Beyond efficacy: new issues for HSV antiviral therapy.

Wald, A.

doi:10.1136/sti.73.2.83

Cited by 2 publications

(3 citation statements)

References 26 publications

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“…Aciclovir is safe and eYcacious for a long period and the introduction of drugs with better bioavailablity such as valaciclovir and famciclovir could make treatment schedules more acceptable. 16 None the less, it would be a major undertaking.…”

Section: Discussionmentioning

confidence: 99%

“…A compartmental model of the type discussed by Anderson 19 and Brunham and Plummer 20 (that is, a model where the population divided according to infection status), was developed to describe the heterosexual spread of genital HSV infection throughout the most sexually active age group of a typical Western population-those aged [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] years. This group has the highest rates of sexual partner change both for males and females, 21 and the peak incidence for HSV-2 infection.…”

Section: Methodsmentioning

confidence: 99%

“…If this is true then the viral titre required to cause symptoms is greater than that required for transmission (between 50% and 70% of transmission events occur during an asymptomatic episode. 32 Aciclovir is known to reduce the frequency both of recurrent symptoms 16 and of viral shedding events detectable by cell culture and DNA polymerase chain reaction (PCR) assays. 2 15 Some asymptomatic shedding can be below the detection limit for cell culture methods, but be detectable by PCR assays.…”

Section: Methodsmentioning

confidence: 99%

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Use of antiviral treatment and prophylaxis is unlikely to have a major impact on the prevalence of herpes simplex virus type 2

White

Garnett

1999

Sexually Transmitted Infections

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Use of antiviral treatment and prophylaxis is unlikely to have a major impact on the prevalence of herpes simplex virus type 2 P J White, G P Garnett Background: Genital infection with herpes simplex virus (HSV) is common and can cause severe morbidity, over many years in some cases. Aciclovir provides suppressive therapy but there is debate over the eVects of its use on the spread of infection. Objectives: To explore the influence of the natural history of genital HSV and the impact of antiviral therapy. Methods: A simple mathematical model of HSV-2 transmission dynamics was developed, and parameter values estimated from published data. Results: The relative durations of the risk of transmitting HSV-2 and the duration of therapy generate a non-linear relation between the duration of antiviral therapy and the reduction in prevalenceof infection. If there is a wide distribution of risk of HSV-2 transmission over the course of an infection then practicable aciclovir use is unlikely to have any great impact on disease transmission dynamics. Conclusions: There are still many uncertainties in the transmission dynamics of HSV-2. In particular, infectiousness over the course of an infection requires more detailed exploration. To have a significant impact on the prevalence of HSV-2 aciclovir use would have to be widespread and for a long duration. (Sex Transm Inf 1999;75:49-54)

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Use of antiviral treatment and prophylaxis is unlikely to have a major impact on the prevalence of herpes simplex virus type 2

White

Garnett

1999

Sexually Transmitted Infections

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Recurrent Genital Herpes Treatments and Their Impact on Quality of Life

et al. 2003

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Herpes genitalis is one of the most common viral sexually transmitted diseases in the world, with an estimated seroprevalence in the US of greater than 20%. Two viruses of the same family cause herpes genitalis: herpes simplex virus 1 and 2. After the resolution of primary infection, the virus persists in the nerve roots of the sacral plexus, often causing recurrent (though generally less severe) outbreaks. These outbreaks, as well as the infectious potential to the patient's sexual partners, results in significant psychological stress on the patient, and has a tremendous negative impact on QOL. Current treatment modalities may result in a reduction in the number of outbreaks and viral shedding, but no cure exists. Although studies have clearly demonstrated the negative impact of recurrent genital herpes on QOL, an assessment scale specific to herpes was not developed until recently. Earlier studies indicated that patients did not perceive a significant benefit from episodic treatment with antivirals, but studies using the Recurrent Genital Herpes Quality of Life Questionnaire (RGHQoL) have now demonstrated that suppressive antiviral therapy improves quality of life in patients with frequent recurrences of genital herpes. However, not all patients with recurrent genital herpes need suppressive therapy, and proposed factors to consider include frequency of recurrence, physical and psychological distress caused by recurrences, and the potential for transmission to the patient's sexual partner. Newer therapeutic modalities, including the topical immune response modifier resiquimod and herpes vaccines, may eventually be shown to further decrease the psychological morbidity of recurrent genital herpes.

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Beyond efficacy: new issues for HSV antiviral therapy.

Cited by 2 publications

References 26 publications

Use of antiviral treatment and prophylaxis is unlikely to have a major impact on the prevalence of herpes simplex virus type 2

Use of antiviral treatment and prophylaxis is unlikely to have a major impact on the prevalence of herpes simplex virus type 2

Recurrent Genital Herpes Treatments and Their Impact on Quality of Life

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