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Systemic Lupus Erythematosus :Definition, Cause, Symptoms, Diagnosis, Treatment, Prognosis
DEFINITION
Systemic Lupus Erythematosus (Lupus Erythematosus Disseminata, Lupus) is a chronic autoimmune disease that causes inflammation and can affect various organs, including skin, joints and internal organs.
On each patient, the inflammation of the tissues and organs will be different. Severity of the disease varies from mild disease to diseases that cause disability, independent of the number and type of antibody that pops up and the affected organ.
Classification of Lupus
CAUSE
Under normal circumstances, immune system functioning to control the body’s defense against infection.
In lupus and other autoimmune diseases, the body’s defense system turns against the body, which produced antibodies to attack its own body cells. These antibodies attack the blood cells, organs and tissue, resulting in chronic disease.
Mechanisms and causes of autoimmune diseases is not fully understood.
The cause of lupus is unknown, but is thought to involve environmental factors and heredity.
Several environmental factors can trigger the onset of lupus:
- Infections
- Antibiotics (especially penicillin and sulfa)
- Ultraviolet light
- Excessive stress
- Certain drugs
- Hormones.
Although lupus is a disease of unknown ancestry, but the cause is unknown genes. Recent discovery of a gene mention of chromosome 1.
Only 10% of patients who have a relative (parent or sibling) who has or will suffer from lupus.
Statistics show that only about 5% of children of lupus patients will suffer from this disease.
Lupus is often referred to as a female disease, although men can also suffer.
Lupus can strike any age, both men and women, although 10-15 times more common in women.
Hormonal factors may explain why lupus is more common in women. Increased symptoms of this disease in the pre-menstrual and / or during pregnancy support the belief that hormones (especially estrogen) may play a role in the onset of this disease.
However, the exact cause of the higher incidence in women and in pre-menstrual, remains unknown.
Sometimes certain heart medications (hidralazin, procainamide, and beta-blockers) can cause lupus-like syndrome, which will disappear when the drug is stopped.
Etiology is not known for sure. There is a strong family factors, especially the immediate family. Increased risk of 25-50% in identical twins and 5% in dizygotic twins, suggesting genetic factors related to. The fact that the majority of cases are sporadic with no known predisposing genetic factors, environmental factors also showed an effect. The infection can induce specific immune responses in the form of molecular mimicry that disrupt the regulation of the immune system.
SYMPTOMS
The number and type of antibodies in lupus, larger than in other diseases, and these antibodies (together with other unknown factors) to determine which symptoms will develop. Therefore, the symptoms and severity of the disease, varies in each patient.
Course of the disease varies, ranging from mild illness to severe disease.
Symptoms in each patient is different, and is characterized by symptom-free period (remission) and the relapse (exacerbation).
In early disease, lupus attacked only one organ, but in the future will involve other organs.
- Muscles and skeleton
Almost all people with lupus have joint pain and most develop arthritis. Joints are often affected are the joints of the fingers, hands, wrists and knees.
Death of bone tissue in the pelvis and shoulders are often a cause of pain in the area.
Arthritis can occur in more than 90% of children with Systemic Lupus Erythematosus (SLE). Generally symmetrical, occurs in several large and small joints. Usually very responsive to treatment compared with other organ abnormalities in Systemic Lupus Erythematosus (SLE). In contrast to the JRA, Systemic Lupus Erythematosus (SLE) is generally very painful arthritis, and pain is disproportionate to the results of physical examination of the joint. Radiological examination showed no change osteopeni joints. Children with polyarticular JRA who several years later to become Systemic Lupus Erythematosus (SLE).
- Leather
In 50% of patients found the butterfly rash on the cheeks and bridge of the nose bone. This rash will usually get worse if exposed to sunlight.
More widespread rash can occur in other body parts are exposed to the sun.
2 to 3% of discoid lupus occurs at the age below 15 years. Approximately 7% of discoid lupus will be within 5 years, so it needs to be monitored on a routine laboratory examination results indicate the presence of antinuclear antibodies (ANA) is accompanied by elevated levels of IgG and high light lekopeni.
- Kidney
Most of the patients showed accumulation of protein in the cells of the kidney, but only 50% who suffer from lupus nephritis (kidney inflammation settled).
At the end of kidney failure can occur, so patients need to undergo dialysis or kidney transplantation.
- The nervous system
Neurological abnormality was found in 25% of patients with lupus. The most common is the mild nature of mental dysfunction, but the disorder can occur in any part of the brain, spinal cord and nervous system.
Seizures, psychosis, organic brain syndrome and headaches are some disorders of the nervous system can occur.
- Blood
Blood disorders can be found in 85% of patients with lupus.
Can form blood clots in the veins and arteries, which can lead to stroke and pulmonary embolism.
Platelet count is reduced and the body to form antibodies against blood clotting factors, which could cause significant bleeding.
Hematologic abnormalities that frequently occur are lymphopenia, anemia, thrombocytopenia, and leukopenia. Anemia often occur due to chronic illness. Interstitial pneumonitis is a result of lymphocyte infiltration. The disorder is difficult to identify and often can not be identified. Usually diagnosed only after reaching an advanced stage.
- Heart
Inflammation of various parts of the heart may occur, such as pericarditis, endocarditis or myocarditis.
Chest pain and arrhythmias may occur as a result of these circumstances.
- Lungs
Can occur in lupus pleuritis (inflammation of the lining of the lungs) and pleural effusion (accumulation of fluid between the lung and packaging).
As a result of these circumstances often arise chest pain and shortness of breath.
Symptoms of lupus:
- Fever
- Tired
- Feel unwell
- Weight loss
- Skin rash
- Butterfly rash
- Skin rash aggravated by sunlight
- Sensitive to the sun
- Swelling and joint pain
- Swollen glands
- Muscle pain
- Nausea and vomiting
- Pleuritic chest pain
- Seizures
- Psychosis.
Other symptoms that may be found:
- Hematuria (blood-containing urine)
- Coughing up blood
- Nosebleeds
- Swallowing disorders
- Patches of skin
- Red spots on skin
- Change the color of the fingers when pressed
- Numbness and tingling
- Sores in the mouth
- Hair loss
- Abdominal pain
- Impaired vision.
Raynaud’s phenomenon is characterized by a pale state, followed by cyanosis, erythema, and re-warm. Occurs because the disposition of immune complexes in the endothelium of blood vessels and local complement activation.
DIAGNOSIS
Lupus diagnosis is confirmed by the discovery of four of the 11 typical symptoms of lupus are:
- Butterfly rash on the face (cheeks and bridge of the nose)
- Rash on the skin
- Injuries to the mouth (usually painless)
- Fluid in the lungs, heart and other organs
- Arthritis (non-erosive arthritis involving two or more peripheral joints, where the bone around the joints are not damaged)
- Abnormalities in kidney function
a. levels of protein in the urine 0.5 mg / day or more
b. presence of abnormal elements in urine derived from red blood cells / white nor Mr renal tubule cells
- Photosensitivity (sensitive to sunlight, causing the formation or worsening of skin rash)
- Nerve or brain dysfunction (seizures or psychosis)
- The results of blood tests positive for antinuclear antibodies
- Immunological abnormalities (positive results on tests of anti-DNA double chain, anti-Sm test, antiphospholipid antibody tests: false positive results for syphilis test)
- Blood disorders
a. Hemolytic anemia or
b. Leukopenia (leukocyte count 4000 cells / mm) or
c. Lymphopenia (lymphocyte count 1500 cells / mm) or
d. Thrombocytopenia (platelet count 100,000 / mm).
When 4 or more criteria is established, the diagnosis of Systemic Lupus Erythematosus (SLE) can be enforced with 98% specificity and sensitivity of 97%.
Complete blood count, ESR, urinalysis, LE cells, ANA *, anti-doublestranded DNA *, antiphospholipid antibodies, other antibodies (anti-Ro, anti-La, anti-RNP), rheumatoid factor, the titer of complement C3, C4, and CH50 *, titers of IgM, IgG, and IgA, Coombs test, creatinine, blood urea *, urine protein> 0.5 gram/24 hours (nephritis) *, and imaging (chest X-ray images *, renal ultrasound, MRI of the head)
The diagnosis is not all laboratory tests should be there, but the initial examination (marked *) should be performed.
Tests to determine the presence of the disease varied, including:
- Blood tests
Blood tests can indicate the presence of antinuclear antibodies, are present in almost all patients with lupus. But these antibodies also can be found in other diseases. Therefore if you find a antinuclear antibodies, should be also checks for antibodies to DNA double chain.
High levels of both antibodies are almost specific for lupus, but not all people with lupus have these antibodies.
Blood tests to measure levels of complement (proteins that play a role in the immune system) and to find other antibodies, it may be necessary to estimate the activity and duration of disease.
- Skin rash or lesions typical
- Chest radiograph showing pleuritis or pericarditis
- Examination of the chest with a stethoscope help indicate the presence of pleural or cardiac friction
- Analysis of the urine showed the presence of blood or protein
- Calculate blood types showed a decrease in some types of blood cells
- A renal biopsy
- Examination of the nerve.
Anti ds-DNA
Limit of normal: 70-200 IU / mL
Negative: <70 IU / mL
Positive:> 200 IU / mL
This antibody was found in 65% – 80% of patients with active Systemic Lupus Erythematosus (SLE) and rarely in patients with other diseases. High amount is specific for Systemic Lupus Erythematosus (SLE), while low to moderate levels can be found in patients with other rheumatic diseases, chronic hepatitis, infectious mononucleosis, and biliary cirrhosis. The number of these antibodies can be down with the right treatment and may increase the spread of diseases, especially lupus glomerulonephritis. The amount is a negative approach in a quiet Systemic Lupus Erythematosus (SLE) disease (dormant).
Anti-DNA antibody is a subtype of antinukleus antibodies (ANA). There are two types of anti-DNA antibodies that attack the double-stranded DNA (anti ds-DNA) and the attack single-stranded DNA (anti ss-DNA). Anti-ss-DNA is less sensitive and specific for Systemic Lupus Erythematosus (SLE) but positive for other autoimmune diseases. Antibody-antigen complex on autoimmune disease are not only for diagnosis but it is a great constributor in the course of the disease. The complex will induce the complement system can cause local and systemic inflammation.
Antinuclear antibodies (ANA)
Normal: zero
ANA is used for the diagnosis of Systemic Lupus Erythematosus (SLE) and other autoimmune diseases. ANA is a group of proteins that react to antibodies attack the nucleus of a cell. ANA is sensitive enough to detect the presence of Systemic Lupus Erythematosus (SLE), positive results occurred in 95% of patients with Systemic Lupus Erythematosus (SLE). But the ANA is not specific for Systemic Lupus Erythematosus (SLE) because ANA is also associated with other rheumatic diseases. High number of ANA related to the emergence of disease and disease activity. After therapy, the illness is no longer active, so the number of ANA is expected to decline. If a negative test result, the patient is not necessarily negative for Systemic Lupus Erythematosus (SLE) should be considered as well as clinical data and other laboratory tests, but if the test result is positive, serologic tests should be done the other to support the diagnosis that the patient is suffering from Systemic Lupus Erythematosus (SLE). ANA may include anti-Smith (anti-Sm), anti-RNP (anti-ribonukleoprotein), and anti-SSA (Ro) or anti-SSB (La).
TREATMENT
Decrease in mineral density associated with dose and duration of steroid treatment. The use of daily low-dose corticosteroids with high-dose intermittent intravenous supplementation with vitamin D and calcium to maintain bone mineral density. Pathological fractures rarely occur in young Systemic Lupus Erythematosus (SLE). The risk of fractures can be prevented with calcium intake and exercise program better. Through the alternate program, the side effects of steroids on growth can be reduced. Before setting the effect of the drug, such as thyroiditis and endocrine causes of growth hormone deficiency should be excluded. Avaskuler necrosis can occur in 10-15% of patients who receive child Systemic Lupus Erythematosus (SLE) high-dose steroids and long-term.
If the symptoms of lupus caused by medication, then stop using the medicine could cure him, although it can take many months.
To cope with arthritis and given anti-inflammatory pleurisi non-steroid.
Severe disease or life-threatening sufferers (hemolytic anemia, heart or lung disease are widespread, kidney disease, central nervous system disease) often needs to be handled by experts.
To control the various manifestations of severe disease may be given corticosteroids or immune system-suppressing drugs.
Some experts give cytotoxic drugs (drugs that inhibit cell growth) in patients who do not respond well to corticosteroids or who depend on high-dose corticosteroids.
For the manifestation of disease in the acute phase include fever, redness, and muscle pain can be given Hydroxychloroquine, NSAIDs (Ibuprofen, Naproxen, Fenoprofen, Ketoprofen, Dexketoprofen, indomethacin, ketorolac, Diclofenac, piroxicam, meloxicam, mefenamic acid, Etoricoxib, Celecoxib) and steroids (Methylprednisolone, Prednisone). while to deal with chronic conditions may be given medications such as Methotrexate, Cyclophosphamide, Belimumab, Rituximab, Azathioprine and Mycophenolate.
The drugs are often used in patients with Systemic Lupus Erythematosus (SLE) :
Diet
Dietary restrictions prescribed by the therapy given. Most of the patients require corticosteroids, and the time allowed is a diet that contains enough calcium, low fat, low in salt. Patients are advised to be careful with dietary supplements and traditional medicines.
Activity
Lupus patients should continue normal activities. Exercise is necessary to maintain bone density and normal weight. But it should not be exaggerated because of fatigue and stress often associated with recurrence.
PROGNOSIS
Recent years has improved the prognosis of patients with lupus, many patients who show mild disease.
Women with lupus who become pregnant can safely hold up to normal babies, there was no heart or kidney disease is severe and the disease can be controlled.
Systemic Lupus Erythematosus has the numbers for the 10-year survival of 90%. The cause of death can be directly caused by the disease lupus, which is due to renal failure, malignant hypertension, CNS damage, pericarditis, autoimmune cytopenia. The worst prognosis was found in patients who have abnormalities of the brain, lungs, heart and kidney weight. Data from several studies in 1950-1960, showed 5-year survival rates of 17.5% -69%. While the years 1980-1990, 5-year survival rates of 83% -93%. Some researchers reported that 76% -85% of patients with Systemic Lupus Erythematosus (SLE) can live for 10 years by 88% of patients experienced at least flawed in several organs in the long term and persistent.
Herpes Simplex : Definition, Cause, Symptoms, Type, Diagnosis, Treatment, Correlation
Herpes
Currently there are two kinds of herpes : herpes simplex and herpes zoster, both derived from different viruses. Zoster, is caused by Varicella zoster virus. The nature of the disease milder than the type caused by herpes simplex virus (HSV). Zoster rash grows in the form of lengthwise on the body right or left alone.
Herpes Simplex Virus (HSV)
Herpes simplex infection is characterized by recurrent episodes of small blisters on the skin or mucous membrane, which contains fluid and feels pain. Herpes simplex causes eruptions on the skin or mucous membranes. This eruption would disappear even if the virus persists in a dormant state within the ganglia (nerve cell bodies), which supply the flavor on the infected area.
CAUSE
Basically Herpes virus also known as Herpes Simplex Virus (HSV). There are two types of herpes simplex virus that infects the skin, the virus is an advanced differentiated HSV1 and HSV2. The reason 84% of cases of venereal disease. The difference between HSV1 and HSV2 are: the preferred HSV1 namely the skin and mucous membranes in the eyes or mucous in the mouth, nose, and ears. HSV1 is a cause of sores on the lips (herpes labialis) and cuts in the cornea of the eye (herpes simplex keratitis); usually transmitted through contact with secretions from or around the mouth. While the preferred HSV2 namely the skin and mucous membranes in the genital and perianal. HSV2 usually causes genital herpes and mainly transmitted through direct contact with sores during sexual intercourse. Shape to form patches on the skin HSV1 small verikels, whereas HSV2 form big verikels, bold, and centered. There are serology anti -HSV1 antibodies and anti-HSV2 antibodies were found.
SYMPTOMS
Recurrent herpes simplex characterized by tingling, discomfort or itching, which felt a few hours to 2-3 days before the onset of blisters. Blisters surrounded by red areas may appear anywhere on the skin or mucous membrane, but is most often found in and around the mouth, lips and genitals. Blisters (which may be painful) tend to form groups, which makes recommendations to one another to form a larger collection.
Periodically, the virus will come back and began to proliferate, often causes skin eruption of blisters on the same location as the previous infection. Viruses can also be found in the skin without causing real blisters, in this state is from the source of virus infection to others.
Herpes Simplex
A few days later the blisters begin to dry and form a thin yellowish scab as well as a shallow ulcer. Healing usually begins within 1-2 weeks later and is usually completely healed within 21 days. But healing in a moist body parts run slower. If the eruption continues to develop at the same place or if there is secondary bacterial infection, then it could be some scar tissue.
Erythema multiforme
A pregnant woman suffering from HSV2 infection can transmit the infection to her fetus, especially if the infection occurs at age 6-9 months of pregnancy. Herpes simplex virus on the fetus can cause a mild inflammation of the lining of the brain (meningitis) or sometimes causing severe inflammation of the brain (encephalitis). Especially for pregnant women infected with HSV2 should be taken seriously, because the virus can penetrate the placenta and cause neonatal damage, impact of congenital and fetal death.
If infants or adults who suffer from atopic eczema are infected by herpes simplex virus, then it could happen herpetikum eczema, which can be fatal. Therefore patients with atopic eczema sufferers should not be associated with an active herpes infection. In people with AIDS, herpes infections in the skin can be persistent and severe. Inflammation of the esophagus and intestines, ulcers around the anus, pneumonia or neurological disorders are also more common in AIDS patients.
Disorders due to herpes in infants is very diverse, ranging from lesions to include encephalitis (inflammation of the lining of the brain), microcephaly (small head), or hidrocephaly (edema of the head). Infection of a newborn can be fatal. Proved by carrying a mortality rate of 60%, while half of the living will suffer neurological defects or abnormalities in the eye.
Herpetic abscess (herpetic whitlow) is a swelling at the tip of a finger that feels pain and redness, which is caused by herpes simplex viruses that enter through wounds in the skin. Herpetic abscesses most commonly occur on the hospital staff who have never suffered from herpes simplex and in contact with body fluids containing the virus herpes simplex.
In addition, the risks faced by sufferers is death, but this rarely happens. Over the past have not done an effective treatment, it is difficult to predict Herpes disease progression. If infected and treated promptly then chances are the risks can be avoided as soon as possible, while recurrence infection can be limited only recurrence frequency.
Herpes on cornea
In the early stages, this infection resembles a mild bacterial infection because the symptoms are mild (sore eyes, watery, red and sensitive to light). Swelling of the cornea causing blurred vision. The infection often causes only mild changes in the cornea and will disappear by itself. Sometimes the virus penetrates deeper and destroy the surface of the cornea.
Re-infection can cause further damage to the corneal surface. If the sufferer to experience repeated infections, can occur ulceration (formation of an open wound), the formation of scar tissue that is persistently and lost a sense of when the eye is touched. Herpes simplex virus can also cause increased blood vessel growth, impaired vision or blindness.
Clinical symptoms of HSV infection which inflict can be seen in the table as follows:
Then, there are other diseases that are included in the group Others Virus (others viruses). This disease group are classified into TORCH disease because it causes disease with symptoms similar to symptoms caused by the four main causes, namely toxo, rubella, CMV and Herpes. Most of the others group virus is a virus that attacks the human nervous tissue (neurophatic).
DIAGNOSIS
Diagnosis based on symptoms that arise in certain body parts and typical for herpes simplex. To confirm the diagnosis can be done by culturing the virus, blood tests to detect elevated levels of antibodies and biopsy. At a very early stage, the diagnosis is established by using the latest techniques of polymerase chain reaction(PCR), which can be used to identify the DNA of herpes simplex virus in tissue or body fluids.
TREATMENT
For most patients, the only treatment of herpes labialis is to keep the infected area clean by washing with soap and water. Then when the area is dried; if left damp, it will aggravate the inflammation, slow healing and facilitate the occurrence of bacterial infections. To prevent or treat a bacterial infection, can be given an antibiotic ointment (like neomycin-basitrasin). If the more severe bacterial infection or cause additional symptoms, may be given antibiotics by mouth or injection.
Husband or wife infected with genital herpes (herpes simplex) never have to do in the form of individual protection devices must use two different kinds of obstacles, that is spermicidal foam (foam exterminator sperm) and condoms. Spermicidal foam in vitro (in laboratory) capable of deadly virus, while condoms to inhibit or reduce viral penetration. Prevention is a combination of both, which was followed by washing the genitals with soap and water after coitus, can prevent transmission of genital herpes is almost 100%. Meanwhile, the sufferer should try to get rid of the factors originators. In addition to psychiatric treatment that helps overcome the psychological factors. Especially in people with recurrent, factors that play a role in generating the attack, though not as severe primary episode, but involve additional psychiatric disorders.
Anti-viral creams (like idoksuridin, trifluridin and acyclovir) is sometimes applied directly on the blisters. Acyclovir or vidarabin by mouth can be used for severe herpes infections and widespread. Sometimes acyclovir should be consumed every day to suppress the recurrence of skin eruption, especially if the genital area.The standard treatment for HSV are acyclovir in pill form two to five times a day. There is another version of acyclovir with the name of valacyclovir. It can be taken two or three times a day, but it is much more expensive than acyclovir. Famciclovir is another drug used to treat HSV.
Mechanism of action of acyclovir based on the inhibition of viral DNA polymerase enzyme. Immediately converted to acyclovir-guanosine monophosphate asiklo by the enzyme thymidine kinase virus, then changed again to asiklo-guanosine triphosphate (GTP-asiklo). Asiklo-GTP join the viral DNA that would lead to cessation of activity of the enzyme DNA polymerase.
Acyclovir poorly soluble in water, and has a low bioavailability (10-20%) when used orally. Therefore, if the desired high concentration of acyclovir, intravenous injections can be administered to the patient. Moreover, it can also be given valaciclovir who have better bioavailability, which is 55%. Valaciclovir this will be converted to acyclovir in the liver.
This medicine is available on the market in the form of tablets, intravenous injection, topical creams, and eye ointment. Dosage form of a cream used to treat herpes on labia, while herpes that attacks the eyes can be treated with acyclovir dosage forms of eye ointment.
Side effects of acyclovir taken orally and injection include dizziness, nausea, diarrhea, headache, and reaction at the injection site. Had also reported the existence of acyclovir kidney damage when used in intravenous injection in large doses, due to the formation of acyclovir crystals in the kidney. When used topically (topical), side effects that usually happens is that the skin feels dry and burning. Meanwhile, when used on the eyes, some patients will experience discomfort in the eye.
Because acyclovir works by affecting the cell’s DNA, then its use should be avoided during pregnancy. Acute toxicity (LD50) of acyclovir for more than 1 g / kg, this is caused by the low oral bioavailability of this drug.
Topical Medications Over-the-counter (OTC): Most of produ-topical OTC products provide only the liberation of symptoms, they do not reduce the healing time. Using a topical anesthetics containing benzocaine (5% to 20%), lidocaine (0.5% to 4%), tetracaine (2%), or dibucaine (0.25% to 1%) will help relieve burning, itching, and pain . The products most commonly recommended is Lipactin gel and Zilactin. It is important to remember that fatherly-topical anesthetic has a shorter duration of action, usually only lasts 20 to 30 minutes. Leather protectors, such as allantoin, petrolatum, and products containing dimethicone helps retain moisture and prevent wound breakdown (rupture) injuries. Balm, lip balm that contains sun protection may also help prevent additional outbreaks if sunlight is a factor that accelerates. For additional pain relief, use of aspirin, ibuprofen, or acetaminophen may be beneficial. Be sure to use these products as directed, and contact your doctor or pharmacist if you have any questions. Do not use topical steroids have, like hydrocortisone, on the wounds. Docosanol 10% cream (Abreva) is the only topical OTC products that known reduce healing time when applied at the first sign of recurrence (tingling sensations). Docosanol applied five times a day until the wound healed. Side effects are common, including rash and itching at the site of application.
For herpes simplex keratitis or herpes genitalis required special treatment. Local treatment for herpes zoster should include cleaning the wound with salt water and keep it dry. Gentian violet can be applied to the wound.
Treatment of infants and mothers with genital herpes vary, there are hospitals that encourage isolation. Furthermore, in infants viral culture examination, liver function, and cerebrospinal fluid (brain), in addition to strict control during the first month of life. Specimens for viral culture taken from the eyes, mouth, and skin lesions.
To help speed healing in cornea, sometimes ophthalmologists use cotton to remove dead cells and damaged the surface of the cornea. Given anti-viral drugs such as trifluridin, vidarabin or idoxuridine, usually in the form of ointments or eye wash solution.
These drugs do not cure HSV infections. However, these drugs can reduce the length and severity of outbreaks that occur. Your doctor may prescribe “maintenance” therapy with daily anti-herpes therapy for people with HIV who experience frequent outbreaks of HSV. This therapy can prevent most outbreaks. This therapy also significantly reduced the number of days in the month when HSV can be detected on the skin or mucous membranes, even with no symptoms.
Lysine supplements, citrus bioflavonoids, Lactobacillus acidophilus and bulgaricus, and vitamins C, E, and B12 also identified potential in the treatment of herpes simplex virus. However, no clinical evidence to support these treatments, and they are not recommended.
CORRELATION
HSV does not include infections that define AIDS. However, people infected with HIV and HSV simultaneously more likely to experience more frequent outbreaks of herpes. These outbreaks can be more severe and last longer than people not infected with HIV.
Herpes sores provide a way for HIV to pass through the body’s immune defenses, so it becomes more easily infected with HIV. A recent study found the risk of people with HSV infected with HIV is three times higher than people without HSV. Another study found that treating HSV can lead to a significant decrease in HIV viral load. Yet another study found that treating genital herpes does not prevent new HIV infections.