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• W2041036284 abstract "Genital herpes simplex virus (HSV) and human papillomavirus (HPV) infections are two widespread infections that are hardly recognized by the public as sexually transmitted diseases (STD). According to a survey of the American Social Health Association only 17% of adults recognize genital herpes as a STD and only 3% are aware of genital warts being sexually transmitted [1]. About 500 000 cases of genital herpes are estimated each year in the USA [2] and more than 20 000 cases are reported from STD clinics in the UK [3]. Data taken from ten developed countries show that 107 million people are herpes simplex virus type 2 (HSV 2) seropositive [4]. HSV 2 infection, which is mainly responsible for genital herpes, has increased worldwide [5]. A recently published report by Fleming et al. showed that every fifth person in the USA older than 12 years is carrying HSV 2 [6]. The HSV 2 seroprevalence has increased by 30% between 1976 and 1994. This affected increase particularly white teenagers [6]. This is surprising, because at the same time intensive HIV-prevention campaigns were performed in the USA. The special features of genital HSV infection which make therapy so vital are that it is carried lifelong and patients may suffer from many recurrences. Fortunately primary disease affects only 1% of those who get infected. Primary herpes is a severe outbreak of disseminated vesicular lesions accompanied by local swelling, discharge and altogether more serious symptoms than those of recurrent disease. However, recurrences with minor symptoms continually affect people and cause distress and psychosocial problems. In addition stable partnerships may be jeopardized and quality of life reduced. The list of complications and risks of genital HSV infection make efficacious therapy highly desirable. This applies particularly to persistent genital erosions and ulcers that make transmission and acquisition of HIV a lot easier [7–9]. In the case of genital herpes during pregnancy, different modes of management are being used. It is important to consider systemic antiviral therapy for the mother and for the benefit of the unborn child, for whom HSV may be dangerous and even life-threatening [10]. It is common knowledge that current systemic antiviral therapies alleviate symptomatic genital herpes and act prophylactically when long term therapy is continued. Treatment with acyclovir is safe according to several studies of long term treatment of persons with recurrent genital herpes [11,12]. Recently, moreover, antiviral therapy of genital herpes has been considerably improved. Valaciclovir, the valylester of acyclovir if given orally, has the same antiviral activity as acyclovir, but has the potential for less frequent administration because of its superior pharmacokinetics [13,14]. Both first-episodes and recurrences are best treated by twice daily oral administration of 500 mg valaciclovir for 5 days. Suppressive therapy is one tablet daily during the first year, in cases with frequent recurrences (history of six to eight genital herpes recurrences per year). Intravenous acyclovir should be reserved for severe first-episode or primary genital herpes. Another compound developed for herpesvirus infections and also successfully used for genital herpes is famciclovir, the diacetylester of penciclovir. Famciclovir acts similarly to acyclovir and valaciclovir. Its efficacy in genital herpes is comparable. There is also better biovailability of famciclovir in comparison to acyclovir which allows a less frequent and more convenient dosing schedule. Dosing three times daily is necessary for first-episode and recurrent disease. Suppressive therapy requires two oral administrations per day [15]. A recently published observation in mice suggests that * Tel.: +49-381-4949701; fax: +49-381-4949702." @default.
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• W2041036284 date "1999-06-01" @default.
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• W2041036284 title "Do we need antivirals for genital herpes simplex virus and human papillomavirus infection?" @default.
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• W2041036284 doi "https://doi.org/10.1016/s0924-8579(99)00004-7" @default.
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