{"id":130,"date":"2020-03-02T14:06:20","date_gmt":"2020-03-02T12:06:20","guid":{"rendered":"http:\/\/dr-bocanescu.com\/?p=130"},"modified":"2020-03-02T14:06:20","modified_gmt":"2020-03-02T12:06:20","slug":"notiuni-teoretice-despre-herpes-virus","status":"publish","type":"post","link":"https:\/\/dr-bocanescu.com\/en\/notiuni-teoretice-despre-herpes-virus\/","title":{"rendered":"Notiuni teoretice despre Herpes Virus"},"content":{"rendered":"

<\/p>\n\n\n\n

  1. Defini\u0163ie.<\/strong><\/li><\/ol>\n\n\n\n

    Herpesul simplex este o viroz\u0103 cutaneo-mucoas\u0103, provocat\u0103 de\nvirusul herpetic uman (HHV), numit \u0219i Herpes Simplex Virus (HSV), care\nafecteaz\u0103 predominant zona oro-facial\u0103 (tipul 1), respectiv zona uro-genital\u0103\n(tipul 2), av\u00e2nd o evolu\u021bie cronic\u0103, persistent\u0103, cu multiple reactiv\u0103ri \u0219i\nremisii de-a lungul vie\u021bii.<\/p>\n\n\n\n

    1. Etiopatogenie.<\/strong><\/li><\/ol>\n\n\n\n

      Contaminarea cu acest virus se poate produce \u00eentr-un\ndiapazon mare de v\u00e2rst\u0103: a) \u00eencep\u00e2nd cu luna a 6 de via\u0163\u0103 (c\u00e2nd copilul pierde\nanticorpii materni) pentru HSV-tipul 1; b) \u00eencep\u00e2nd cu debutul vie\u021bii sexuale\n(istoric pozitiv pentru boli venerice, num\u0103r mare de parteneri sexuali) pentru\nHSV-tipul 2. Dup\u0103 primoinfec\u021bie, care mai des deruleaz\u0103 asimptomatic, virusul\nse cantoneaz\u0103 \u00een ganglionii senzitivi regionali, unde r\u0103m\u00e2ne \u00een stare latent\u0103.\nSub influen\u021ba unor factori, acesta se reactiveaz\u0103, produc\u00e2ndu-se o replicare\nviral\u0103, urmat\u0103 de recuren\u021b\u0103. Infec\u0163iile virale sunt un barometru al s\u0103n\u0103t\u0103\u0163ii,\n\u00een general, \u015fi al sistemului imun, \u00een particular, recuren\u0163ele herpesului\nsimplex semnaliz\u00e2nd, de obicei, prezen\u0163a altor afec\u0163iuni intercurente sau\nderegl\u0103ri de fond.<\/p>\n\n\n\n

      1. Tablou\n clinic.<\/strong><\/li><\/ol>\n\n\n\n

        Sub aspect clinic, exist\u0103 un polimorfism lezional: eritem,\nvezicule grupate, cruste seroase, eroziuni policiclice, iar \u00een formele mai\ngrave, \u00een special la imunocompromi\u015fi \u2013 ulcera\u021bii, cruste masive (imaginea\nal\u0103turat\u0103 mai sus), limfadenopatie regional\u0103. Semnele subiective principale:\nsenza\u021bia de arsur\u0103, prurit \u015fi durere local\u0103. Uneori, evolu\u0163ia poate fi discret\u0103,\ninfraclinic\u0103. Cele mai importante forme clinice sunt: herpesul oro-facial\n(labialis, bucalis, nasalis, facialis, ophthalmicus) \u0219i herpesul genital (la\nfemei: mucoasa labiilor mari \u015fi mici, mucoasa vaginului; la b\u0103rba\u0163i: glandul\npenian \u015fi foi\u0163a intern\u0103 a prepu\u0163iului). La nivelul degetelor, virusul\nherpetic poate determina panari\u0163iu (imaginea al\u0103turat\u0103 ma jos). De obicei,\nacesta este o complica\u0163ie a herpesului primar, oral sau genital.\nAbordarea chirurgical\u0103 este contraindicat\u0103, pentru ca poate favoriza diseminarea\nvirusului \u015fi exacerbarea bolii.<\/p>\n\n\n\n

        \"\"
        Panaritiu herpetic<\/span><\/strong><\/figcaption><\/figure>\n\n\n\n

        <\/a><\/p>\n\n\n\n

        La atopici, virusul poate determina suprainfect\u0103ri\nherpetice, cu tablou clinic manifest \u015fi stare general\u0103 alterat\u0103 (imaginea\nal\u0103turat\u0103 mai jos), iar la nou-n\u0103scu\u0163i poate fi observat herpesul neonatal\nintrapartum (la trecerea f\u0103tului prin canalul cervical). Cele mai grave\ncomplica\u021bii: encefalita herpetic\u0103 \u0219i sepsisul.<\/p>\n\n\n\n

        \"Suprainfectare<\/figure>\n\n\n\n

        <\/a><\/p>\n\n\n\n

        In afara formelor clinice de primo-infectie herpetica, se\ncunosc si forme grave care apar la persoanele imunosupresate. Astfel, acest\nvirus determina la persoanele imunosupresate, o infectie severa cu leziuni\ncutaneo-mucoase, necrotice, extinse cu tendinta la generalizare, insotite de\nhepatita fulminanta, meningoencefalita.<\/p>\n\n\n\n

        1. Diagnostic.<\/strong><\/li><\/ol>\n\n\n\n

          Diagnosticul herpesului simplex se bazeaz\u0103 pe tabloul clinic\nspecific plus, la necesitate, diverse investiga\u021bii: a) virusologice\n(eviden\u0163ierea particulelor virale prin microscopie electronic\u0103, eviden\u0163ierea\nvirusului \u00een culturi celulare, eviden\u0163ierea Ag virale cu Ac monoclonali,\neviden\u0163ierea ADN prin hibridare molecular\u0103); b) serologice (eviden\u0163ierea Ac IgM\n\u015fi IgG prin reac\u0163ii specifice \u015fi nespecifice); c) histopatologice sau\ncitodiagnosticul.<\/p>\n\n\n\n

          Frecvent sunt intalnite recidivele. Acestea pot fi\ndeclansate de infectii generale, medicamente imunosupresante, tulburari\ndigestive, traumatisme, oboseala, stres, menstruatie.<\/p>\n\n\n\n

          Herpesul reurrent prezinta urmatoarele caracteristici:<\/p>\n\n\n\n

          • Numarul leziunilor este mai mic<\/li>
          • Durata de eliminare a virusului este mai scurta(\nin medie 4 zile)<\/li>
          • Leziunile se vindeca mai repede ( in medie\n10 zile)<\/li>
          • Simptomele generale sunt foarte rare, ca de\naltfel si adenopatia regionala<\/li>
          • Localizarea cea mai frecventa este la nivelul\nbuzelor si regiunea genitala.<\/li><\/ul>\n\n\n\n
            1. Tratament.<\/strong><\/li><\/ol>\n\n\n\n

              Scopul unui tratament antiviral const\u0103 nu at\u00e2t \u00een eradicarea\ninfec\u0163iei, c\u00e2t \u00een limitarea acesteia, prevenirea complica\u0163iilor \u015fi\nminimalizarea recidivelor. Tratamentul herpesului simplex cuprinde: <\/p>\n\n\n\n

              a) medica\u021bia etiotrop\u0103 (binevenit\u0103 at\u00e2t \u00een formele acute, c\u00e2t\n\u015fi \u00een cele cronice de boal\u0103, de preferin\u0163\u0103 \u00een faza de replicare a virusului \u2013\n\u00eencep\u00e2nd cu primele 24-48 ore de la debutul erup\u021biei) \u2013 antivirale (aciclovir,\nvalaciclovir, famciclovir, foscarnet); <\/p>\n\n\n\n

              b) medica\u021bia patogenic\u0103 (doar \u00een formele cronice, \u00een recuren\u021be)\n\u2013 imunoterapie specific\u0103 (imunoglobuline antiherpetice, vaccinuri\nantiherpetice) \u0219i nespecific\u0103 (cicloferon, viferon, imunofan); <\/p>\n\n\n\n

              c) medica\u021bia topic\u0103 \u2013 coloran\u021bi anilinici, antiseptice,\nantivirale;<\/p>\n\n\n\n

              d) vitaminoterapie, in vederea cresterii imunitatii;<\/p>\n\n\n\n

              e) imunoglobuline specific, antiherpertice, imunomodulatoare\nnespecifice( Isoprinosina, Baraka; levamisole) sau vaccinuri antiherpetice.<\/p>\n\n\n\n

              In concluzie, putem spune ca la ora actuala exista medicatie\neficace si bine tolerata in infectia herpetica.<\/p>","protected":false},"excerpt":{"rendered":"

              Defini\u0163ie. Herpesul simplex este o viroz\u0103 cutaneo-mucoas\u0103, provocat\u0103 de virusul herpetic uman (HHV), numit \u0219i Herpes Simplex Virus (HSV), care afecteaz\u0103 predominant zona oro-facial\u0103 (tipul 1), [\u2026]<\/span><\/p>","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/dr-bocanescu.com\/en\/wp-json\/wp\/v2\/posts\/130"}],"collection":[{"href":"https:\/\/dr-bocanescu.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/dr-bocanescu.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/dr-bocanescu.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/dr-bocanescu.com\/en\/wp-json\/wp\/v2\/comments?post=130"}],"version-history":[{"count":1,"href":"https:\/\/dr-bocanescu.com\/en\/wp-json\/wp\/v2\/posts\/130\/revisions"}],"predecessor-version":[{"id":134,"href":"https:\/\/dr-bocanescu.com\/en\/wp-json\/wp\/v2\/posts\/130\/revisions\/134"}],"wp:attachment":[{"href":"https:\/\/dr-bocanescu.com\/en\/wp-json\/wp\/v2\/media?parent=130"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/dr-bocanescu.com\/en\/wp-json\/wp\/v2\/categories?post=130"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/dr-bocanescu.com\/en\/wp-json\/wp\/v2\/tags?post=130"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}