Gupta Rachna, Warren Terri, Wald Anna
Department of Medicine, University of Washington, Seattle, USA.
Lancet. 2007 Dec 22;370(9605):2127-37. doi: 10.1016/S0140-6736(07)61908-4.
Genital herpes is the main cause of genital ulcers worldwide; the prevalence of herpes simplex virus (HSV) type 2 infections in the general population ranges from 10% to 60%. Most genital herpes is caused by HSV-2, although HSV-1 accounts for about half of new cases in developed countries. The risk of HIV acquisition is three times higher in people with HSV-2. Neonatal herpes is an uncommon but serious complication of genital herpes. Most genital HSV-2 infections are unrecognised and undiagnosed; infected individuals, even with mild symptoms, shed HSV, and can infect sexual partners. Since clinical diagnosis is neither sensitive nor specific, virological and type-specific serological tests should be used routinely. Oral antiviral drugs for HSV infections are safe and effective and can be used both to treat episodes and to prevent recurrences. Antiviral treatment of the infected partners and condom use reduce the risk of sexual transmission of HSV-2.
生殖器疱疹是全球生殖器溃疡的主要病因;普通人群中2型单纯疱疹病毒(HSV)感染率在10%至60%之间。大多数生殖器疱疹由HSV-2引起,不过在发达国家,HSV-1约占新发病例的一半。感染HSV-2的人感染HIV的风险高出三倍。新生儿疱疹是生殖器疱疹一种罕见但严重的并发症。大多数生殖器HSV-2感染未被识别和诊断;即使症状轻微,受感染个体也会排出HSV,并可感染性伴侣。由于临床诊断既不敏感也不特异,应常规进行病毒学和型特异性血清学检测。用于HSV感染的口服抗病毒药物安全有效,可用于治疗发作期和预防复发。对受感染伴侣进行抗病毒治疗并使用避孕套可降低HSV-2性传播的风险。