One-day valacyclovir effective for genital herpes

By Martha Kerr

NEW YORK (Reuters Health) - Recurrent outbreaks of herpes simplex virus 2 (HSV2), or "genital herpes," can be effectively treated with a one-day course of valacyclovir (sold under the trade name Valtrex), according to results of a pilot study published in the journal Sexually Transmitted Diseases.

Dr. Stephen K. Tyring of the University of Texas Health Science Center in Houston and colleagues enrolled 115 patients with recurrent HSV2 infection. The patients were given a one-day supply of valacyclovir - 2,000 milligrams, twice daily, for a total of 4,000 milligrams a day), to be taken at the first signs of a recurrence. Patients kept diaries of their symptom duration and collected genital swabs for viral cultures to be performed 14 days following initiation of treatment.

Tyring's team reports that 90 patients (78 percent) had a recurrence or the signs of initial symptoms, and 4 patients (5 percent) developed a second recurrence during the 14 days after valacyclovir treatment.

The average duration of genital sores and pain was 5 day and 3 days, respectively.

Viral shedding was detected in 60 patients and lasted an average of 2 to 3 days. Viral shedding is when virus is detectable in the genital area -- a time when the infection is easily transmitted. Of the 60 subjects with viral shedding, 14 (23 percent) had an additional shedding episode after the initial sore healed, and this second recurrence lasted about 2 days.

"The one-day course appears to be as effective as the three- to five-day course," Tyring commented in an interview with Reuters Health. "The question of viral shedding between these different schedules, however, is yet to be studied."

He and his colleagues conclude that the one-day valacyclovir regimen "may be a convenient treatment for recurrent genital herpes and comparative trials are warranted."

SOURCE: Sexually Transmitted Diseases, April 2008.