Once-daily valacyclovir to reduce the risk of transmission of genital herpes*

  title={Once-daily valacyclovir to reduce the risk of transmission of genital herpes*},
  author={Lawrence Corey and Anna Wald and Raj Patel and Stephen L. Sacks and Stephen K. Tyring and Terri J Warren and John M. Douglas and Jorma Paavonen and Rhoda Ashley Morrow and Karl R. Beutner and Leonid Stratchounsky and Gregory J. Mertz and Oliver N Keene and Helen A. Watson and Dereck R. Tait and Mauricio Vargas-Cortes},
  journal={Obstetrics \& Gynecology},
BACKGROUND Nucleoside analogues against herpes simplex virus (HSV) have been shown to suppress shedding of HSV type 2 (HSV-2) on genital mucosal surfaces and may prevent sexual transmission of HSV. METHODS We followed 1484 immunocompetent, heterosexual, monogamous couples: one with clinically symptomatic genital HSV-2 and one susceptible to HSV-2. The partners with HSV-2 infection were randomly assigned to receive either 500 mg of valacyclovir once daily or placebo for eight months. The… 

Reducing the transmission of genital herpes

  • S. Barton
  • Medicine
    BMJ : British Medical Journal
  • 2005
A recently published study was undertaken in 1484 heterosexual, immunocompetent couples to determine if daily valaciclovir could reduce the sexual transmission of genital herpes.

Valacyclovir and acyclovir for suppression of shedding of herpes simplex virus in the genital tract.

Although the suppression of viral replication is not complete, valacyclovir and acy Clovir are highly effective in suppressing the frequency and quantity of genital HSV shedding.

Oral antiviral therapy for prevention of genital herpes outbreaks in immunocompetent and nonpregnant patients.

In placebo-controlled trials, there was a low quality evidence that the risk of having at least one clinical recurrence was reduced with acyclovir, and in parallel-group trials by daily dose, no clear evidence was found of a dose-response relationship for any drug.

Famciclovir Reduces Viral Mucosal Shedding in HSV-Seropositive Persons

Famciclovir therapy decreases genital HSV shedding in HSV-seropositive persons, especially those with a history of genital herpes, and antiviral drugs may have varying effects on symptomatic and asymptomatic viral shedding, depending on the clinical history of the disease.

Effect of valacyclovir on viral shedding in immunocompetent patients with recurrent herpes simplex virus 2 genital herpes: a US-based randomized, double-blind, placebo-controlled clinical trial.

It is demonstrated that 1 g/d of valacyclovir administered for 60 days was generally well tolerated and was an effective suppressive therapy that significantly reduced total (clinical and subclinical) HSV-2 shedding compared with placebo in immunocompetent patients diagnosed as having recurrent HSv-2 genital herpes.

Famciclovir for the treatment of recurrent genital herpes: a clinical and pharmacological perspective

Famciclovir, a synthetic acyclic guanine derivative, is the prodrug of pencic Lovir, which demonstrates in vitro antiviral activity against various types of herpes virus, including herpes simplex virus-2, and is well tolerated, with an adverse events profile similar to placebo.

Utility of episodic acyclovir therapy for HSV-2 in Africa.

A randomized trial of episodic acyclovir therapy among 88 HIV-1 seronegative, HSV-2 seropositive African women with recurrent genital herpes concluded that diminished virologic response to acyClovir among African women did not explain the failure of HSv-2 suppressive therapy to prevent HIV acquisition and has potential when included as part of first-line syndromic management of GUD.

Valacyclovir Prophylaxis to Prevent Recurrent Herpes at Delivery: A Randomized Clinical Trial

Valacyclovir suppression after 36 weeks of gestation significantly reduces HSV shedding and recurrent genital herpes requiring cesarean delivery.

Genital herpes.




Valaciclovir for the suppression of recurrent genital HSV infection: a placebo controlled study of once daily therapy. International Valaciclovir HSV Study Group.

It is demonstrated that once daily valaciclovir (500 mg), is highly effective and well tolerated for the suppression of recurrent genital HSV infection.

Effect of condoms on reducing the transmission of herpes simplex virus type 2 from men to women.

Analysis of data from a randomized, double-blind, placebo-controlled trial of an ineffective candidate HSV-2 vaccine suggests that identification of discordant couples can reduce transmission of HSv-2, especially for heterosexual couples in which the male partner has HSV -2 infection.

Frequent genital herpes simplex virus 2 shedding in immunocompetent women. Effect of acyclovir treatment.

HSV-2 shedding in the genital mucosa occurs much more frequently than previously appreciated and likely plays a role in the epidemic spread of genital herpes worldwide.

Reactivation of genital herpes simplex virus type 2 infection in asymptomatic seropositive persons.

Seropositivity for HSV-2 is associated with viral shedding in the genital tract, even in subjects with no reported history of genital herpes.

Frequency of Acquisition of First‐episode Genital Infection with Herpes Simplex Virus from Symptomatic and Asymptomatic Source Contacts

Efforts to identify individuals with undiagnosed genital herpes and to instruct these individuals concerning the risk of disease transmission in the presence of lesions are needed if the rate of transmission is to be decreased; however, methods designed to deerease the rates of transmission by asymptomatic individuals must also be evaluated.

Recurrence Rates in Genital Herpes after Symptomatic First-Episode Infection

The natural history of symptomatic recurrences in the complete population and in the subset of untreated patients is summarized.

Recombinant glycoprotein vaccine for the prevention of genital HSV-2 infection: two randomized controlled trials. Chiron HSV Vaccine Study Group.

Efficient and sustained protection from sexual acquisition of HSV-2 infection will require more than high titers of specific neutralizing antibodies, and protection against sexually transmitted viruses involving exposure over a prolonged period will require a higher degree of vaccine efficacy than that achieved in this study.

A prospective study of new infections with herpes simplex virus type 1 and type 2. Chiron HSV Vaccine Study Group.

Nearly 40 percent of newly acquired HSV-2 infections and nearly two thirds of new HSv-1 infections are symptomatic, and among sexually active adults, new genital HSVs type 1 and 2 infections are as common as new oropharyngeal HSV -1 infections.

The association between genital ulcer disease and acquisition of HIV infection in homosexual men.

It is suggested that genital ulcerative diseases are an important risk factor for the acquisition of HIV infection in homosexual men; measures directed at control of these diseases may reduce the transmission of HIV in this population.

Human Immunodeficiency Virus Infection and Genital Ulcer Disease in South Africa: The Herpetic Connection

Serologic evidence of HSV‐2 infection and current cases of genital herpes are strongly associated with HIV infection among men who present to STD clinics with GUD or urethritis.