Richard Whitley1, Francisco Diaz-Mitoma, Kamal Hamed. 1. Department of Pediatrics, Division of Infectious Disease, University of Alabama at Birmingham, Birmingham, AL 35233, USA. RWhitley@Peds.uab.edu
Abstract
BACKGROUND: Genital herpes is a lifelong incurable viral infection that can have a significant psychological and emotional impact on patients. A common therapy for treating recurrent outbreaks is the episodic use of nucleoside analogues for 3-5 days. However, since maximum viral replication occurs within 24 h after symptoms first appear, the best option may be short-term, patient-initiated episodic therapy, administered during the onset of prodromal symptoms. This commentary will examine the results of a recent clinical trial of patient-initiated episodic famciclovir therapy that is administered for a single day and compare efficacy data from that trial with data from trials of currently prescribed antiviral therapies. FINDINGS: This recent trial that evaluated the efficacy of single-day famciclovir compared to placebo in the treatment of recurrent genital herpes found that famciclovir decreased time to lesion healing and duration of symptoms, and increased the proportion of patients who did not progress to a full outbreak. Although no head-to-head studies have been completed, single-day famciclovir therapy seems to provide improvement that is similar to or better than that associated with traditional longer-term treatments. CONCLUSION: The increased convenience for the patient of single-day therapy may lead to improved patient compliance and better overall management of recurrent genital herpes outbreaks.
BACKGROUND: Genital herpes is a lifelong incurable viral infection that can have a significant psychological and emotional impact on patients. A common therapy for treating recurrent outbreaks is the episodic use of nucleoside analogues for 3-5 days. However, since maximum viral replication occurs within 24 h after symptoms first appear, the best option may be short-term, patient-initiated episodic therapy, administered during the onset of prodromal symptoms. This commentary will examine the results of a recent clinical trial of patient-initiated episodicfamciclovir therapy that is administered for a single day and compare efficacy data from that trial with data from trials of currently prescribed antiviral therapies. FINDINGS: This recent trial that evaluated the efficacy of single-day famciclovir compared to placebo in the treatment of recurrent genital herpes found that famciclovir decreased time to lesion healing and duration of symptoms, and increased the proportion of patients who did not progress to a full outbreak. Although no head-to-head studies have been completed, single-day famciclovir therapy seems to provide improvement that is similar to or better than that associated with traditional longer-term treatments. CONCLUSION: The increased convenience for the patient of single-day therapy may lead to improved patient compliance and better overall management of recurrent genital herpes outbreaks.