The Virus
The HSV 1 and 2, exactly as the varicella-zoster-virus, are classified in the subfamily of the Alphaherpesvirinae. Important characteristics of this subfamily are a short replicative cycle, the production of a lytic infection in cellular culture and the institution of latency period in sensorial ganglions, with the consequence of probable reactivation.
Clinical manifestations
The classical manifestation of a first infection of HSV-1 is characterized by a gingiva-stomatitis with submandibular lymph-adenopathy. Others clinical manifestations are conjunctivitis, keratitis and whitlows. The most serious manifestation is the encephalitis (in children and adults) with a mortality of 70%. The classical presentation of a first infection of HSV-1 is the genital herpes. The 85% of genital herpes are caused by the HSV-2 (it provokes reactivations), while the rest by HSV-1 (it doesn’t provoke reactivations). The most serious consequence of the genital herpes is the neonatal herpes, which results by the exposition of the baby to the secrete virus in mother’s vagina during the birth. The mother-child transmission is about 5% if the mother has a reactivation. It’s higher (more than 50%) if the mother contracts the first infection. Complications for the baby can be skin’s, eyes’, mucosa’s and central nervous system’s infection, but even a generalized infection with a very high mortality (70%) if it’s not treated.
Epidemiology
The prevalence of the infection HSV-1 gradually increases from childhood to get the 70-80% in adults.
For the HSV-2 (it’s a sexual transmitted disease) the infection begins in the teenage and it gets a maximal prevalence in adults of the 15-50% (it depends on demographic variability).
A preexistent immunity for the HSV-1 doesn’t protect against an infection of HSV-2,but clinical manifestations are softer or asymptomatic.
Test
Amplification through PCR of a specific gene for HSV 1 (gpD) and for HSV 2 (gpG).
Sample taking
Eye’s, vesicle’s smear, liquor, biopsy, urethra’s, virginal’s, cervical’s smear.
