- 1 Notes
- 2 Clinical manifestations
- 2.1 Herpes labialis
- 2.2 Genital herpes
- 3 Pathophysiology
- 4 Epidemiology
- 5 HERPES VIRUS
Herpes is a disease is considered benign in healthy subjects, but can be very serious in people with immune deficiencies, infants or pregnant women.
This disease, sometimes painfully experienced, can never be completely cured and therefore requires the holder to take precautions, including outside of crises where there is potentially infectious.
Chemotherapy, immunosuppressed patients and infectious disease subjects treated with chemotherapy saw their salaries decline as defenses in part or totally destroy the defense cells of the body. This action is the destruction of stem cells from bone marrow cells are the progenitors of immune cells circulating in the blood and tissues. Patients find themselves thus immunocompromised.They share with all the AIDS infectious complications of a person who has lost his tusks immunology immunosuppression and assaults by microorganisms. From the moment when the defenses are reduced, bacteria, viruses or fungi are able to attack the body’s cells and tissues in particular where it has most affinity. This attack will be mitigated by the presence of specific antibodies if they exist. Indeed, the cells defenses may disappear, they leave for about 3 months of defense proteins that circulate throughout the body before disappearing. (These are the maternal antibodies, which enter the blood and protects the fetus during the 1 st month of life after birth) So we will assist patients unprotected to the outbreak of severe forms of viral, bacterial, parasitic or fungal infections. During prolonged illnesses, we are going to appear affections whose subject was carrying but did not express themselves due to the suppression antibody.The main diseases are chickenpox and shingles, herpes, whooping cough, measles and mumps, toxoplasmosis, candidiasis, tuberculosis, but also called opportunistic infections with microorganisms that are expressed only in immunocompromised individuals. Varicella-zoster (see separate article) If immunosuppression, varicella is profuse, there remains almost no skin. Multiorgan dissemination is especially liver (hepatitis may progress to severe cirrhosis) and lung (bronchiolitis with risk of acute respiratory failure). There is a risk of acute encephalitis, characterized by headaches, numbness or a restlessness, convulsions, coma.la mortality is 15 to 20%, excluding the effects possibles.Les Antibiotics have no course action on the disease itself, at most they can avoid or moderate superinfections! treatment involves intravenous acyclovir. Used high-dose IV, it only prevents replication of the virus: it does not kill viruses already present and does not repair the cells already infected or destroyed:the problem is that when clinical signs appear and allow the diagnosis, viral distribution is already very important! Varicella must therefore be properly regarded as the worst nightmare of chemotherapy patients and in general the immunocompromised. The shingles will take considerable size and disseminate the same way. A few shingles contaminate an immunocompromised as varicella because it is an expression of the same virus. The herpes. (See separate article) They also have their serious in immunocompromised patients. Besides their size can be considerable, they are capable of meningitis and meningoencephalitis herpetic. Sequelae are final. pertussis, measles and mumps. When immunosuppression is prolonged, the antibodies are scarce and are emerging diseases for which the person was already immune.The measles and mumps are likely to meningitis (reaching the brain covering) and meningo-encephalitis (reaching the lining of the brain and the brain itself), measles can also give very serious lung damage. pertussis cough will give suffocating, exhausting for a person already weakened These complications are rare but not nonexistent. Toxoplasmosis (see separate article) Toxoplasmosis is caused by a parasite and neutralized very common form of cyst in the body by the antibodies. He can wake up in the immunocompromised. The deficits are a multivisceral bit like chicken pox, the skin is spared the candidoses.Les candidiasis or yeast infections also occur in these states and can affect any tissue of the body even if they touch the tube referentially tract. Current treatments are very effective. Tuberculosis. It is a bacterial disease which reappears. It is prevented by the vaccine ‘BCG’ and monitored through the tuberculin tests.In cases of immune deficiency, it affects all the organs (lungs, kidneys, heart, bone, brain, etc.) The main problem lies in the fact that tuberculosis tend to be resistant to treatment. Other opportunistic diseases are many. We include infections cyto-megalo-virus are relatively frequent and extremely varied causes symptoms suggestive of influenza. We include the PCP affecting mainly the lungs. The list of possible infection is endless. Cited here are the most traditional and main lines of diagnostic research. In practice, these are a few precautions and a lot of vigilance that can pass through most often. Some précautions.Chaque whenever possible, should be properly vaccinated. Vaccination provides several months of circulating antibodies. On transient decrease in immunity such as in most chemotherapy, circulating antibodies are not affected and therefore the protection already acquired against certain diseases (disease of childhood vaccines) continues.Whenever there is suspicion of an infectious disease in any environment, do not expose the child or adult immuno déficient.Chaque time there is suspicion of infection or any symptoms, you should seek medical advice.
HIV transmission is through droplets of saliva from an infected person. The virus is highly contagious and transmission can be ‘remote’ as a bedroom with another example: we speak of ‘infection’ flying.
The buttons are also potentially infectious stage of vesicles (buttons topped with a small bubble) because the virus is present in large quantities. This mode of contamination is less important than transmission by saliva and the buttons are more contaminants when they dry and give way to the crust.
The first contact with the body of the virus causes a rash on the skin and whole body: it’s chickenpox. This rash disappears spontaneously within a few days (10-12 days).
Nevertheless, the disappearance of clinical signs does not correspond to the total elimination of the virus from the body: at this stage, the virus ‘exit’ the skin along the path of nerves and ganglia wins the spinal cord where it remains in life, the silent state. We’re talking about latency of the virus. In general, the latency period is final and the virus never becomes active.
Sometimes, during a stress (fatigue, infection) or in people with weakened immune system, the virus reactivates and becomes virulent. It migrates back along the nerves to the skin to trigger a new eruption of the same type as chickenpox, but this time much more localized (usually on a part of the chest, eyes …): it Shingles is a viral reactivation that match.
In half the cases the clinical manifestations of primary infection are completely asymptomatic.In the other half, the events are mostly characterized by a cluster of vesicles rapidly becoming yellowish transparent and crusted with tingling, burning or itching characterized.
While patients have symptomatic and asymptomatic viral shedding identical, it is unclear why the reactivation of the virus tends to be asymptomatic in some individuals and symptomatic among others.
Access to oral herpes lasts 8 to 15 days. The disease is contagious at all times, but even more so when the lesions are still present (including the form of crusts, that we should not touch, which may bleed slightly but it is visible).
The penetration of the virus in the organism occurs during a contact with an infected person (even if no skin manifestations):viruses penetrate the host when there is a breach mucocutaneous, and will multiply in epithelial cells where they are responsible for cell degeneration with ballooning nonspecific. These mechanisms may be the cause of the manifestations of primary herpes infection. In a second step, the virus will reach the ganglion corresponding to the infected area, centripetally, to ‘back’ along the sensory nerves. Finally, the herpes recurrences occur when, in response to physical stress or psychological variable, viruses returning the skin to develop it again. These episodes are more or less frequently from one individual to another, and of variable intensity, but still in their topography.
In France, a study published in 2002 HERPIMAX examined a sample of 4412 individuals collected in 1996 under the program SU.VI.MAX. This study showed a seroprevalence in the population average of 67% for HSV-1 and 17.2% for HSV-2.
In Australia, a study published in 2006 covered a sample of 4000 individuals collected in 1999-2000 in the framework of AusDiab. This study showed a seroprevalence in the population average of 75.7% for HSV-1 and 12.1% for HSV-2.
United States, a study published in 2006 covered a sample of 11 508 individuals collected in 1999-2004 under the NHANES program of the National Center for Health Statistics. This study showed a seroprevalence in the population average of 57.7% for HSV-1 and 17.0% for HSV-2. In March 2010, the Center for National Deasease indicated that the prevalence of HSV-2 remained high (16.2%) especially among African Americans (39.2% prevalence) and black women (48.0% prevalence).
Herpes is misdiagnosed, either because he is asymptomatic, either because he is mistaken for a fungal infection or irritation, or becaufe patients can not get an appointment with their doctor early enough.One third of adults had symptoms of herpes, but barely a quarter of these people had their diagnosis confirmed by a doctor.
DNA virus large (80 to 100 nanometers) to capsid of cubic symmetry, carrying 162 CAPTOMERES.
The herpes viruses include:
1 – Herpes simplex virus: HSV or herpes virus hominis HVH. Several herpes simplex virus were counted.
The HHV1 causes during primary infection, usually in childhood gingivostomatitis with fever, vesicular eruption on the oral mucosa or immediately around the buccal cavity, submandibular lymphadenopathy, or sometimes CONJUNCTIVITIS keratitis (see these terms). The repetition of this eruption is common throughout its existence at stress, sun exposure, rules, etc. from various infections ….
The HHV2 responsible for genital herpes, is often recurrent and is usually venereal contamination.
2 – Other viruses have been discovered:the HHV3, HHV4, and recently HHV5 HHV6, and HHV8 HHV7 were highlighted. All these viruses are harmless and so far seem gradually acquire virulence compared with the likely environmental changes.
HHV6 virus can infect T cells but also different cells such as epithelial cells.
Primary infection is usually in the first year. The virus may then be responsible for latent or persistent infections.
It has been found liable there is little time to exanthema subitum in infants (6th disease) and febrile syndromes in young children.
Late infection can cause mononucleosis (see mononucleosis).
The virus may be responsible for acute hepatitis, from pneumonia. It has been implicated in some states of chronic fatigue, sarcoidosis, autoimmune diseases, even lymphoproliferative disorders.
This virus is sensitive to ganciclovir and foscarnet.
The virus is HHV7 neighbor HHV6.HHV7 infection appears to be independent HHV6 infection and HHV-6 infection does not provide protection for HHV7.
So far, no specific pathology has been described by HHV7 infection but that virus is present in the saliva of 75% of healthy subjects.
HHV8 is sexually transmitted but also through saliva.
The virus only becomes dangerous only when immunosuppression
It plays a role in Kaposi’s sarcoma and lymphoma B cells.
HHV8 infection is rare in northern Europe and Asia.
It is common in Africa
It is observed in the United States in the male homosexual community.
3 – CYTOMEGALOVIRUS: CMV
4 – the Epstein Barr virus: EBV
5 – the varicella-zoster virus: VZV.
The herpes virus can persist indefinitely in a latent state in the body and may manifest themselves clinically that during stress, fever, during menstruation, sun exposure, etc. …
They persist in sensory nerve ganglia for HSV and VZV in the salivary glands for CMV in B lymphocytes for CMV and EBV.
The diseases caused by herpes viruses are more severe in the newborn, leukemia, immunocompromised, transplant, cancer patients, that is to say, all individuals whose immune defenses are reduced.
– GENITAL HERPES INFECTION PRIMO
– Recurrent genital herpes
– HERPES AND PREGNANCY
– HERPES VIRUS
– AIDS AND SARCOMA HERPESVIRUS
– HERPES FALSE PANARAS
– Burkitt’s lymphoma.