The Effect of Daily Valacyclovir Suppression on Herpes Simplex Virus Type 2 Viral Shedding in HSV-2 Seropositive Subjects Without a History of Genital Herpes

  title={The Effect of Daily Valacyclovir Suppression on Herpes Simplex Virus Type 2 Viral Shedding in HSV-2 Seropositive Subjects Without a History of Genital Herpes},
  author={Rhoda S. Sperling and Kenneth H. Fife and Terri J Warren and Lynn P Dix and Clare A. Brennan},
  journal={Sexually Transmitted Diseases},
Background: A substantial number of HSV-2 seropositive individuals lack a history of clinically recognized genital herpes. These individuals can transmit disease during periods of asymptomatic viral shedding. The frequency of asymptomatic shedding and the efficacy of antiviral therapy in reducing shedding has not been assessed in this population. Objective: To compare the effect of valacyclovir 1 g once daily for 60 days versus placebo on asymptomatic viral shedding in immunocompetent, HSV-2… 

Herpes Simplex Virus Type 2 Infection in Young Adult Women: Risk Factors for Infection and Frequency of Viral Shedding

HSV 2 infection is very common among young adult women, but symptomatic genital herpes is not, and early intervention strategies will be needed to control HSV 1 infection.

A double-blind placebo-controlled study to evaluate valacyclovir alone and with aspirin for asymptomatic HSV-1 DNA shedding in human tears and saliva.

The HSV-1 DNA copy number was not reduced by treatment with 500 mg of valacyClovir daily or with a combination of daily valacyclovir plus twice-daily doses of aspirin over 30 days.

Use of the designation “shedder” in mucosal detection of herpes simplex virus DNA involving repeated sampling

Most HSV-2 seropositive people shed HSV from the genital mucosa, and overall shedding rates provide consistent measures regardless of the number of swabs collected, as well as dichotomisation of people into “shedder” and “non-shedders” or “high”and “low” shedders yields inferences that depend upon sampling interval length.

One-day famciclovir vs. placebo in patient-initiated episodic treatment of recurrent genital herpes in immunocompetent Black patients

Famciclovir has proven efficacy and safety in the overall RGH population and many study sites either lacked prior experience in conducting clinical studies in patients with HSV infection or enrolled small numbers of patients, which may have compromised efficacy outcomes.

Mucosal Herpes Immunity and Immunopathology to Ocular and Genital Herpes Simplex Virus Infections

The phenotypic and functional properties of innate and adaptive mucosal immune cells, their role in antiherpes immunity, and immunopathology are reviewed and the progress and limitations in developing a safe and efficient mucosal herpes vaccine are discussed.

Implementation of Routine Access to Herpes Simplex Virus Type 2 Antibody Testing in a Public Health Sexually Transmitted Disease Clinic

Improved education regarding HSV-2 and subsidized testing may be needed in the populations that have the highest prevalence in order to encourage testing, especially among the highest risk individuals.

Screening for HSV-2 infection in STD clinics and beyond: a few answers but more questions.

Although asymptomatic in most persons, HSV-2 causes a range of important problems, including recurrent genital ulcerations, devastating neonatal infection, and enhanced HIV transmission, with estimates that HSVs-2 may account for 25% to 35% of HIV infections in sub-Saharan Africa.

Serologic Screening for Genital Herpes: An Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.

Serologic screening for genital herpes was associated with psychosocial harms, including distress and anxiety related to positive test results, and evidence from RCTs does not establish whether preventive antiviral medication for asymptomatic HSV-2 infection has benefit.

Oral infections of herpes simplex virus: symptoms, diagnosis, and treatment and pathophysiology in periodontal disease

The current review discusses Herpes Simplex Virus: Oral Infections’ Symptoms, Diagnosis, and Treatment and Pathphysiology of HerpesSimplex Virus in Periodontal Disease.

Interventions for men and women with their first episode of genital herpes.

Low quality evidence is found from two studies of oral acyclovir, when compared to placebo, reduced the duration of symptoms in individuals undergoing their first episode of genital herpes.



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.

Suppression of Subclinical Shedding of Herpes Simplex Virus Type 2 with Acyclovir

To determine whether acyclovir suppresses subclinical shedding of HSV-2 in the genital tract, a placebo-controlled, crossover trial of suppressive acyClovir therapy in women with recently acquired genital herpes is conducted.

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.

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

Once-daily suppressive therapy with valacyclovir significantly reduces the risk of transmission of genital herpes among heterosexual, HSV-2-discordant couples.

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.

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.

Detection of viral DNA to evaluate outcome of antiviral treatment of patients with recurrent genital herpes

PCR and then Southern blot hybridization greatly enhanced the ability to detect herpes simplex virus at the lesion site and proved to be of greater diagnostic value in assessing genital herpes than the standard culture method currently used.

Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States.

Declines in HSV-2 seroprevalence in the United States in 1999-2004 are shown, suggesting that the trajectory of increasing HSVs simplex virus type 1 (HSV-1) and HSVs type 2 serop revalences in theUnited States has been reversed.

Herpes simplex virus type 2 in the United States, 1976 to 1994.

Improvements in the prevention of HSV-2 infection are needed, particularly since genital ulcers may facilitate the transmission of the human immunodeficiency virus.