GynecologyGynecology2079-56962079-5831Consilium Medicum3013910.26442/20795696.2019.1.190236Review ArticleBasic principles of management of patients with genital herpesPestrikovaTatiana YuPhD, Professor, Heard of the Department of Obstetrics and Gynecologytyp50@rambler.ruYurasovaElena APhD, Professor of the Department of Obstetrics and Gynecology-YurasovIgor VPhD, Assistant Professor of the Department of Obstetrics and Gynecology-KotelnikovaAnastasia VAssistant of the Department of Obstetrics and Gynecolog-Far Eastern State Medical University of the Ministry of Health of the Russian Federation15022019211808509042020Copyright © 2019, Consilium Medicum2019Background. Genital herpes is a chronic recurrent sexually transmitted viral disease. Recurrent genital herpes is a serious medical and psychosocial issue which significantly worsens patients’ quality of life. Such a course of the disease is a stressful and psycho-traumatic factor limiting patients’ social life. In addition, in about 10% of cases, relapses of genital herpes cause depression, acute psychosis and suicidal tendencies. Herpesvirus infection occupies a leading position among perinatal TORCH infections. Herpes infection exerts an unfavorable and often fatal effects on pregnancy and childbirth and it is of a relevant issue up today since its role in causing fetal and newborn disorders does not tend to decrease. Current an increase in genital herpes relapse rate dictates need for further research. Study of various etiotropic antiviral therapy regimens effectiveness is necessary for the further elaboration of optimal treatment regimens and preparation for pregnancy. Aim. To search for adequate etiotropic antiviral therapy regimens aimed at reducing genital herpes relapse rate. Materials and methods. To write this review domestic and foreign publications were searched in Russian and international search systems (PubMed, eLIBRARY, etc.) for the last 2-10 years. The review includes articles from peer-reviewed literature. Results. The review describes features of genital herpes clinical course, its diagnosis, differentiated diagnosis and complications. Various treatment regimens are presented. The effectiveness of etiotropic therapy with various drugs was estimated. Conclusions. Episodic use of valaciclovir for recurrent genital herpes allows to reduce significantly a current relapse severity and duration as well as to provide psychological support to patients.genital herpeschronic recurrent diseaseetiotropic antiviral therapyvalaciclovirгенитальный герпесхроническое рецидивирующее заболеваниеэтиотропная противовирусная терапиявалацикловир[Женское здоровье. Руководство для врачей первичного звена. Под ред. А.Конноли, А.Бриттон. Пер. с англ. под общ. ред. В.Н.Прилепской. М.: МЕДпресс-информ, 2018. [Zhenskoe zdorov'e. Rukovodstvo dlia vrachei pervichnogo zvena. Pod red. A.Konnoli, A.Britton. Per. s angl. pod obshch. red. V.N.Prilepskoi. Moscow: MEDpress-inform, 2018 ]][Мацца Д. Справочник по гинекологии. Под ред. Г.Т.Сухих, И.А.Аполихиной. Пер. с англ. М.: Практическая медицина, 2017. [Matstsa D. Spravochnik po ginekologii. Pod red. G.T.Sukhikh, I.A.Apolikhinoi. Per. s angl. Moscow: Prakticheskaia meditsina, 2017 ]][Федеральные клинические рекомендации по ведению больных с генитальным герпесом. М., 2015. [Federal'nye klinicheskie rekomendatsii po vedeniiu bol'nykh s genital'nym gerpesom. Moscow, 2015 ]][Гинекология. Национальное руководство. Под ред. Г.М.Савельевой, Г.Т.Сухих, В.Н.Серова и др. 2-е изд., перераб. и доп. М.: ГЭОТАР-Медиа, 2017. [Ginekologiia. Natsional'noe rukovodstvo. Pod red. G.M.Savel'evoi, G.T.Sukhikh, V.N.Serova et al. 2-e izd., pererab. i dop. Moscow: GEOTAR-Media, 2017 ]][Пестрикова Т.Ю., Юрасов И.В., Юрасова Е.А. Воспалительные заболевания в гинекологии. М.: Литтерра, 2009. [Pestrikova T.Iu., Iurasov I.V., Iurasova E.A. Vospalitel'nye zabolevaniia v ginekologii. Moscow: Litterra, 2009 ]][Петерсен Э.Э. Инфекции в акушерстве и гинекологии. Пер. с англ. под общ. ред. В.Н.Прилепской. М.: МЕДпресс-информ, 2007. [Petersen E.E. Infektsii v akusherstve i ginekologii. Per. s angl. pod obshch. red. V.N.Prilepskoi. Moscow: MEDpress-inform, 2007 ]][Bollen L, Whitehead S, Mock P et al. Maternal herpes simplex virus type 2 coinfection increases the risk of perinatal HIV transmission: possibility to further decrease transmission? AIDS 2008; 22: 1169-76.][Саразитдинова В.Ф. Наиболее распространенные вирусные инфекции, передаваемые половым путем (герпетическая, папилломавирусная, цитомегаловирусная). Клин. дерматология и венерология. 2011; 3: 82-7. [Sarazitdinova V.F. Naibolee rasprostranennye virusnye infektsii, peredavaemye polovym putem (gerpeticheskaia, papillomavirusnaia, tsitomegalovirusnaia). Klin. dermatologiia i venerologiia. 2011; 3: 82-7 ]][Vergou T. Herpes Simplex Virus Infection (Orofacial). Eur Handbook Dermatol Treatments 2015; 373-7. doi.org/10.1007/978-3-662-45139-7_38][Patel R, Alderson S, Geretti A et al. European guideline for the management of genital herpes, 2010. Int J STD AIDS 2011; 22: 1-10.][Bentley J, Neubauer A., Sauerbrei A. Value of herpes simplex virus typespecific serology: a case report. J. Clin Virol 2012; 54: 269-71.][Руководство по амбулаторно-поликлинической помощи в акушерстве и гинекологии. Под ред. В.Н.Серова, Г.Т.Сухих, В.Н.Прилепской, В.Е.Радзинского. 3-е изд., перераб. и доп. М.: ГЭОТАР-Медиа; 2016. [Rukovodstvo po ambulatorno-poliklinicheskoi pomoshchi v akusherstve i ginekologii. Pod red. V.N.Serova, G.T.Sukhikh, V.N.Prilepskoi, V.E.Radzinskogo. 3-e izd., pererab. i dop. Moscow: GEOTAR-Media; 2016 ]][Stanberry L.R. Genital and Perinatal Herpes Simplex Virus Infections. Sex Transmit Dis 2013; 26: 273-313. doi.org/10.1016/b978-0-12-391059-2.00012-7][Шульженко А.Е., Зуйкова И.Н. Психосоциальные аспекты генитальной герпес-вирусной инфекции. Рос. журн. кожн. и вен. болезней. Герпес (Прил.). 2007; 1: 13-8. [Shul'zhenko A.E., Zuikova I.N. Psikhosotsial'nye aspekty genital'noi gerpes-virusnoi infektsii. Ros. zhurn. kozhn. i ven. boleznei. Gerpes (Pril.). 2007; 1: 13-8 ]][Paladino P, Mossman K.L. Mechanisms Employed by Herpes Simplex Virus 1 to Inhibit the Interferon Response. J Int Cytokine Res 2009; 29 (9): 599-608. doi.org/10.1089/jir.2009.0074][Cao S, Gan Y, Dong X, Lu Z. Herpes simplex virus type 2 and the risk of cervical cancer: a meta-analysis of observational studies. Arch Gynecol Obstet 2014; 290 (6): 1059-66. doi.org/10.1007/s00404-014-3365-7][Patel R, Alderson S, Geretti A et al. European guideline for the management of genital herpes, 2010. Int J STD AIDS 2011; 22: 1-10.][Workowski K.A, Bolan G.A; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 2015; 64: 1-137.][Wagenlehner F.M, Brockmeyer N.H, Discher T et al. The presentation, diagnosis and treatment of sexually transmitted infections. Dtsch Arztebl Int 2016; 113: 11-23.][Пестрикова Т.Ю., Юрасова Е.А., Юрасов И.В. Медикаментозная терапия в практике врача акушера-гинеколога. М.: Литтерра, 2011. [Pestrikova T.Iu., Iurasova E.A., Iurasov I.V. Medikamentoznaia terapiia v praktike vracha akushera-ginekologa. Moscow: Litterra, 2011 ]][LeGoff J, Péré H, Bélec L. Diagnosis of genital herpes simplex virus infection in the clinical laboratory. Virol J 2014; 11: 1-17.][Deutsche STI-Gesellschaft. Sl-Leitlinie STI/STD - Beratung, Diagnostik und Therapie. Online: http://www.awmf.org/uploads/tx_szleitlinien/ 059-006 l_S1_STI_STD-Beratung_2015-07.pdf; last access: 22.06.2016.][Инструкция по применению Валвира. https://yandex.ru/health/pills/ product/valvir-35633 [Instruktsiia po primeneniiu Valvira. https://yandex.ru/health/pills/product/valvir-35633 ]][Инструкция по применению Ацикловира. https://yandex.ru/health/ pills/product/aciklovir-47837 [Instruktsiia po primeneniiu Atsiklovira. https://yandex.ru/health/ pills/product/aciklovir-47837 ]][WHO. Herpes simplex virus. News bulletin. 2016; 400. http:// www.who.int/mediacentre/factsheets/fs400/ru][Jones C.A. Vertical transmission of genital herpes: prevention and treatment options. Drugs 2009; 69 (4): 421-34.][Sauerbrei A. Herpes genitalis: diagnosis, treatment and prevention. Geburtshilfe Frauenheilkd 2016; 76 (12): 1310-7.][Handel S, Klinger E.J, Washburn K et al. Population-based surveillance for neonatal herpes in New York City, April 2006-September 2010. Sex Transmit Dis 2011; 38 (8): 705-11.][Robinson J.L, Vaudry W.L, Forgie S.E, Lee B.E. Prevention, recognition and management of neonatal HSV infections. Expert Rev Antiinfect Ther 2012; 10 (6): 675-85.][Corey L, Wald A. Maternal and neonatal HSV infections. N Engl J Med 2009; 361 (14): 1376-85.][Hollier L.M, Wendel G.D. Third trimester antiviral prophylaxis for preventing maternal genital herpes simplex virus (HSV) recurrences and neonatal infection. Cochrane Database System Rev 2008; Is. 1.][Пестрикова Т.Ю., Юрасова Е.А., Котельникова А.В. и др. Оценка клинической эффективности противовирусной терапии при рецидивирующем генитальном герпесе. Акуш. и гинекол. 2017; 9: 127-31. [Pestrikova T.Iu., Iurasova E.A., Kotel'nikova A.V. et al. Otsenka klinicheskoi effektivnosti protivovirusnoi terapii pri retsidiviruiushchem genital'nom gerpese. Akush. i ginekol. 2017; 9: 127-31 ]]