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Genital
Herpes Treatment Cuts
Spread
Daily
Valtrex Helps Prevent Spread of Virus to Partner
March 24, 2003
(San Francisco) -- In the 1970s, herpes was forever. In the 1980s,
it was the "gift that kept on giving." But while herpes is still
forever, new research suggests that in the 21st century genital
herpes treatments can help prevent spread of this sexually transmitted
disease.
"This
is the first time that antiviral therapy has demonstrated the
ability to prevent or reduce transmission of a virus," researcher
Gisela Torres, MD, of the University of Texas Medical Branch Center
for Clinical Studies.
Torres
studied close to 1,500 monogamous couples in their 30s in which
one partner was infected with genital herpes. In half of the couples
the infected partner took 500 mg of the genital herpes drug Valtrex,
while the infected partners in the remaining couples were given
placebos. The study was funded by GlaxoSmithKline.
In
the group that took the genital herpes treatment, spread of symptomatic
herpes to the partner was 77% less than in the group that took
placebo, says Torres. The researchers also looked at silent spread
of genital herpes since the virus is often transmitted without
the partner developing any symptoms. Treatment with Valtrex reduced
the rate of silent transmission by 50%.
Overall,
the transmission rate was 3.8% in the placebo group and 1.9% in
the Valtrex group, she says.
Torres,
who presented the research at the 61st annual meeting of the American
Academy of Dermatology, says several factors contribute to transmission.
"The
risk for transmission increases as sexual activity increases.
In this study, transmission was significantly higher among couples
who had sex more than 10 times a month compared to those who limited
intercourse to no more than five times a month," she says. "But
even in this case, [Valtrex] was protective so that the transmission
rate among highly sexually active couples was less if the infected
partner was taking antiviral therapy."
The
rate of herpes infection has been steadily increasing for the
last 20 years and research suggests that 1 in 5 adults has genital
herpes. Herpes can be spread even when the infected person has
no sores or irritations from the disease. With silent transmission
a real risk, Torres says the need for genital herpes treatments
to suppress the virus and prevent spread is especially urgent.
Of
particular concern are women of childbearing age who can pass
along the infection during pregnancy. If a child is born with
herpes, "there is a risk for serious complications and even death,"
says Torres.
"If
the woman is the positive partner, she should be on antiviral
therapy for the last trimester of her pregnancy so that she reduces
the risk for viral shedding during delivery. If the woman is the
uninfected partner, we would advise the couple to begin suppressive
therapy before considering pregnancy," said Torres.
Herpes
is a disease of recurrent outbreaks and some people have flare-ups
10 or more times a year. In this study, patients averaged five
recurrences a year before genital herpes treatment. After eight
months of treatment, 60% of Valtrex patients had no outbreaks
compared with 20% of placebo patients.
Peter
Heald, MD, professor of dermatology at Yale-New Haven Hospital
in New Haven, Conn., says the results are impressive, but he questioned
the safety of "a lifetime of [Valtrex] treatment." Torres says
that other studies demonstrate that antiviral therapy is "safe
up to 10 years."
Warren
Heymann, MD, dermatologist at Cooper Hospital/University Medical
Center in Camden, N.J., says, "This treatment should be considered
for all affected couples of child-bearing age."
But
the genital herpes treatment is not cheap," says Torres' CO-researcher
Mathijis Bretjens, MD, also of the University of Texas Medical
Branch. "But our experience is that insurers are willing to pay
for the treatment, and even if coverage is denied, patients will
pay for this protection."
Torres
says that other genital herpes drugs may also be effective at
reducing the risk for transmission.
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