Genital Herpes: Insights into Sexually Transmitted Infectious Disease.
Genital Herpes: Insights into Sexually Transmitted Infectious Disease.
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DOI：
10.15698/mic2016.09.528
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发表时间：
2016-06-27
期刊：
影响因子：
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通讯作者：
Shukla D
中科院分区：
文献类型：
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作者：
Jaishankar D;Shukla D
病原学、传播和保护：单纯疱疹病毒-2（HSV-2）是性传播感染的主要原因，在受感染宿主的一生中反复出现。目前还没有有效的疫苗或抗病毒药物能够提供对该病毒的完全保护或免疫，该病毒在世界各地流行。病理/症状：原发性和复发性感染导致生殖器周围的病变和炎症，后者占生殖器疱疹病例的大多数。免疫功能低下的患者（包括新生儿）易受其他全身性感染的影响，包括神经系统炎症的衰弱后果。流行病学、发病率和流行率：全世界有5亿多人受到感染，大多数报告的病例涉及16至40岁的年龄组，这与这一年龄组的性活动增加相吻合。虽然这些数字是估计数，但实际数字可能被低估，因为许多人没有症状或没有报告症状。治疗和治愈：目前处方的药物，主要是核苷类似物，只能减轻活动性感染引起的症状，但不能消除病毒或减少潜伏期。因此，没有针对生殖器疱疹的治愈方法，并且感染的患者在其整个生命中遭受疾病症状的周期性复发。感染的分子机制：在过去的几十年里，我们对HSV感染机制的理解取得了许多新的进展。病毒进入受体如nectin-1和HVEM已被鉴定，细胞骨架信号传导和膜结构如丝状伪足已直接参与病毒进入，宿主马达蛋白及其病毒配体已被证明有助于衣壳转运，并且许多宿主和HSV蛋白已被鉴定有助于病毒复制和发病。对自噬和其他先天免疫机制的作用有了新的认识，这些机制被破坏以增强HSV的发病机制。本文综述了我们目前对HSV-2及其相关疾病的认识以及现有或即将推出的新治疗方法。
Etiology, transmission and protection: Herpes simplex virus-2 (HSV-2) is a leading cause of sexually transmitted infections with recurring manifestations throughout the lifetime of infected hosts. Currently no effective vaccines or prophylactics exist that provide complete protection or immunity from the virus, which is endemic throughout the world. Pathology/Symptomatology: Primary and recurrent infections result in lesions and inflammation around the genital area and the latter accounts for majority of genital herpes instances. Immunocompromised patients including neonates are susceptible to additional systemic infections including debilitating consequences of nervous system inflammation. Epidemiology, incidence and prevalence: More than 500 million people are infected worldwide and most reported cases involve the age groups between 16-40 years, which coincides with an increase in sexual activity among this age group. While these numbers are an estimate, the actual numbers may be underestimated as many people are asymptomatic or do not report the symptoms. Treatment and curability: Currently prescribed medications, mostly nucleoside analogs, only reduce the symptoms caused by an active infection, but do not eliminate the virus or reduce latency. Therefore, no cure exists against genital herpes and infected patients suffer from periodic recurrences of disease symptoms for their entire lives. Molecular mechanisms of infection: The last few decades have generated many new advances in our understanding of the mechanisms that drive HSV infection. The viral entry receptors such as nectin-1 and HVEM have been identified, cytoskeletal signaling and membrane structures such as filopodia have been directly implicated in viral entry, host motor proteins and their viral ligands have been shown to facilitate capsid transport and many host and HSV proteins have been identified that help with viral replication and pathogenesis. New understanding has emerged on the role of autophagy and other innate immune mechanisms that are subverted to enhance HSV pathogenesis. This review summarizes our current understanding of HSV-2 and associated diseases and available or upcoming new treatments.