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Home Treatment Options Treatment Options Study Suggests Benefits of Suppressive Therapy For Newly Diagnosed Patients

Study Suggests Benefits of Suppressive Therapy For Newly Diagnosed Patients

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Most studies to assess the effectiveness of suppressive antiviral therapy for genital herpes have enrolled individuals with an established history of recognized recurrences. As a result, many healthcare providers facing a newly-diagnosed patient with no history of recurrences may not consider suppressive therapy at the outset for a patient. But rather than wait until the patient has experienced recurrences, recent studies suggest that daily suppressive therapy might be the better option at the outset, helping to both reduce the frequency of recurrences and improve quality of life.

The most recent study of 384 participants, recruited from the U.S., Canada, Argentina, Brazil and Chile, sought to confirm and expand upon observations made in an earlier pilot study in Washington and Oregon. The study enrolled individuals who had a first recognized episode of genital herpes (HSV-2) either at the time of the screening visit or within the previous three months of the visit. Participants were given either a 1g daily dose of valacyclovir or a placebo and were followed for 24 weeks.

The study confirmed that these newly-diagnosed patients responded just as patients with a known history of recurrences. Among those that completed the study successfully (following the study protocol to the conclusion of the study), 72.7% in the valacylcovir group were recurrence-free versus 42.9% of the placebo group. One question the study didn’t address was the impact of daily suppressive therapy on the frequency of viral shedding in newly-diagnosed patients. However, study authors note that preliminary results from another recent study suggest that the effect on shedding should be similar in both patient groups as well.

With this new research, healthcare providers have new data to guide their management of newly-diagnosed patients. As the study authors note, “Clinicians should consider suppressive therapy as another treatment option in newly diagnosed patients, especially in adolescents, those with difficult psychological adjustments, or those who have an uninfected partner and are concerned about transmission. The latter group is especially important in light of the recent observation that the risk of transmission of HSV-2 to an uninfected partner is unrelated to the frequency of clinical recurrences in the HSV-2-infected partner.”

For more information, see the July 2008 issue of Sexually Transmitted Diseases. (Sexually Transmitted Diseases: Vol. 35(7) July 2008. pp 668-673)


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