Content

Herpes virus types 1 and 2 are the most common forms of herpes infection. The peculiarity of both is that they are able to remain in the body for a long time and not detect themselves in any way. Symptoms of a viral infection begin to appear after disturbances in the functioning of the immune system. The first type affects the lips (called oral), and the second affects the genitals (called genital). The pathogen is transmitted by contact.

What is HSV

The abbreviation stands for “herpes simplex virus.” HSV types 1 and 2 are a viral disease that affects the skin and mucous membranes and manifests itself as focal inflammation in the form of blisters grouped in clusters. This process is called ballooning degeneration. In the English version, the abbreviation looks like HSV (Herpes Simplex Virus). The disease is divided into 2 main, more common types:

1. HSV-1, herpes type 1 or labial. Bubbles are localized in the corners or along the edges of the lips. Often occur after hypothermia of the body due to drafts. In common parlance it is called a “cold”. The problem causes both physical and moral discomfort.
2. HSV-2, HSV type 2, or genital herpes. This form affects the mucous membrane of the genital organs and the anal area. Papules are localized on the penis, prostate, vagina, perineum and rectum.

The causative agent of the disease

HSV types 1 and 2 - what kind of disease this is is known to many. The cause is the DNA-containing pathogen Herpes simplex (herpes simplex, HSV). It is a member of the Herpesviridae family. Its shape is round and its diameter reaches 150-300 nm. When exposed to unfavorable factors, such as sunlight, drying, high and low temperatures, it dies. Main properties of the pathogen:

• the presence of an antiviral link that suppresses the immune system of the human body;
• the ability to persist for a long time in intracellular structures, transferring genetic material to daughter cells (this is called persistence);
• virus types 1 and 2 differ in the favorite location of pathological rashes;
• There is HSV type 3, which causes herpes zoster and chickenpox, and type 4, which causes infectious mononucleosis.

Source of the disease

The virus carrier or patient is the source of the disease. The pathogen can enter the body at an early age. Children 3-6 years old are especially prone to infection. At this age, the antibodies that were transferred from the mother at birth stop acting, so the susceptibility to HSV increases. The microorganism penetrates the body and settles on epithelial cells, where a host cell suitable for it is located.

Then it enters the blood, nerve fibers, plexuses and ganglia. The pathogen remains in the body forever, going deep into the nerve nodes. There it assumes a latent state until activated by unfavorable factors that reduce immune defense. An infected person may contain viral cells:

• nasopharyngeal mucus;
• discharge from ulcers and erosions;
• blood during menstruation;
• conjunctival secretion;
• vesicle contents;
• sperm;
• vaginal and cervical secretions.

How is the herpes virus transmitted?

The pathogen is not able to remain in environmental conditions for a long time, so it can be transmitted in numerous ways. This results in a high risk of infection and widespread pathology. It is transmitted in such ways as:

1. Direct contact. Transmission occurs through contact with the skin or mucous membranes of a virus carrier or a sick person.
2. Indirect (indirect). The microorganism gets on personal or intimate hygiene items, dishes, after which the skin or mucous membranes of a healthy person come into contact with them. Since the pathogen has low resistance to the environment, the transmission condition is a short period of time. For this reason, this route of transmission is rarely observed.
3. Transplacental. The pathogen is transmitted from mother to child through the placenta.
4. Sexual transmission of HSV type 2. The genital form is infected directly during sexual intercourse due to contact of the mucous structures of the urogenital tract. This is a type of direct transmission.
5. Airborne. Through exhaled air and tiny droplets, the microorganism is transmitted to a healthy person when he inhales.
6. Vertical. It is the transmission of the virus from mother to fetus during childbirth.

Features of the HSV virus types 1 and 2

Both forms of the virus are characterized by lifelong infection, when the pathogen cannot be completely eliminated. The difference between them is the age when infection occurs more often:

1. Herpes virus type 1 (labial) affects a person between 3 and 5 years. This is due to the fact that during this period the baby becomes more independent, and the antibodies received from the mother cease to function. The result is that the child’s body becomes more susceptible to bacteria and viruses.
2. The development of HSV type 2 (genital) occurs when a person has already reached puberty. This is explained by the fact that this form of pathology is sexually transmitted.

What diseases does it cause?

HSV causes disease only under certain conditions. The main one is the weakened immunity of the virus carrier. The infection rate of the human population under favorable conditions for the virus is about 90%. HSV type 1 is observed in 60% of cases, and type 2 in 30%. Each form causes certain diseases:

Risk factors

Penetrating into the human body through mucous membranes or microcracks in the skin, HSV is localized in the nerve ganglia, where it enters a latent state. This means that the pathogen remains in the human body forever, which is why it is not possible to completely recover from it. Under favorable conditions, the virus is activated, resulting in the appearance of vesicles. Factors that lead to this are:

• excessive alcohol intake;
• hypothermia;
• visits to the solarium;
• overheating of the body (“solar” HSV, which develops due to a lack of melanin);
• physical or mental injuries;
• hormonal changes;
• medical procedures, including abortions;
• weakening of the immune system.

How does herpes simplex virus types 1 and 2 affect the body?

The development of HSV is a long process that includes several stages. The first is infection that occurs through direct, airborne, vertical, sexual or indirect routes. The virus then goes through the following phases:

1. Transition to a latent state. After entering the body through one of the routes, the infection takes on an inactive form, in which there are no symptoms. This does not mean that the pathogen is not in the body. It is simply “waiting” for favorable conditions to manifest itself.
2. Activation of HSV. Occurs under the influence of triggers, i.e. factors that trigger certain processes in the body.
3. Development of antibodies to the virus. After an infection enters the body, the immune system produces antibodies to it. This is the name of a special type of proteins in blood cells - immunoglobulins, designated by the Latin letters ig. There are 5 types of antibodies that characterize the disease in their own way:

• IgM – appears first after infection;
• IgG – detected several days after the previous one, the most common class of antibodies (75%);
• IgA – produced in mucous membranes, found in saliva and breast milk;
• IgE – indicates the presence of an allergy, is present in the blood in small quantities;
• IgD - produced in the embryo during gestation; in adults only minor traces are observed.

Stages of development

This form of virus is called labial. This pathology is familiar to many; it is more common. The incubation period of primary infection is 1-8 days. The rash may appear on the lips, cheeks, and other areas of the face. The entire process of infection development goes through 4 main stages:

1. Itching and tingling in the lips. More often the virus is localized in their corners. A person feels how they itch very much. Against this background, redness of the lesion appears. The peculiarity of this stage is that if you start treatment, you will be able to prevent the virus from moving to the next stages. Effective here are Acyclovir, Gerpevir, Herperax, Ribavirin, Oxolinic ointment.
2. The appearance of small bubbles. Their contents are transparent. Over time it becomes cloudy. The itching persists against this background.
3. Ulceration of vesicles in areas of epithelial erosion. A serous exudate is released from them, which contains millions of viral particles. At this stage, the person is especially contagious to others. If an antibody test is performed, it shows the presence of IgG.
4. Crust formation. Comes in 3-5 days. It is important not to disturb the integrity of the crusts, otherwise the lesion will bleed and hurt. Symptoms disappear completely 7-9 days after the appearance of itching on the lips.

Herpes simplex type 2

The course of this form is similar to the development of the labial one. The difference is that the bubbles are localized not on the face, but on the skin and mucous membrane of the genital organs. They can be found on the clitoris, labia, pubis, buttocks, sacrum, and glans penis. Skin hyperemia occurs first, then blisters form. Gradually they turn into ulcers, which become covered with crusts when ulcerated.

In some patients, the pathology manifests itself as small individual spots, similar to insect bites. For this reason, a person does not always recognize the presence of HSV. The following factors can provoke activation of the genital form:

• overwork;
• emotional stressful situations;
• flu;
• angina;
• ARVI;
• surgical operations;
• sexual contact;
• frequent drinking of alcohol.

Symptoms of the disease

Signs of the disease may vary depending on the location, strain of the herpes rash and the individual characteristics of the person. A characteristic symptom is a rash of vesicles. Labial herpetic infection is characterized by sores on the lips, nose, and facial skin. Vesicles are observed at the entrance to the vagina with vaginal herpes in women, on the penis with HSV type 2 in men. In addition to the appearance of ulcers, the following symptoms are possible:

1. General signs of intoxication. Possible increased temperature, fever, lymphadenitis (enlarged lymph nodes), malaise. Sometimes numbness occurs at the site of inflammation.
2. The appearance of a rash on the palate, tongue, tonsils, oropharynx, and inner surface of the cheeks. In this case, HSV proceeds like a respiratory disease.
3. Pain syndrome. With genital herpes, there is pain in the lower abdomen and in the genital area. There may be purulent discharge from the vagina. In men with the genital form, burning and pain in the urethra occur when urinating. In this case, medications are often prescribed in the form of suppositories.

Diagnosis of herpes simplex virus

The diagnosis is made by a dermatovenerologist. Sometimes a consultation with an ophthalmologist, gynecologist, or urologist is necessary. If a person has ever suffered from type 1 HSV, it does not mean that he will never suffer from its second form. It is especially dangerous due to the possible development of tumors and necrosis, and even blindness if the eyes are affected. A common complication is herpetic vesicular dermatitis. During pregnancy, it can lead to its termination. The most dangerous consequence is infertility.

• pregnancy planning;
• normal course of pregnancy;
• patients with immunodeficiency;
• patients with suspected urogenital infections;
• patients with blistering skin rashes;
• pregnant women with suspected intrauterine infections.

Diagnostic methods

The entire diagnostic process involves more than just a visual examination. Due to the difference in symptoms in certain patients, additional laboratory and instrumental studies are required. Today there are the following methods for diagnosing HSV:

1. Virological research. It consists of isolating the pathogen in the culture of sensitive tissues. This method is considered the “gold standard” in detecting viral infections. The sensitivity of the study is 95-100%. Its use is limited by high cost, technical complexity, and duration of the study.
2. Cytological examination. It is a light microscopy of specially stained smears of biological material. HSV is confirmed by giant cells and intranuclear inclusions. The method is inexpensive, fast, but has only 60% sensitivity.
3. Biological method. If the material is applied to scarify the cornea of ​​a rabbit, then if HSV is present, it will develop keratiat. In newborn mice, a neuroinfection called encephalitis occurs in the brain using this diagnostic method.
4. Enzyme-linked immunosorbent assay (ELISA). Determines the presence of antibodies to the pathogen in the blood.
5. PCR of cerebrospinal fluid is a polymerase type of chain reaction. The molecular biological method detects DNA particles of the causative agent of herpes infection. The technique is capable of identifying even one viral cell in the taken biomaterial.

Enzyme immunoassay for herpes virus

To carry out an enzyme immunoassay, blood, cerebrospinal fluid, amniotic fluid, saliva or breast milk are taken. The procedure is carried out in two stages. First, the collected material is first combined with an antigen, after which the immune complex is monitored. Second, a chromogen is added to determine the level of pathogenic microflora in the body based on the intensity of the staining. There are 2 types of ELISA:

1. Qualitative analysis. Of the 5 main classes of immunoglobulins, IgM, IgG, IgA, IgE, IgDI detects only the first 3. The analysis determines the type of infection and the presence of relapses in the past.
2. Quantitative analysis. Determines the amount of immunoglobulins in the blood. Roughly assesses the state of the immune system.

The marker of primary penetration is anti hsv IgM antibodies. Anti hsv IgG is also important in diagnosis. They appear in the blood a few days after infection. To decipher the result, reference values ​​are used. These may vary from laboratory to laboratory, but are always indicated on the form. The result of the analysis is one of the diagnoses:

1. Seropositivity. Antibody levels are below the threshold.
2. Seronegativity. Antibody levels are above the threshold.

Decoding the results

The detected antibodies and their quantity make it possible to judge whether a person has had a herpes infection in the past or has recently appeared. The primary marker is IgM. It is an indicator of infection. An IgG antibody indicates infection of the body with HSV type 1 or 2. The analysis is described in detail in the table:

Herpes simplex types 1 and 2 during pregnancy

Due to herpes infection, the fetus develops deformities in the womb. In infants, HSV can cause congenital pathologies. The genital form is especially dangerous for pregnant women. It leads to mental and physical disorders in the child much more often. In the early stages, miscarriages or fetal death in the womb are noted. In pregnant women, the disease is more severe. In addition to the classic symptoms, the following appear:

• copious light-colored vaginal discharge;
• swollen genitals, their soreness;
• heat;
• painful and frequent urination.

For this reason, pregnant women are tested for antibodies igM and iGG. The analysis is carried out several times throughout the entire period of gestation. The results of the study are deciphered as follows:

Index	Decoding
	If the readings are negative, the woman is healthy and has never had the disease. Due to the fetus's lack of immune protection, there is a risk of infection.
	There are 3 decryption options: If there was previously seronegativity, no symptoms of herpes infection were noted - this is the second half of the primary infection with a threat to the fetus. If there has already been an infection before, then the woman is a virus carrier, and the result means a relapse. Immunity is present, but there is a risk to the fetus. Presence of immunity. For clarification, consideration of 2 types of IgG is required. If immunity has been confirmed, then there is no threat to the fetus.
	The initial stage of the disease, there is a risk for the child.
	The first half of the primary acute infection requires antiviral treatment.

Treatment of HSV types 1 and 2

It is immediately worth noting that HSV cannot be cured completely. Treatment only helps to stop the exacerbation and prevent the development of infection in the future. Basic principles of therapy:

1. Herpes is a viral microorganism, so antibacterial drugs do not work on it. Levomekol, Tetracycline and other antibiotic ointments will not be effective. Antiviral drugs become the basis of etiotropic therapy.
2. The use of medications is irrational if the labial form manifests itself in a mild degree.
3. There are no medications for prevention - you cannot protect yourself from the occurrence of herpes in the future with the help of medications.
4. Physiotherapy with infrared or ultraviolet radiation may be used. In some cases, antiviral chemotherapy is used.

Use of antiherpetic antiviral drugs

Inactivation of the pathogen is carried out only with antiviral agents. The approach to treatment is complex, so therapy includes both systemic and local drugs. First group:

1. Acyclovir. A drug from the group of acyclic nucleosides that inhibits the replication of viral cells. You need to take 5 tablets of 200 mg daily for 5-10 days. Contraindications: hypersensitivity, breastfeeding, pregnancy, age under 2 years. The medicine can cause multiple adverse reactions.
2. Famciclovir. Blocks the synthesis of viral DNA of cells, prevents the replication of viruses. For genital herpes - 3 times daily, 250 mg for 5 days, for labial herpes - 1 time per day, 1500 mg. After taking, nausea, allergies, and headache are possible. The drug should not be taken in childhood.
3. Valaciclovir. Inhibits the activity of DNA polymerase of herpes viruses. Once a day you need to take 1000 mg, divided into 2 doses. Cannot be used by HIV-positive people under 18 years of age, after bone marrow or kidney transplantation. Almost all potential adverse reactions are possible. An analogue is Valtrex.

The immediate site of the lesion can be treated with ointments. They must also contain antiviral components. The following drugs are commonly used:

1. Zovirax. Based on acyclovir, which inhibits the replication of herpes simplex viruses. Use a cotton swab to apply the cream to the affected area up to 5 times a day. treatment lasts 4 days. Zovirax is prohibited if you are allergic to acyclovir. After use, itching, angioedema, dermatitis, redness, and burning are possible.
2. Acyclovir Hexal. Stops viral DNA synthesis. The drug is prohibited during pregnancy, breastfeeding, and renal impairment. You need to apply the cream 4-6 times a day. Treatment lasts 5-10 days. After application, redness and itching may occur.

Immunostimulating therapy

Herpes is activated against the background of a general weakening of the immune system. For this reason, complex treatment of the virus additionally includes immunomodulators:

1. Kagocel. Has antiviral and immunomodulatory effects. For herpes, you need to take 2 tablets three times a day for 5 days.
2. Neovir. Effective against viruses, helps strengthen the immune system. You need to take 750 mg per day. The course of treatment is 5-7 doses with breaks of 2 days. An analogue is Reaferon.

Symptomatic treatment

While being treated with antiviral drugs, the doctor prescribes some patients medications that relieve certain signs of infection. The following medications may be used for specific herpes symptoms:

1. For fever and aches. Antipyretics Ibuprofen and Paracetamol are indicated.
2. From itching, pain, burning. Local analgesics such as Benzocaine and Lidocaine are effective.
3. To prevent bacterial infection. To disinfect the lesion, after taking a bath and drying the skin, each element of the rash is lubricated with a solution of brilliant green, Fucarcin, Miramistin or 2% silver nitrate.

Adaptogens

This group of drugs consists of herbal products. They are able to activate the internal resources of the body, increase tone and immunity. Against this background, the body copes with herpes faster. Each drug indicated must be used according to the instructions. Useful for herpes are fir and sea buckthorn oil, as well as tinctures:

• propolis;
• Schisandra chinensis;
• aralia;
• aloe vera;
• Eleutherococcus;
• ginseng.

Vitamins and microelements

Vitamin therapy can increase immunity and restore the body weakened after suffering from a virus. To help cope with the disease:

• Ascorbic acid (vitamin C);
• zinc preparations;
• vitamin E capsules;
• vitamin A;
• vitamin B1 (thiamine).

How to treat HSV types 1 and 2 with folk remedies

You should not completely rely on folk recipes. The herpes virus is very dangerous under certain conditions, and in the absence of adequate treatment it becomes recurrent. During treatment with medications, you can use the following recipes:

1. Apply crushed garlic to the problem area 2 times a day.
2. Wipe the area of ​​inflammation with freshly squeezed celandine juice up to 3 times a day using a cotton swab.
3. Brew 200 ml boiling water 1 tbsp. l. lemon balm. Cover with a towel and leave until cool. Drink the strained infusion 100 ml before meals. At the same time, lubricate the rash with raw egg white.
4. Take a piece of ice from the refrigerator, wrap it in a thin napkin and apply it to the area of ​​inflammation for a couple of minutes. In the early stages this method is very effective.

Prevention of herpes

A vaccine against herpes has not yet been developed. There are no medications that would definitely protect against such an unpleasant virus. For this reason, for prevention, you can only perform the following actions:

• treat all chronic diseases;
• provide adequate nutrition and sleep;
• to harden;
• observe the correct work and rest schedule;
• often be in the fresh air;
• exercise;
• take multivitamin complexes;
• protect yourself with condoms.

Video

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.

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Often, the herpes simplex virus (HSV) occurs latently and is activated when the immune system is weakened. That is why it is necessary to donate blood for analysis on time. Laboratory testing of its composition is part of a series of examinations that must be carried out, for example, during pregnancy. When diagnosing, the composition of urine is studied, a scraping and smear are taken. One of the methods for diagnosing herpes is PCR (polymerase chain reaction).

A blood test gives the most reliable result for the presence of the herpes virus.

PCR technique: advantages and disadvantages

One of the advantages of this method of studying blood composition is the ability to find a small amount of this virus. An important feature of the study is the determination of herpes immediately after infection has occurred, that is, before the first manifestations of the disease occur. Using the PCR method, differential diagnosis is carried out, viruses of the 1st and 2nd types are identified. However, the high-tech technique may produce inaccurate results. If the patient is diagnosed with the wrong type of herpes, there is a high probability of violation of basic instructions during the collection of the test material and the conduct of work. In such cases, there is a high probability of receiving false data. Therefore, it is necessary to diagnose infections using several methods and repeat them if the doctor has doubts about the plausibility of the final results.

Types of PCR tests for herpes

PCR analysis helps to find a particle of viral DNA in a short time, and it is impossible to confuse one type of herpes with another. A day later, it will become known which virus this or that rash belongs to.

Simple

Studies and tests that can be used to detect this type of herpes are carried out when rashes of unknown origin occur. In addition, the doctor gives a referral if there is a suspicion of the presence of a genital herpetic rash and herpes itself inside the body, to determine its type. To carry out tests, you need to donate the following materials: blood, the contents of rashes, smears, urine, etc. When studying secretions (for example, in smears), specialists add substances that cause the growth of all viral DNA molecules, which makes it possible to determine their number and presence.

Tests for herpes simplex also include taking smears.

If a chronic exacerbation of genital HSV has occurred, then using this method (for example, with a smear or scraping) it is possible to determine what danger the patient poses to the partner before the next relapse. A specialist will help you choose the appropriate therapy. Women should visit a gynecologist for a smear to determine HSV. In this case, a gynecological speculum and a brush are used to examine the contents of the cervical canal (if cervical herpes is suspected). Examine the discharge that is in the cervical canal. Men should see a urologist to have their urethra examined. The doctor should insert and then remove the tampon that is inside using gentle circular movements. Analyzes take little time. The PCR technique will help detect HSV in case of relapse. Accurate data can be obtained using ELISA.

Shingles

The material is submitted to the laboratory and studied for the presence of DNA and RNA of herpes. To carry out analysis if a type of herpetic rash is suspected, the contents of the rash, etc., are taken. The results allow us to determine the nature and type of infection. The result can be positive or negative.

Preparing for diagnosis

Before testing for herpes, you should prepare your morning urine. The contents of the bubbles that have formed on the skin and other biological materials are also studied. The referral must be issued by a doctor. In addition, a day before the tests, doctors prohibit eating fried foods, spices, and drinking medications. If you cannot stop taking your medications regularly, you should tell your specialist. The timing of the diagnosis is also important. The doctor sets the time, most often the examination is carried out at 10 am. It is extremely undesirable to worry before diagnosis. You should avoid physical activity, as this will affect your results. Before diagnosis, it is recommended to rest for 15 minutes in a calm environment.

General information about the study

Both types of herpes simplex (HSV 1/2) are DNA enveloped viruses. They are the most common viral pathogens and can cause a range of diseases, including herpes simplex (herpes labialis, HSV-1, and herpes genitalis, HSV 1/2), gingivostomatitis and keratoconjunctivitis, as well as more severe conditions. (encephalitis, disseminated herpetic infection of the newborn). In the structure of the HSV 1/2 shell, protein molecules were found that have virulent and antigenic properties specific to this pathogen (ngB, ngC, ngD and others). In laboratory diagnostics, these antigens are used to identify HSV 1/2. One of the methods for their detection is immunofluorescence.

Immunofluorescence (IF) is an immunohistochemical study that allows you to identify the pathogen antigen in a biomaterial sample. It is based on the interaction of the HSV 1/2 antigen and an antibody specific to it, labeled with a fluorescent dye (fluorochrome), as well as on the registration of fluorescence when studying the biomaterial in ultraviolet light. The method allows you to obtain results in a shorter time than isolating the virus in cell culture, and is also characterized by greater accuracy compared to another common analysis - the Zanck test with Wright-Giemsa staining.

The sensitivity of IF depends on the stage of herpes viral infection. The most accurate result will be obtained by analyzing discharge from vesicles and “fresh” erosions. The sensitivity of the test is about 70%. Detection of the virus using IF is less likely if the discharge is obtained from ulcerative defects, pustular elements or crusts. For this reason, to diagnose herpes viral infection using IF, repeated (multiple) collection of biomaterial is recommended. Also, the sensitivity of the test is maximum when taking discharge at the very first rash and decreases significantly after 72 hours (19%). The greatest sensitivity is achieved when studying samples obtained from elements of “genital herpes” in comparison with elements of other localization. It should also be noted that the sensitivity of the test decreases when analyzing biomaterial taken during treatment with antiviral drugs. Given these features, a negative result should be interpreted taking into account the clinical picture and some other laboratory data.

IF is characterized by a fairly high specificity (96-99%). This means that a positive test result can confidently confirm the diagnosis of herpes viral infection.

IF can be successfully used when examining patients at risk for herpes viral infection (for example, patients with multiple sexual partners) and with its symptoms. Conversely, IF should not be used in patients without risk factors (eg, prepubertal girls) and patients with asymptomatic HSV1/2 infection. Given the prevalence of asymptomatic HSV1/2 infection among pregnant women, this test is not recommended for the examination of those planning pregnancy and pregnant women without clinical signs of genital herpes.

When confirming the diagnosis of genital herpes using IF, examination for other sexually transmitted infections (gonorrhea, trichomoniasis, chlamydia, etc.) is also recommended. In addition, all sexual partners of the patient should be tested for STIs.

What is the research used for?

For diagnostics:

• simple blistering lichen;
• herpetic gingivostomatitis;
• herpetic keratoconjunctivitis.

When is the study scheduled?

For symptoms:

• “genital herpes” in men (grouped vesicular, erosive or ulcerative rashes in the genital or thigh area, dysuria, discomfort in the groin or perineum);
• “genital herpes” in women (mucous vaginal discharge and dyspareunia are added to the described symptoms);
• herpetic keratoconjunctivitis (acute onset of the disease, lacrimation, photophobia, blepharospasm, injection of scleral vessels, intense pain in the area of ​​the affected eye);
• herpetic gingivostomatitis (acute onset of the disease, fever, swelling and erythema of the gums, painful cervical lymphadenopathy, as well as vesicular rashes in the oral cavity and on the skin of the perioral area).

Data Aug 02 ● Comments 0 ● Views

Doctor Maria Nikolaeva

After infection with a herpes infection, the virus integrates into the DNA structure of the nervous system. In the absence of diseases and other factors that weaken the immune system, the pathogen does not pose a danger to the body. However, before pregnancy, as well as for people with immunodeficiency, it is necessary to test for HSV (herpes simplex virus). In the first case, the pathogen is capable of disrupting the intrauterine development of the child, in the second - causing severe diseases of the internal organs.

Testing for herpes simplex virus types 1 and 2 (HSV 1 and 2) is carried out in several ways. Such studies are resorted to in the following cases:

• the disease occurs without pronounced symptoms (it is especially important to diagnose infections when genital herpes develops);
• women planning pregnancy have not previously shown signs of herpes on the mucous membrane of the genital organs or other parts of the body;
• frequent relapses of herpes;
• frequent exacerbations of chronic diseases;
• infertility and other diseases of the reproductive system of unknown etiology.

Tests for herpes

It is mandatory to be tested for antibodies to HSV 1 and 2 both before and after conception. This is explained by the fact that in the absence of the virus in the body, contact with the carrier of the pathogen leads to infection not only of the mother, but also of the unborn child. Primary infection during pregnancy provokes developmental disorders or fetal death. In addition, to avoid infecting the newborn during childbirth, it is recommended to conduct a blood test for HSV 2. If the test results show the presence of herpes of this type, a cesarean section is often prescribed.

HSV can be detected using the following methods:

1. Polymerase chain reaction (PCR). This blood test for herpes virus types 1 and 2 can detect the presence of viral DNA in the human body.
2. Enzyme-linked immunosorbent assay (ELISA). The method is based on identifying immunoglobulins that the body produces after infection with HSV. ELISA helps diagnose the virus, even if the infection was a long time ago.

If the analysis for herpes types 1 and 2 did not give an accurate result, an immunofluorescence reaction (RIF) is used. This method also involves testing blood taken from the patient.

If herpes often appears on the lips, it is necessary to evaluate the state of immune defense, for which an immunogram is prescribed. In difficult situations, a biochemical blood test is used, which detects disturbances in the functioning of internal organs. This method is especially relevant in cases of exacerbation of genital infection.

Polymerase chain reaction

PCR diagnosis is carried out using liquid taken from a vesicular rash or scrapings from the mucous membranes. This study is most effective immediately after infection. DNA determination by PCR is carried out to diagnose the type of virus.

The effectiveness of the polymerase chain reaction is explained by the fact that after infection the body produces antigens to HSV, which are detected in the test material.

PCR analysis - what is it?

Preparation for the procedure

Diagnosis of infections is carried out in the laboratory. Before submitting material for PCR, the patient must:

• Avoid sexual intercourse for 3-4 days;
• within a week, stop douching and using vaginal suppositories;
• refuse to visit baths, saunas, swimming pools;
• do not consume alcoholic beverages, fried and salty foods;
• If possible, limit your medication intake.

Polymerase chain reaction is not carried out during the acute course of infectious diseases, after severe fatigue or stress. Each of the above factors can affect the results of the study.

results

An analysis for the detection of herpes simplex virus antigens makes it possible to estimate the concentration of the pathogen particle in the collected material. If the test gives a positive result, it indicates the presence of an infection in the body. In such situations, treatment with antiviral drugs is prescribed or the therapy is adjusted.

When the study gives a negative result, the procedure must be repeated. If the following analysis does not reveal the presence of an antigenic load, then antiviral treatment is not carried out.

PCR - no infection will remain undetected

Biopsy as an addition to PCR

An important feature of PCR is that the results of tests for herpes types 1 and 2 will be positive provided that the virus is present in the collected material. However, over time, the concentration of the pathogen in the separated fluids decreases. At the same time, inflammation of the tissues of the reproductive system organs persists.

This process develops because the herpes virus changes the immune response, and the body begins to attack its own cells. As a result, the polymerase chain reaction does not give a positive result in the chronic course of the disease. In such circumstances, an analysis for class M and G antibodies to the herpes simplex virus (ELISA) becomes less informative.

In such conditions, a provocative test is prescribed, during which the patient is prescribed to take Pyrogenal or other drugs, after which the blood is examined to detect pathogen particles.

Additionally, a tissue biopsy is performed on organs that the doctor suspects are affected by herpes. The material is taken from the uterine cavity, prostate gland or other parts of the reproductive system.

Cytopathic changes in herpes cells are determined by treating samples with formaldehyde and paraffin. The virus, integrating into the body, damages tissues from the inside. Therefore, if the study reveals altered nuclei and cytoplasm of cells, the presence of herperovirus is diagnosed. In addition, compliance with the norm of leukocytes in the smear also indicates infection with this pathogen.

Linked immunosorbent assay

After infection with a herperovirus, the human body produces special proteins (antibodies) that suppress the activity of the infection. These immunoglobulins are carried throughout the body and begin to fight the pathogen in the areas into which it “descends.”

There are several classes of antibodies that are detected using enzyme immunoassay:

1. IgM. Antibodies of this type are formed during the first two weeks after infection. If the ELISA shows the presence of IgM in the blood, then they speak of a recent infection or an exacerbation of herpes. Over time, the concentration of these antibodies gradually decreases.
2. IgG. Antibodies appear some time after infection (approximately 12-16 days). As in the case of IgM, the concentration of IgG increases with relapses of the disease.
3. IgG to early early proteins of herperovirus. These antibodies also arise during an exacerbation of the disease.

The enzyme immunoassay evaluates the avidity of IgG immunoglobulins. This indicator determines the ability of antibodies to bind to viral particles. During exacerbation of the disease, avidity is low. As herpes progresses, the rate gradually increases. Avidity helps clarify when a relapse occurred.

What is ELISA

Decoding

When deciphering a blood test for herpes types 1 and 2, the herpes simplex titer is usually indicated. The study provides the following results:

1. Lack of IgG and IgM antibodies. The patient is not a carrier of herpes.
2. Absence of IgM and presence of early and late IgG. The result indicates recent infection (confirmed by PCR) or relapse of the disease.
3. The presence of only late IgG. The result of the analysis shows the presence of the virus in the body in a latent state.
4. Presence of IgM and IgG (including late ones). The test result indicates a recent exacerbation or infection.
5. The results of the avidity analysis are interpreted as follows:
6. 50-60%. This result requires repeated enzyme immunoassay after 2 weeks.
7. Below 50%. The indicator indicates a recent infection.
8. Above 60%. Chronic herpes was diagnosed.

If the test result is positive, the patient must consult a therapist (dermatologist) for herpes localized on the body, or a gynecologist (urologist) for herpes localized on the genitals.

Immunofluorescence reaction

The effectiveness of RIF directly depends on the level of virus concentration in the collected material. The essence of the method comes down to the following: special dyes are introduced into the blood, which include antibodies to herpes. If a pathogen is present in the body, the latter enters into a chemical reaction. Dyes highlight viral particles under a microscope.

RIF is rarely used to detect herpes. This is explained by the high sensitivity of the method to various infections. Therefore, if other viral particles are present in the human body, the RIF result will be false positive.

Other techniques

Sometimes, to detect herpes in the body, a culture method is used, in which cells are collected. The latter are then infected with viral particles, after which the nature of the ongoing processes is assessed.

If necessary, allergy tests are prescribed, which exclude or confirm the patient’s hypersensitivity to certain irritants. This procedure is carried out in cases where it is not possible to differentiate an allergic reaction and an exacerbation of herpes by external signs due to the similarity in symptoms.

The list of tests required to make a diagnosis is compiled individually for each patient. Herperoviruses types 1 and 2 do not pose a threat to the body. At the same time, frequent manifestations of infection indicate a sharp weakening of the immune system. In such cases, you need to contact an immunologist.

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Herpes is one of the most common viral diseases on the planet. According to statistics, at least 90% of the population are carriers of this virus. Clinical signs differ for different types of herpes, the disease can manifest itself on the skin and mucous membranes. Types 1 and 2 and deciphering the data is a way to identify the pathogen, determine its type and choose the appropriate treatment regimen.

What is a pathogen?

The causative agent of herpes is a DNA-containing virus. Most often it affects the skin, mucous membranes, genital organs, less often - the tissues of the nervous system and internal organs.

Infection can occur in one of the following ways:

• contact (including when using common household items and personal hygiene);
• airborne;
• sexual;
• vertical (from mother to child during pregnancy and childbirth).

After entering the body, the virus may not manifest itself clinically for a long time. The human immune system keeps the pathogen population under control, and it is not able to reproduce. The first symptoms occur when the level of immune defense decreases, including seasonal immunodeficiencies. Therefore, herpes often accompanies other viral and bacterial diseases, fungal infections.

The patient may not know that he is a virus carrier, but still infect others.

Herpesvirus type 1

Most often, the disease is localized on the skin of the face and body and is manifested by the following symptoms:

• redness of the skin at the site of virus activation;
• the appearance of a small rash (the blisters open on their own, and ulcers form in their place);
• itching and swelling.

The disease manifests itself locally, but some patients also complain of fever, chills, weakness and muscle pain. During the period of relapse of herpes, the patient is most dangerous to others, since the pathogen is in the contents of the vesicles.

Herpesvirus type 2

Herpes of the second type is classified as a sexually transmitted disease. In addition, there are also contact, household and vertical transmission routes. Clinically, the disease manifests itself as a rash on the genitals and skin of the thighs. Tests for herpesvirus are mandatory during pregnancy. The virus is dangerous for the fetus: there is a risk of developing pathologies, as well as infection of the baby during childbirth.

In what cases should you contact the laboratory?

During a relapse of the disease, herpes virus types 1 and 2 can be determined by a simple examination. A characteristic itchy rash, which has a specific localization, is the only sign that will be the basis for diagnosis. In addition, bubbles often appear in the same place, on the same side.

You only need to donate blood to a laboratory for analysis in a few cases:

1. if herpes manifests itself non-standardly, in an erased form or with complications;
2. during pregnancy planning;
3. if you need to find out the duration of infection (for example, during pregnancy to assess the potential risk to the fetus).

A rash can be a sign of a large number of diseases of infectious and non-infectious origin. Using a blood test, you can determine the type of virus, confirm the diagnosis and prescribe treatment as necessary.

Methods for determining the herpes virus in the blood

There are several detection techniques. They are effective in controversial situations, as well as in cases where the disease is asymptomatic. During a relapse, you can also examine the contents of the blisters, skin scrapings or smears of the mucous membranes. The attending physician will determine what tests need to be taken based on the capabilities of the laboratory and the financial situation of the patient.

There are several standard rules that will allow you to get the most accurate result. Tests are taken on an empty stomach. Most often, blood is collected in the morning, from 8 to 10 o'clock. The day before, you should not eat fatty foods or alcohol. Test results can also be affected by stress or any other emotional stress.

Testing for herpes types 1 and 2 is most often carried out using two methods - PCR (polymerase chain reaction) and ELISA (enzyme-linked immunosorbent assay). Other methods may also be used, depending on the equipment of the laboratory and its technical capabilities.

Polymerase chain reaction (PCR)

PCR is a sensitive reaction that allows you to detect the DNA of viral cells in the material being tested. The essence of the method is that a certain gene is copied many times, as a result of which the presence and type of pathogen can be identified. It is important that the reaction will not occur if the DNA being tested is not in the material.

The polymerase chain reaction makes it possible to detect the virus immediately after infection, long before the disease begins to manifest itself clinically. It is also prescribed in cases where it is necessary to determine the specific type of virus, and not just its presence.

The laboratory provides forms with indicators that are easy to decipher on your own. the result indicates the presence of the virus in the blood, negative - the absence. This is the most reliable and sensitive analysis that detects even the smallest concentration of the pathogen. Polymerase chain reaction gives one of the most reliable results, therefore it is considered expensive. The forms also contain information about the type of herpes.

Enzyme-linked immunosorbent assay (ELISA)

ELISA is a reaction that is based on the isolation of the antigen-antibody complex. Herpes virus type 1 or 2 is an antigen for the body (foreign substance), in response to which the immune system releases special proteins - antibodies (immunoglobulins or Ig).

Antibodies are carried in the bloodstream through the body to the focus of the disease and there they begin to fight the infection. There are several main classes of immunoglobulins that can be detected during a herpes test:

• IgM are the first antibodies that are formed in the patient's body. They can be found in the patient’s blood within 2 weeks from the moment of infection. In addition, these proteins appear during the awakening of the virus in chronic herpes.
• IgG are antibodies, on the basis of which we can talk about a chronic infection that has been in the patient's body for a long time. The number of immunoglobulins of this class increases sharply with the next recurrence of herpes.
• IgG to the early early proteins of the herpes virus are antibody proteins that occur in the blood after IgM and also indicate the presence of the disease in an acute or chronic form.
• They also evaluate such an indicator as. It characterizes the ability of this immunoglobulin to bind to the virus and form an antigen-antibody complex. At the beginning of the disease, this indicator is weakly expressed, but in the active phase of the disease it increases sharply.

The doctor will interpret the results. Each laboratory has its own standard values. The patient receives a form in which his antibody values ​​\u200b\u200bare indicated, as well as those from which it is necessary to build on. If the amount of immunoglobulins is below normal, the result is negative, if higher, the result is positive.

IgM	IgG to early early proteins	Late IgG	Result
-	+	+	If the patient has not previously had herpes, this result indicates a primary acute infection. During pregnancy, in this case, there is a threat to the fetus. If a person is a carrier of the virus (the disease was previously manifested clinically or was detected by a laboratory method), we are talking about a recurrence of herpes. The mother's immune system during pregnancy provides protection to the fetus, but it may need to be treated.
-	-	+	The patient is a carrier of the herpes simplex virus, and his body has developed immunity that does not allow the disease to manifest itself clinically. This result is found during periods of remission of herpes.
+	+	-	Such data indicate the first stage of the development of herpes infection. In this phase, there is a threat to the life of the fetus.
+	+	+
-	-	-	A person has never encountered the herpes virus, and his immune system does not provide protection against it. If this test is performed during pregnancy, doctors worry about infection and the development of acute herpes. In this case, the condition of the fetus will be at risk.

Separately, decoding of analyzes for IgG avidity is carried out. Possible results are presented in the table:

Avidity index, %	Result
50-60%	This indicator is a threshold zone and cannot indicate any result. The studies must be repeated after 14 days.
Below 50%	The result indicates the presence of low-avidity immunoglobulins. They are detected during primary infection.
Above 60%	High-avidity immunoglobulins were detected. This result can appear with chronic herpes or in carriers of the virus.
Negative	The patient's body has never been in contact with the virus. During pregnancy, it is necessary to monitor indicators, since there is no immune protection for both the mother and the fetus.

Test results may vary in different laboratories. They depend on equipment and other factors, but are generally reliable.

Immunofluorescence reaction (RIF)

RIF is another way to detect a virus in the material being tested, including blood. This reaction shows the most accurate result if the concentration of the pathogen is high. The essence of the method comes down to adding special dyes with antibodies to the substrate (blood) and its subsequent microscopy. If the virus is present, it reacts chemically with the antibodies and glows under the microscope.

Deciphering a blood test for herpes by RIF is the results of microscopy. The characteristic glow indicates the presence of a pathogen. The accuracy of the data will be affected not only by the amount of herpes virus, but also by the presence of another infection in the blood. If it is there in high concentration, you can get a false positive result.

This method consists of isolating the virus from the test material and infecting biological objects (cell cultures, chicken embryos) in laboratory conditions. The method is time-consuming and is not used in normal situations. Most often it is used for scientific research. To carry it out, a specially equipped virology laboratory is required to isolate the pathogen in the room and prevent its spread.

Conclusion

Herpes is one of the most common diseases in the world. Its characteristic feature is that the pathogen remains in the patient’s blood for many years and only sometimes causes clinical manifestations of the disease. It does not pose a danger to an adult, but can cause pregnancy pathologies and be transmitted from mother to child during childbirth. The best way to prevent herpes is to support your own immune system, which will control the virus population and prevent the appearance of symptoms of the disease.