RU2191576C2 - Method for treating subclinical form of female genital herpesvirus infection - Google Patents

Abstract

FIELD: medicine, venerology. SUBSTANCE: it is suggested to apply Valtrex antiviral preparation, Neovir immunomodulating preparation and Acylact preparation affecting urogenital tract microflora at certain dosages and modes for outpatient treating subclinical form of female genital herpesvirus infection. The method enables to prevent virus secretion out of urogenital tract in 90.5% cases and exclude potential relapses. EFFECT: higher efficiency of therapy. 1 tbl

Description

 The invention relates to medicine, namely to venereology, is intended for outpatient treatment of patients with subclinical form of genital herpes virus infection (GVI).

 A known method of treating patients with a subclinical (asymptomatic) form of genital HVI using complex therapy (antiviral and immunomodulating drug) (Batkaev EA, Lipova EV Treatment of genital herpes and urogenital chlamydia. Moscow, 1999). As antiviral drugs, various virusostatics are used (acyclovir, valtrex, alpizarin, metisazon, virazole, etc.). As immune preparations, various immunomodulators are used (amixin, half-dan, cycloferon, dibazole, etc.).

 The disadvantage of this method is the low percentage of therapeutic effect (70%), in 30% of cases, the virus continues to be excreted from the urogenital tract, i.e. they remain sources of infection and they still have the likelihood of this form of the disease becoming manifest.

 The leading role in the pathogenesis of herpes virus infection belongs to the interferon link of the immune system, as evidenced by a number of authors of the study (Jumigo P.A., 1990, Kuratulaev K.N., 1991, Khaldin A.A., 1995, Sukhikh G.T., Vanko L.V., Kulakov V.I., 1997).

 Known drug neovir. With parenteral administration, the drug causes the rapid formation in the body of high titers of endogenous interferons. As a result, a state of resistance to viruses is formed in the cells, and immune responses are also induced to destroy the virus and the affected cells.

 Known drug valaciclovir (valtrex), intended for oral therapy of herpetic infections. Once in the cell, it has a specific inhibitory effect on the replication of the herpes virus.

 Known drug acylact. Acylact is a microbial mass of live acidophilic lactobacilli, which have high antagonistic activity against a wide range of pathogenic and conditionally pathogenic microbes, which determines the corrective effect of the drug in cases of genital bacteriocinosis disorders.

 The aim of the invention is to increase therapeutic efficacy, the cessation of virus excretion in patients with a subclinical form of genital HVI, as well as reducing the likelihood of a relapse in the form of rashes in patients with this form of the disease.

 This goal is achieved by obtaining a more pronounced therapeutic effect with the combined use of the antiviral drug valtrex, the immunomodulating drug neovir and the drug that affects the microflora of the genitourinary tract - acylact.

 Patients with a subclinical form of genital HBV are prescribed valtrex 0.5 g 2 times a day for 10 days, a course dose of 10 g, neovir is administered at a dose of 250 mg intramuscularly 10 injections, the interval between injections is 48 hours (immediately before injection, the drug is diluted 1, 5 ml of a 0.5% solution of novocaine). After taking valtrex, acylact is prescribed in the form of vaginal suppositories in 5 doses daily, at night, for 10 days.

 Before prescribing therapy in patients, the lysozyme activity of the vagina is determined to assess the biocenosis of the genital tract ("Method for the rapid diagnosis of the inflammatory process of the female genital area," Kazakov A.V., Telyakova G.V., Scherbakova N.V., 1990), vaginal pH, flora with the calculation of the total microbial number (by seeding on blood agar).

 A table is presented with its own data on the dynamics of lysozyme activity and vaginal pH.

 The results of a comparative analysis before and after treatment indicate that under the influence of therapy, the pH of the vagina normalizes with an increase in lysozyme activity.

 Using the proposed method is illustrated by the following examples.

 Example 1

Patient P., 25 years old. Diagnosis: Genital herpes, subclinical course. Concerns about burning, discomfort in the genital area, mild serous discharge from the vagina for 2 years. During a gynecological examination at the place of residence, no bacterial and fungal infections were detected, however, the patient periodically underwent local therapy using vaginal suppositories with antifungal and antibacterial effects. A positive effect of treatment was not achieved. Clinical and laboratory examination in UrNII DV and I in the urinary tract revealed a herpes simplex virus type 2, vaginal pH 5.0, lysozyme activity of the vagina negative, the genital tract flora was represented by streptobacteria, hemolytic streptococcus, non-hemolytic staphylococcus, total microbial number 10 ⁷ . The patient was prescribed valtrex 0.5 g 2 times a day for 10 days in combination with neovir at a dose of 250 mg, ten injections, with an interval between injections of 48 hours. After taking valtrex, acylact was prescribed in the form of vaginal suppositories in 5 doses daily, at night, for 10 days. Against the background of the therapy, the subjective sensations stopped by the 4th day of treatment. In the control analyzes, the herpes simplex virus type 2 was not detected in the genital tract, the lysozyme activity of the vagina was 6 mm, the pH of the vagina was 4.0, the total microbial number was 10 ⁵ (lactobacilli, G + bacillus, non-hemolytic staphylococcus). During 1 year of monitoring the patient, complaints did not resume, laboratory indicators at the same level.

 Example 2

Patient P., 29 years old. Diagnosis: Genital herpes, subclinical course. Concerns about burning in the genital area, serous discharge from the vagina for 3 years. During a gynecological examination at the place of residence in the general analysis of the smear, the increase in the number of leukocytes to 40-80 was repeatedly determined, but no bacterial and fungal infections were detected. The patient periodically underwent courses of general antibacterial therapy, as well as local treatment using vaginal suppositories that have antifungal and antibacterial effects. A positive effect of treatment was not achieved. Clinical and laboratory examination in UrNII DV and I revealed a herpes simplex virus type 2, vaginal pH 5.0, lysozyme activity of the vagina negative, genital tract flora was represented by streptobacteria, non-hemolytic staphylococcus, streptococcus, and the total microbial number 10 in the urinary tract ⁶ . The patient was prescribed valtrex 0.5 g 2 times a day for 10 days in combination with neovir at a dose of 250 mg intramuscularly, ten injections, with an interval between injections of 48 hours. After taking valtrex, acylact was prescribed in the form of vaginal suppositories in 5 doses daily, at night, for 10 days. Against the background of the therapy, the subjective sensations stopped. In the control analyzes, the herpes simplex virus type 2 was not detected in the genital tract, the lysozyme activity of the vagina was 5 mm, the pH of the vagina was 4.0, and the total microbial number was 10 ⁵ (lactobacilli, G + bacillus, corynebacteria). Over 1.5 years of monitoring the patient, complaints have not resumed, laboratory indicators are at the same level.

 By the proposed method and applying the indicated methods to control the effectiveness, 21 patients with a subclinical form of genital GVI were treated in the Ural Research Institute of DV and I, the control group - 16 people. No side effects were detected during treatment. In 100% of patients with a subclinical form of genital herpes, there was no transition of this form of the disease to the manifest form (observation period 2 years), herpes simplex virus was not detected in the genital tract during control tests in 90.5% (19 people).

 To assess the condition of the genital tract microbiocenosis and the effect of the proposed method of treatment on its correction (to stop the virus excretion from the genitourinary tract) in patients, the lysozyme activity of the vagina (by the indicated method), the pH of the vagina, the total microbial number and types of microorganisms are determined before treatment and after its completion ( inoculation of the genital tract on blood agar).

Before treatment, the shift of the vaginal pH to the alkaline medium prevailed in patients with negative lysozyme activity of the vagina, the total microbial number 10 ⁴ -10 ⁵ in 47.6% of patients, 10 ⁶ in 33.3%, 10 ⁷ in 19.1%, streptobacteria, hemolytic streptococcus and staphylococcus, non-hemolytic streptococcus with a low content of lactobacilli predominated in the flora, which indicates a disturbed biocenosis of the genital tract.

After therapy, normalization of the vaginal pH (3.8-4.2) was observed in 100% of patients, lysozyme activity of the vagina to 2 mm in 23.8% of patients, from 2 to 4 mm in 47.6%, more than 4 mm in 19%. The total microbial number remained at a predominant value of 10 ⁴ -10 ⁵ (in 52.4% of patients), however, hemolytic streptococcus and staphylococcus were not found in the genital tract, and the percentage of lactobacilli was significantly increased.

 The use of the proposed method for the treatment of subclinical forms of genital HBV allows you to stop the virus from the genitourinary tract in 90.5%, which is more pronounced than when using the known method.

 The results are shown in the table.

Claims (1)

 A method of treating a subclinical form of genital herpes virus infection in women, including the use of antiviral and immunomodulating drugs, characterized in that patients are prescribed valtrex 0.5 g 2 times a day, a course of 10 days, at the same time, 250 mg neovir is administered intramuscularly, 10 injections, intervals between injections 48 hours, after the end of taking valtrex, acylact is prescribed in the form of vaginal suppositories, 5 doses daily, at night, for 10 days.

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