| 问题1:HSV-1和HSV-2两种疱疹病毒有何区别?
回答:HSV-2病毒是引起生殖器疱疹的主要病毒,并且它总是通过与其他人的生殖器(或者肛门)接触而感染;HSV-1病毒是引起口腔和唇部疱疹(通常表现为水泡或溃疡)的病毒。同时还通常通过病毒感染者为他人提供口交的途径,引发被感染者的生殖器感染HSV-1病毒而患生殖器疱疹,这种感染占原发性生殖器疱疹感染的50%。感染HSV-2型的生殖器疱疹经常会复发,尽管有时会没有症状,而感染HSV-1型的生殖器疱疹很少复发。因此,绝大多数复发性生殖器疱疹是由于感染HSV-2型病毒感染的。
Q1. What is the difference between HSV-1
and HSV-2?
A. Herpes simplex virus HSV type 2 (HSV-2) is the usual cause
of genital herpes and is always acquired by genital (or anal)
contact with another person. HSV type 1 (HSV-1) is the cause
of herpes sores on the lips and in the mouth (often called
fever blisters or cold sores). It also causes up to 50% of
initial genital herpes infections, usually acquired during
oral sex. Genital HSV-2 infection almost always recurs frequently,
with or without symptoms, whereas HSV-1 genital herpes reactivates
infrequently. Therefore, the large majority of recurrent genital
herpes is due to HSV-2
问题2:我去找了一家按摩房的性服务提供者,她为我提供了无保护措施的口交服务,我感染生殖器疱疹的机会是多大?
回答:一般来说,通过任何单单一次的口腔-生殖器的接触,感染HSV-1型生殖器疱疹的几率非常低。然而在没有更多详细资料的情况下,不可能知道准确的概率。感染几率的大小取决于性服务提供者是否患有口腔和唇部疱疹,以及口腔和唇部疱疹病毒(HSV-1)当时是否在发作期;如果她当时有正在发作期的口腔和唇部疱疹溃疡或水泡,那么感染生殖器疱疹的概率会相当大。但是这仍取决于你是否和这个世界上近一半的人一样,以前身体的任何部位早已经感染过了HSV-1型病毒,(因为近一半的人儿童时代或成年后都感染过HSV-1型的口腔和唇部疱疹),如果你以前已经感染过,那么通过接受这次口交而感染生殖器疱疹的几率就为零,因为你的身体对再次感染已经产生免疫。另外,通过口交不会感染HSV-2型生殖器疱疹。
Q2. I visited a sex worker at a massage
parlor. She performed unprotected oral sex on me. What are
my chances of contracting herpes?
A. On average, the risk of acquiring genital herpes simplex
type 1 (HSV-1) infection is very low for any single episode
of oral-genital exposure. However, it is impossible to know
for sure without more information. The risk of course depends
on whether or not the sex worker has an oral HSV-1 infection
and whether or not she had an outbreak at the time; the risk
would be quite high if she had an active cold sore. But it
also depends on whether or not you already are infected with
HSV-1 (of any part of your body)—as does half the population.
If so, there is no risk; you are immune to catching it again.
There is no risk of acquiring genital HSV-2 infection from
oral sex.
问题3:生殖器疱疹的症状是什么?什么时候出现?
回答:生殖器疱疹症状的初次发作,通常发生在感染后2-10天内,症状一般持续2-3周。初次发作时,如果不经过治疗,患处一般会发作(即发红、刺痒、也可能疼痛)1-2周,然后再经过7-10天会完全愈合,所以从发作到愈合的整个过程一般在2-4周。复发症状的周期会更短,典型的一般在7-14天。初发的症状有非常多种形式,包括:发生在阴茎、阴道、宫颈、肛门、臀部或者极少数情况下身体的其他任何部位上的水泡或溃疡。经常是首先出现一个小的红色的丘疹,然后发展成为水泡,继而变得疼痛,发生溃疡。经过几天后,溃疡会结痂,最后直至愈合。在比较潮湿的区域,如阴道口、阴唇或肛周附近,痛处会发展得较快并且很快发展成感觉很疼痛的表面溃疡。初次发作通常也会引起双侧的症状,即在生殖器官、肛周地区等两侧都都有症状,并且腹股沟附近两侧的淋巴管可能会肿胀。而复发则一般都只发生在一侧,并且通常不会发生淋巴肿胀的现象。通常症状非常轻微或者没有特别的感觉,比如发痒、疼痛、象类似轻微擦伤的皮损,或排尿时疼痛,因此疱疹很容易被误认为其他问题,例如霉菌感染,股癣、尿道感染或其他类似问题。不是所有感染生殖器疱疹的人都有这些症状,很多人根本没有一点症状。然而,所有因HSV-2病毒感染生殖器疱疹的人都有“无症状排毒”期,在“无症状排毒”期内他们将可能传染给他们以前尚未被传染的性伴侣。
Q3. What are the symptoms of herpes?
How soon do they show up?
A. The symptoms of a first outbreak of genital herpes usually
appear 2 to 10 days after exposure to herpes and last an average
of 2 to 3 weeks. With the first infection, without treatment
the sores typically are active (that is, red, irritated, perhaps
painful) for 1-2 weeks, then take another 7-10 days to heal
completely, so total time from onset to complete healing generally
pmtis 2-4 weeks. Recurrent outbreaks are briefer, typically
7-14 days. Symptoms of a first genital herpes infection vary
widely and may include any of the following: blisters or other
sores on the penis, vagina, cervix, anus, buttocks, or (rarely)
elsewhere on the body. Small red bumps usually appear first,
then develop into blisters, and then become painful, open
sores. Over a period of days, the sores may scab over. Finally,
they heal. In moist areas, such as around the vaginal opening,
labia, or around the anus, lesions often rapidly develop into
open sores that can be especially painful.First episodes often
cause lesions bilaterally, that is on both sides of the genitals,
anal area, etc swollen lymph glands in the groin. Recurrent
outbreaks almost always are limited to once side or the other—up
to but not across the body’s midline and lymph gland swelling
usually is absent. Often symptoms are mild or nonspecific,
such as itching, irritation, or scratch-like sores, or painful
urination, so that herpes can easily be mistaken for other
problems, such as yeast infection, jock itch, urinary tract
infection, and others. Not everyone has all these symptoms
and many infected persons have no symptoms at all. However,
everyone with genital HSV-2 infection has periods of “asymptomatic
shedding of the virus, when they can transmit herpes to their
uninfected sex partners.
问题4:既然这样那我被传染了疱疹但是我没有症状,是不是意味着我会永远都不出现疱疹的症状?
回答:您以后可能不会也可能会。生殖器疱疹通常在感染后初发时有可以察觉到并且持续时间较长的症状。事实上,有40%的人第一次发现生殖器疱疹发作从而意识到自己感染了HSV-2时,他已经被感染了好几个月甚至好多年。还有一些感染者从来不发生任何症状,或者症状非常轻微或不典型,以至根本没有注意到。
Q4. So if I think I contracted herpes
but I have no symptoms. Does that mean I never will have symptoms?
A. You might or might not. Genital herpes often first causes
recognized symptoms a long time after acquisition. In fact,
40% of persons with the first known outbreak of genital HSV-2
infection have been infected for several months or years.
Some infected people never develop symptoms, or have such
mild or atypical ones that they don’t notice them.
问题5:最快多久可以通过检验来确定自己是否感染了疱疹?
回答:如果有已经发生的症状,最好的诊断是从症状处取样来检测病毒,通常医生采取的是“培养法”。但是如果通过“培养法”得出的诊断是阴性或当时没有发生疱疹的症状,则通过血清测试可以检测到是否血液中已产生HSV病毒的抗体,即身体对病毒的反应,从而判断是否感染了疱疹。然而,从身体感染了HSV病毒到产生出抗体,需要几周的时间。大部分感染者感染后需4周左右才能在血检中查出抗体阳性,但也有的最长需12周,甚至极少数人需4-5个月。但是约90%的人从感染到血检可以检出阳性的时间为6周。当然这一切都取决于准确的检验,参考问题6。
Q5. How early can I take a test to determine
if I caught herpes?
A. If there are fresh herpes lesions, the best diagnostic
method is to take a sample from the sores to test for the
virus, usually by culture. But when the culture is negative
or if there are no lesions at the time, a blood test can detect
antibodies to HSV – that is, the body’s reaction to the virus.
However, it takes a few weeks for antibodies to develop. Most
infected people have positive blood tests by 4 weeks after
infection, but it can take up to 12 weeks and, rarely, up
to 4-5 months. But about 90% of infected people become positive
by 6 weeks.
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