Genital herpes is a viral infectious skin disease, which mainly occurs in male foreskin, glans penis and coronary sulcus, and female labia, clitoris or cervix. Genital herpes is caused by herpes simplex virus infection, which usually occurs 2 ~ 10 days after infection, and individual patients may develop symptoms several months or a year later. Most women are sick. Belonging to the category of "heat sore" in traditional Chinese medicine.
Human is the only natural host of herpes simplex virus, and the infection rate of the population is as high as 80-90%, and 10% is asymptomatic. In recent years, the number of patients with genital herpes has been increasing all over the world, especially among sexually active people, about 30% people suffer from genital herpes, especially among young people, and the incidence of this disease is even higher than gonorrhea.
The disease is mainly transmitted through sexual organ contact, and patients and asymptomatic carriers are the main sources of infection. Among adults, the positive rate of genital herpes virus antibody is high. Generally, it is about 10-70%, which mainly changes with social and economic status and sexual life. According to the survey, the excretion rate of genital herpes virus in vagina among women with low socioeconomic status is 0.4- 1.33%. When a group of prostitutes did reproductive tract examination, it was found that the excretion rate of genital herpes virus was as high as 12%, and 70% prostitutes carried genital herpes virus. Therefore, the occurrence of genital herpes is obviously related to sexual contact.
The disease is highly contagious, and about 60-80% of women will be infected if they have one-time contact with men with penile herpes. This disease is very harmful and has a high recurrence rate. At present, there is no specific therapy, which can still cause female infertility, abortion or neonatal death. At present, many scholars also believe that the incidence of cervical cancer and penile cancer is closely related to genital herpes virus infection, which has attracted great attention.
The diameter of herpes simplex virus is about 120 ~ 150 micron. It consists of a core with DNA in the middle and three concentric structures, namely, envelope, body cover and capsid. The shell surface is a 3: 3: 2 icosahedron composed of 162 shell particles, and the body is composed of fibers. The envelope sometimes comes from the nucleus and sometimes from the cell membrane. It is unstable to both high temperature and low PH, can survive for several months at low temperature, and is inactivated at 50℃ and 90℃ for 30 minutes.
Herpes simplex virus can be divided into two types: type I and type II. Herpes type I mainly spreads through close contact with respiratory tract, skin and mucous membrane, and infects skin, mucous membrane and organs above the waist. For example, it can cause inflammation and herpes of oral mucosa, nasal vestibule, conjunctiva and throat. 99% of oral herpes is caused by herpes virus type I infection. Herpes ⅱ virus mainly exists in women's cervix, vagina, vulva skin and men's penis and urethra, and is the chief culprit of genital inflammation and herpes. According to relevant statistics, 90% of the pathogen of genital herpes is herpes type II virus, and only 10% is herpes type I virus. After contact with sexual organs, it lurks for about 2-20 days (average 6 days). Immunodeficiency, such as immunosuppressants, kidney transplantation, severe burns, severe malnutrition, malignant tumors of blood and lymphatic system, can lead to herpetic eczema, recurrent corneal ulcer, and even systemic disseminated herpes, which is fatal. Neutralizing antibodies and complement-binding antibodies are produced in vivo after 1-3 weeks of infection, and the residual virus may transfer to trigeminal ganglion (herpes virus type I) or sacral ganglion (herpes virus type II) along the nerve axis and enter a static state for a long time. When some inducing factors, such as anxiety, trauma, cold, sun exposure, hair blowing, trauma, infection, drug allergy, high fever, menstruation, pregnancy, etc. Disturbing the physiological balance of the body, the specific transcription enzyme needed for virus proliferation appears in nerve cells, activating the virus and causing recurrence. Humoral antibodies can not prevent the recurrence of herpes virus, and weakened cellular immunity has a great influence on the recurrence.
The clinical manifestations of genital herpes can be divided into primary and recurrent. It takes about 2 ~ 10 days from contact to onset, which is the incubation period. At first, there was a burning sensation in the affected area, and soon on the basis of erythema, 3 ~ 10 red papules appeared, accompanied by itching. The papules quickly turn into small blisters, and after 3 to 5 days, they become pustules. After rupture, a large area of erosion, ulcer, conscious pain, and finally scab healing. The whole process can last about 20 days.
Men are common in glans penis, coronary sulcus, urethral orifice, penis, scrotum, thigh and arm. Women are prone to labia, pubic mound, clitoris, perianal region or vagina. About 90% patients, the virus can invade the cervix at the same time, leading to increased leucorrhea or lower abdominal pain, and can be complicated with cervicitis and metritis. Most male and female patients have bilateral inguinal lymphadenopathy. When inflammation spreads to urethra and bladder in the later stage, dysuria, dysuria, frequent urination and urinary retention may occur in severe cases. In addition, other symptoms may occur at the same time, such as fever, general malaise, headache, neck stiffness, meningitis and sacral nervous system insufficiency. There are more women with this disease than men, and the symptoms are more serious than men. Among the patients, about 10% suffered from pharyngitis, and 10% of men and 26% of women with primary genital herpes were accompanied by extragenital lesions, mainly in arms and fingers. The second week after herpes occurs in common genitals, it is mostly caused by self-inoculation of virus in infected genital parts.
Among patients with genital herpes, homosexual men can suffer from anorectal infection of rectal herpes virus type II, which is second only to male anorectal proctitis caused by Neisseria gonorrhoeae. The clinical manifestations are severe pain in anus and rectum, constipation, pus discharge, internal urgency, backache, and blisters and ulcers in anus.
Recurrent genital herpes occurs within 1 ~ 4 months after the first infection. Nearly 60% of the patients relapsed within one year after the first infection with herpesvirus type II, and relapsed 4-6 times in the first year. The number of times will be reduced in the future. Recurrent patients have fewer systemic symptoms than primary patients, and the course of each attack is shorter. Usually, the skin lesions subside about 10 days. Some scholars have found that only 14% of patients with herpes simplex virus type I relapse, which is much lower than that of patients infected with herpes simplex virus type II. Recurrence is usually in the same place, but the number, duration and self-conscious symptoms of blisters are lighter than those of the primary one, the lymph nodes are not enlarged, and the systemic symptoms are less. Recurrent genital herpes mostly occurs in vulva, vagina, cervix and glans penis, and the incidence of urethra is rare. Recurrent genital herpes is difficult to control, and sometimes the pain is severe, which leads to the mental burden of patients, but it produces psychological obstacles, such as fear of cancer, fear of infecting sexual partners, avoidance of sexual life with sexual partners, and unwillingness to associate with the opposite sex, leading to sexual dysfunction, affecting family harmony and even depression.
Genital herpes virus is closely related to genital malignant tumor. As early as 1960s, it was suggested that herpesvirus II, which caused genital herpes, might be a potential carcinogen of cervical cancer. In recent ten years, it has been found that cervical cancer is related to sexual activity. Herpes ⅱ virus is a common pathogenic factor among sexually active people. The cervix is often the replication site of the virus, and genital herpes is often complicated with cervical cancer. Women who have had genital herpes are 5- 10 times more likely to have cervical cancer than women who have never had genital herpes. Recently, the specific antigen of herpesvirus II was found in cervical cancer tissues, exfoliated cells or precancerous cells. It shows that herpes virus type ⅱ plays an important role in the occurrence of cervical cancer. In addition, herpes simplex virus-like particles were also observed in the biopsy materials of penile cancer patients. However, the direct evidence that herpes simplex virus is the pathogenic factor of genital malignant tumor is not sufficient and needs further confirmation.