Parent D
Clinique de Pathologie des Muqueuses, Hôpital Erasme, Bruxelles.
Rev Med Brux. 2005 Sep;26(4):S360-3.
In developed countries, genital herpes is, together with papillomavirus infections, among the most common sexually transmitted diseases. HSV is a dormant virus causing lifelong infection and recurring with or without clinical symptoms. Exposure to lesions and to asymptomatic viral shedding result in transmission. Thus, in most cases, finding the exact path of viral transmission is impossible. The diagnosis is often clinical: classic lesion presentation and typical localised recurrences. The confirmation of the diagnosis is obtained by virus isolation, the most sensitive method is PCR but viral culture techniques are the most widely used. Today, the nucleoside analog antivirals (aciclovir, valacicovir, famciclovir, penciclovir), are the only efficient and well tolerated treatments for genital herpes. The virus resistance to these molecules in immunocompetent patients is very low and has not increased since their introduction. Thus, for these patients, treatment failure is generally due to low bioavailability which is resolved by increasing doses. Ideally a vaccine against herpes should be prophylactic (preventing primary infection) and therapeutic (preventing recurrences). None is available today despite intensive research for the past two decades.
在发达国家，生殖器疱疹与乳头瘤病毒感染一样，是最常见的性传播疾病之一。单纯疱疹病毒（HSV）是一种潜伏病毒，可导致终身感染，并可伴有或不伴有临床症状复发。接触病变部位和无症状病毒脱落会导致传播。因此，在大多数情况下，不可能找到病毒传播的确切途径。诊断通常基于临床症状：典型的病变表现和典型的局部复发。诊断的确认通过病毒分离获得，最敏感的方法是聚合酶链反应（PCR），但病毒培养技术是使用最广泛的。如今，核苷类似物抗病毒药物（阿昔洛韦、伐昔洛韦、泛昔洛韦、喷昔洛韦）是治疗生殖器疱疹唯一有效且耐受性良好的药物。免疫功能正常的患者对这些药物的病毒耐药性非常低，自引入这些药物以来并未增加。因此，对于这些患者，治疗失败通常是由于生物利用度低，可通过增加剂量来解决。理想情况下，一种抗疱疹疫苗应该具有预防性（预防初次感染）和治疗性（预防复发）。尽管在过去二十年中进行了深入研究，但目前尚无可用的疫苗。
