body temperature, chills, malaise, muscle, joint and headaches. During this period, the herpes simplex virus enters the intercellular space and spreads through the circulatory and lymphatic systems. Edema erythema is formed. Sometimes signs of general intoxication appear simultaneously with the appearance of rashes.

The period of rash - the typical clinical picture of the disease is characterized by the appearance of edematous erythema of varying degrees of intensity, against the background of which grouped bubbles (vesicles) with a diameter of 1 to 3-4 mm with a tense tire and serous transparent contents quickly appear. Grouped blisters filled with clear liquid against a background of edematous erythema are the main sign of herpetic infection.

Rashes of blisters with herpes simplex can appear on the mucous membranes and skin in the area of ​​the red border of the lips, mouth, upper palate, gums, tonsils, nasopharynx, cheeks, forehead, ears, eyes, genitals, buttocks, thighs, lower back, etc. The number of such vesicles varies significantly - from single elements to several dozen. Occasionally merging, they form flat, tense, multi-chambered bubbles.

The appearance of a rash means that the virus infects the cells of the mucous membranes and skin. The more actively the virus multiplies, the larger the affected area.

Regression period - after a few days, the contents of the bubbles become cloudy, they open and erosions with fine scalloped outlines form. After 3–5 days, honey-yellow loose crusts form at the site of collapsed blisters and erosions, after which epithelization occurs. In the normal course of herpes, the process lasts 1.5–2 weeks, but occasionally extends to a month.

The acute period of herpetic infection lasts from 8 to 22 days. After a week, the severity of clinical manifestations begins to subside. After the initial infection, the virus remains in the body, accumulating in the spinal and cranial ganglia of the nervous system, and the immune system produces antibodies to it. Under the influence of provoking factors, a latent infection can become active at any time and become aggravated.

There are 2 stages of infection:

• Active stage of infection:
  productive viral infection, the implementation of genetic information ends with the formation of viral offspring, daughter viral particles. An active infection may occur:
• with clinical manifestations (relapse),

asymptomatic.

Herpes simplex virus in women

, as a rule, affects the entrance to the vagina, the mouth of the urethra or the labia, but can affect extragenital areas, such as the perineum and anus, thighs, buttocks, and 70-90% of women are diagnosed with cervicitis. In complicated cases, the virus spreads to the uterus, fallopian tubes and ovaries. Herpes simplex virus, symptoms in women include blistering rashes, signs of inflammation, vaginal discharge, enlarged inguinal lymph nodes, itching when urinating, pain in the lower back, perineum and pelvis.

Herpes simplex virus in men

predominantly affects the area of ​​the urogenital organs (glans penis, foreskin, urethra), perineum, pubis, scrotum. A feature of lesions caused by the herpes simplex virus in men is multifocality. The pathological process often involves the lower part of the urethra, the mucous membrane of the anus and rectum, which can occur secondary to the appearance of rashes on the external genitalia, or can occur as an isolated lesion.

Herpes simplex in men, in addition to the rash, is manifested by enlarged inguinal lymph nodes, lower back pain, burning in the groin, numbness in the pelvic area after prolonged sitting or sleep. Complications of infection can be herpetic prostatitis, urethritis, proctitis. Since the herpes simplex virus is an agent that disrupts spermatogenesis and has the ability to infect sperm, infection with this virus can cause infertility in men.

Determination of DNA of herpes simplex virus types 1 and 2

The study is carried out using a highly sensitive PCR (polymerase chain reaction) technique. The DNA of the virus is determined by examining a scraping from the urethra, collecting morning urine or cerebrospinal fluid. If the analysis revealed DNA fragments of herpes simplex virus type 2 or 1, this indicates the presence of a herpes infection. If viral DNA is not detected, it means that it is not present in the sample taken, or is still present there in a concentration below the sensitivity limit of the test.

In Lab4U, using laboratory methods, you can accurately determine the presence of herpes simplex virus types 2 and 1, as well as get an impression of the course of the infectious process and possible complications. All this provides the doctor with valuable information that helps in diagnosis and choice of treatment regimen.

References

1. Herpes simplex (HS) in adults. Clinical guidelines, 2016. - 31 p.
2. Zubritsky, M.G., Nedzved, M.K., Silyaeva, N.F. and others. Herpetic infection: Etiology, pathogenesis, clinical picture and diagnosis. Journal of GrSMU, 2009. - No. 3(27).
3. Lima, L., Silva, A., Schmidt-Chanasit, J. et al. Diagnosis of human herpes virus 1 and 2 (HHV-1 and HHV-2): use of a synthetic standard curve for absolute quantification by real time polymerase chain reaction. Mem Inst Oswaldo Cruz., 2022. - Vol. 112(3). - P. 220-223.

Sowing on cell culture (HSV, CMV)

Sowing on cell culture (HSV, CMV)

— not only detects the virus, but also provides information about its activity (aggressiveness).
Analysis of culture results during treatment allows us to draw a conclusion about the effectiveness of the therapy. Herpes simplex virus (HSV)
, or herpes, comes in two types: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Both forms of the virus are highly contagious.

The main route of transmission of herpes: airborne, contact, sexual, intrauterine, blood transfusion, during organ transplantation. Primary herpesvirus infection and reactivation of the infection (to a much lesser extent) during pregnancy can cause pregnancy pathology or intrauterine infection of the fetus. The cause of intrauterine infection of the fetus is most often HSV-2, but infection with HSV-1 is also possible. In addition, mothers can pass the virus to their newborn during childbirth, which can cause neonatal herpes, a rare disease that can be fatal.

HSV-1 ( Herpes Simplex virus I)

- transmitted through oral contact and often causes a “cold” on the lips (orolabial herpes).

Typical symptoms of HSV-1 include:

• a rash on the lips and mucous membrane of the mouth of a group of crowded small bubbles (vesicles) filled with transparent contents;
• inflammation, swelling of the skin and mucous membranes in the area of ​​the rash.

HSV-1 can also cause the genital form of the disease.
Lip disease caused by type I virus can gradually spread to other mucous membranes, including the genitals. Infection can occur through direct contact with infected genitals during sexual intercourse, rubbing of genitals against each other, oral-genital contact, anal intercourse, or oral-anal contact. And even from a sick sexual partner who does not yet have external signs of the disease. HSV-2

- is one of the sexually transmitted infections that can cause genital herpes.

It is spread mainly through sexual contact through skin-to-skin contact.

The genital herpes virus Herpes simplex type 2 primarily affects the integumentary tissue (epithelium) of the cervix in women and the penis in men, causing pain, itching, and the appearance of transparent blisters (vesicles) in place of which erosions/ulcers form. However, with oral contact, damage to the covering tissue of the lips and oral cavity is possible.

HSV and pregnancy

In pregnant women: the virus can cross the placenta into the fetus and cause birth defects. Herpes can also cause spontaneous abortion or premature birth. But the danger of infection of the fetus is especially likely during childbirth, when passing through the cervix and vagina during primary or recurrent genital infection in the mother. Such infection increases the mortality rate of newborns or the development of severe brain or eye damage by 50%. Moreover, a certain risk of infection of the fetus exists even in cases where the mother does not have any symptoms of genital herpes at the time of birth. A child can become infected after birth if the mother or father has lesions in the mouth, or receive the virus through breast milk.

Cytomegalovirus (or CMV)

is a species from the group of herpesviruses (Herpesvirus), belonging to the genus Cytomegalovirus of the subfamily 3-herpesviridae. Found everywhere. The incidence statistics are very variable, probably due to the fact that a significant number of virus carriers are asymptomatic. There are no ways to completely cure herpes yet, i.e. an infected person remains a carrier of the pathogen for life.

CMV

is an infection similar to herpes or chickenpox, only with much more serious and unexpected consequences - from damage to internal organs to irreversible changes in the central nervous system. Determining this disease in the early stages is problematic; its exact incubation period is still unknown. Manifestations of infection can be mistaken for inflammation of the genitourinary system, common ailments such as ARVI (acute respiratory viral infection) and other common diseases. Very often, CMV leads to numerous inflammations in several internal organs at once.

During pregnancy, the virus is not always transmitted from a sick mother to her child. But if CMV infection occurs during pregnancy or the disease intensifies, then the likelihood of transmitting the disease to the fetus increases significantly.

Cytomegalovirus infection is transmitted sexually, through saliva, breast milk, during pregnancy (from mother to child), through a shared washcloth, towel, dishes, etc.

Most often, cytomegalovirus infection manifests itself as an acute respiratory viral infection. Patients complain of general malaise, runny nose, and fatigue. There is an enlargement and inflammation of the salivary glands, accompanied by a whitish coating on the tongue and gums, as well as copious secretion of saliva.

In the generalized form of CMV infection, damage to parenchymal (internal) organs is observed. The kidneys, pancreas, liver tissue, spleen, and adrenal glands become inflamed. This is accompanied by “unreasonable”, at first glance, bronchitis and pneumonia, which are difficult to treat with antibiotics. Patients' immune status decreases, and there are fewer platelets in the peripheral blood. Damage to the intestinal walls, peripheral nerves, blood vessels of the eyes and brain are quite often observed. The submandibular and parotid salivary glands become enlarged, and the joints become inflamed. Skin rashes may appear.

In women and men, damage to the genitourinary system gives symptoms of chronic non-specific inflammation. In this case, if the viral nature of the pathology is not detected, treatment of the disease with antibiotics will be ineffective.

The most serious and dangerous complications of cytomegalovirus are the pathology of pregnancy, fetus and newborn. If the fetus is infected during pregnancy, the risk of developing this pathology will be maximum. However, we should not forget that problems can also arise in pregnant women when a latent CMV infection is activated, when the virus enters the blood, subsequently infecting the fetus. According to statistics, CMV is the most common cause of miscarriage. Intrauterine cytomegalovirus infection causes damage to the central nervous system (hearing loss and mental retardation). In 20–30% of cases it ends in the death of the child.

The symptoms of herpes can vary significantly from person to person. If you experience signs of infection, we recommend that you undergo a “Cell Culture (HSV, CMV)” test to detect herpesvirus within 48 hours from the moment of their onset.

Advantages of cell culture seeding

The main advantage of cell culture seeding is the high accuracy of the study in case of a positive result. In addition, by cell culture it is possible to determine which type of herpes virus - first, second or CMV - caused the infection. If the result of laboratory diagnostics on cell culture is positive, you can be sure that you have the herpes virus.

The main disadvantage of cell culture seeding is the high percentage of false negative results. Since the virus must be in an active state for culture, if the herpetic vesicle or ulcer is small or is already beginning to heal, then the amount of virus may not be enough for a normal study. If diagnosis is made later than 48 hours after the onset of symptoms, there is a high risk of a false negative result. Sowing the virus on a cell culture can be even less reliable when diagnosing during relapses (positive results are obtained only in 30% of cases of repeated outbreaks of herpes).

Preparation

No special preparation required.
It is recommended to take blood no earlier than 4 hours after the last meal. Blood is taken into a test tube with EDTA. Urine collection
On the eve of the test, it is not recommended to eat vegetables and fruits that can change the color of urine (beets, carrots, cranberries, etc.), or take diuretics.

Before collecting urine, it is necessary to perform a thorough hygienic toilet of the external genitalia. Collect a strictly morning portion of urine, excreted immediately after sleep. Women are not recommended to take a urine test during menstruation; To prevent vaginal discharge from getting into the urine, it is recommended to insert a tampon into the vagina.

The day before the test, avoid drinking alcohol and having sexual intercourse.

The material is collected in a sterile plastic container. The average portion of morning urine is collected. When urinating for the first time in the morning, release a small amount of urine (the first 3-5 seconds) into the toilet, and then, without interrupting urination, collect a medium portion of urine in a clean container. Continue urinating into the toilet. Close the container and label it.

We must try to reduce the time it takes to deliver the material to the laboratory as much as possible. Long-term storage leads to the growth of bacteria.

It is necessary to deliver the container with urine to the medical office as soon as possible from the moment the biomaterial is taken. Urine in a sterile plastic container for culture is stable for no more than 2 hours at a temperature of 18–20°C, and no more than 6 hours at a storage temperature of 4–8°C.

Preparation for saliva collection:

• It is advisable to collect in the morning;
• do not brush your teeth or eat for at least 4 hours;
• The saliva is collected in a sterile container.

Smear from a woman’s urogenital tract
Taking a smear is not allowed on menstruation days. Three days before the collection, you must stop using vaginal suppositories, tampons, spermicides, and avoid sexual intercourse the day before. You should not douche on the eve of the examination. After an ultrasound examination using a vaginal sensor, colposcopy, or biopsy, at least 48 hours must pass.

Smear from the male urogenital tract

1–2 days before taking a smear, it is necessary to exclude sexual contact. You should not urinate for 1.5–2 hours before the procedure.

Interpretation of results

The result of the study is given as a percentage. Normally, these viruses are not detected in cell culture.

The interpretation of the results should be carried out by the attending physician.