Prescription Pharmacy Rx News
Once-daily valacyclovir prevents genital herpes transmission
Drug cuts herpes risk by half in susceptible
patients who have infected partners, New England Journal of Medicine
study shows.
In 1,484 immunocompetent, heterosexual, monogamous couples,
the risk of transmission from a partner with clinically symptomatic
genital herpes to an uninfected partner was reduced significantly
when the former took once-daily doses of valacyclovir 500 mg
(Valtrex—GlaxoSmithKline).
The Valacyclovir Herpes Simplex Virus Transmission Group, led
by Lawrence Corey, MD, of the Fred Hutchinson Cancer Research
Center in Seattle, conducted the 8-month trial, which served as
the basis for a recent FDA approval of a transmission-reduction
indication for Valtrex.
Herpes simplex virus type 2 was acquired by 14 of 743 (1.9%)
susceptible individuals whose infected partners were taking valacyclovir,
compared with 27 of 741 (3.6%) of those whose infected partners
were taking placebo, a significant 48% reduction in risk. The risk of clinically symptomatic
herpes type 2 infection was reduced by 75%, affecting only 4 treated
patients, compared with 16 individuals on placebo.
In an accompanying editorial, Clyde S. Crumpacker, MD, discusses
the need for similar research into the effects of acyclovir and
role of herpes virus in the transmission of the AIDS virus: “Generic
acyclovir is inexpensive (therapy with 400-mg tablets given twice
per day costs 20 cents per day, or about $73 per year), it is
unlikely to induce resistance with prolonged use, and it is the
safest of the antiviral drugs. The urgency of such trials is enormous,
because they promise to separate the complex issues of confounding
sexual behavior from questions about whether HSV-2 really is causal
in HIV-1 transmission. Millions could benefit if the use of acyclovir
is proven to decrease the transmission of HIV-1 by preventing
HSV-2 genital ulcers. The time for ethically designed interventional
studies is now.”
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