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Genital Herpes can Reactivate During High Doses of Medication Treatment

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Patients with genital herpes are still receiving outbreaks even during high doses of antiviral therapy, according to a new study from the University of Washington.

Herpes Simplex Virus 2 (HSV-2) causes ulcers in the skin or mucus membranes of the mouth, lips, or genital area. However, not all patients with HSV-2 have immediate symptoms, but can still transmit the virus through sexual contact. The reason for this is due to the HSV-2 being able to hide in the nervous systems, and still cause periodic outbreaks.

When a reactivation occurs, the virus inside the nerve cell travels along the nerve and ultimately to the skin causing shedding, which allows new sores to surface. Further testing by researchers proved that HSV shedding and further outbreaks are three times more frequent than previously noted.

Researchers gathered 113 HSV patients, and used three separate studies, to compare those who were receiving herpes medication compared to those who were using no medication to treat symptoms.

The results confirmed that those taking high doses of said medications still had shedding, causing reactivation. With higher doses of medications, HSV shedding was diminished by 50 percent, but with standard doses there were no change in patients having outbreaks, which equal about 16 episodes per year.

“Our finding that high dose valaciclovir increases the kinetics of viral clearance, but not expansion, supports the hypothesis that these antiviral drugs do not suppress the release of virions into the genital tract. That we could not eliminate or even alter the frequency of shedding episodes with high-dose valaciclovir suggests that the maximum benefit of shedding reduction has probably been reached for currently available antiviral drugs,” said the study authors.

After the study, researchers learned that although current HSV medications do benefit patients, stronger ones are needed to fully assist those with the Herpes Virus.

“Although currently available anti-HSV therapy benefits patients by preventing clinical HSV recurrences, suppressive therapies with greater potency, including antiviral drugs or immunotherapy in the form of therapeutic vaccines are needed to provide substantial public health benefits, such as prevention of HSV-2 transmission and HIV-1 acquisition and transmission,” the authors concluded.

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