Herpes Simplex 2 Research Paper
Herpes Simplex 1 and Simplex 2:
Episodic vs. Suppressive Antiviral Therapy
Abstract
Herpes is a global problem that is becoming more prevalent as adolescents are becoming sexually active. This paper will talk about how herpes simplex 1 is often treated by each occurrence which is known as episodic treatment and how herpes simplex 2 can be treated both by the occurrence (episodically) and long term which is known as suppressive therapy. Research is now being done to determine whether episodic or suppressive antiviral therapy is more effective in decreasing the spread of the herpes simplex 1 and 2 viruses. Three journal articles are used to analyze this information. Keywords: Episodic and Suppressive
Herpes …show more content…
simplex 1 and simplex 2: Episodic vs. Suppressive Antiviral Therapy
Herpes is a global problem that is becoming more prevalent as adolescents are becoming sexually active. This is a major health concern especially for parents with soon to be or currently sexually active teens. There are three categories of herpes; herpes simplex 1 (oral), herpes simplex 2 (genital) and herpes zoster (shingles). Research is now being done to determine whether episodic or suppressive antiviral therapy is more effective in decreasing the spread of the herpes simplex 1 and 2 viruses.
Herpes Simplex 1 Oral
Herpes simplex 1, herpes labialis or cold sores, is most often treated by each occurrence with a cream and can also be treated with oral antiviral medication.
Treating each occurrence is known as episodic treatment and this can be a very useful way to treat the common cold sore because most people will not adhere to an every day, for the rest of their life, oral medication for suppressive antiviral therapy. Over the counter creams such as Abriva, Zovirax, and Zilactin are available for people affected by cold sores and make treatment easy because you don’t need to go to a doctor for a prescription. However, this treatment is not always successful if the affected person does not adhere to the directions which include applying the cream five times a day, every four hours and this schedule would last for up to 10 days. There is a study that was performed to see if a high dose short duration oral medication would have better results for people affected by cold sores. During the study two groups of people, men and women that had been affected by chronic cold sores were given either a 1 day high dose of valacyclovir therapy at the first sign of a cold sore or a 2 day high dose of valacyclovir therapy. The results showed that both of these regimens had significant benefits over the long dose episodic cream therapy and that the 2 day therapy did not have better results than the 1 day high dose valacyclovir therapy. (Spotswood L. Spruance, 2002) Trials to show if long term …show more content…
suppressive therapy for herpes simplex 1 have not been performed with any significant results to date.
Herpes Simplex 2 Genital
Genital herpes simplex 2 is one of the most prevalent sexually transmitted diseases in the world and can either be treated by suppressive or episodic antiviral medication. Episodic treatment with an oral medication aims to alleviate the acute symptoms and signs of an outbreak while suppressive therapy aims to prevent the reactivation and recurrent outbreaks of the herpesvirus. Valacyclovir is also the drug of choice for genital herpes as it was for oral herpes and a study was done to see if valacyclovir could be used in a 3 day treatment versus the usual 5 day treatment for episodic treatment. Men and women over the age of 18 and who had more than 4 herpes outbreaks in the last year were used in this study. The results showed that there was no statistical difference in the results when only taking the valacyclovir for 3 days versus the 5 day treatment. This is good news for people who want to treat their outbreaks only as they happen and not with long term therapy because they will only have to take 3 days worth of medication before they see the symptoms receding.
Valacyclovir is also given as a once a day suppressive antiviral therapy for people suffering from multiple simplex 2 outbreaks.
While it does not cure the disease it does greatly reduce the number of outbreaks and therefore reduces the risk of new cases of herpes in others. Suppressive therapy of herpes simplex 2 with valacyclovir is also showing to improve the quality of life for patients with recurrent genital herpes. This was shown when a questionnaire called the “Recurrent Genital Herpes Quality of Life Questionnaire (RGHQoL)” was given to a group of people in an international, multicentre, randomized, double blind placebo controlled parallel group study. Each participant who was undergoing therapy either with antiviral medication or with a placebo was given the same 20 question survey each month for a year to evaluate the effects of the drugs on their quality of life. The overall data showed that those receiving the antiviral therapy had reduced feelings of depression and fear of
rejection.
Episodic Vs Suppressive Therapy
Episodic treatment is very common and allows the patient to receive care with many over the counter antiviral creams or short term oral antiviral medications, while suppressive therapy requires long term use of oral antiviral medications. It seems that most people choose to treat an outbreak of herpes simplex 1 with over the counter creams as it is readily available and you don’t have to go to a doctor for a prescription. Suppressive therapy for both simplex 1 and 2 is a necessary option for people who have multiple outbreaks a year and are looking to reduce their chances of outbreak which could in turn reduce the number of newly infected people. Having both types of therapy available is necessary because not every person with herpes simplex 1 needs to treat it like they would if they had simplex 2.
Conclusion
The research that has been done has shown benefits to both suppressive and episodic antiviral therapy in the treatment of herpes simplex 2 and for herpes simplex 1 episodic still seems the best method. While it would be ideal for every affected person with either simplex 1 or simplex 2 to undergo suppressive therapy it is not a realistic thing as the cost would be very high as well as compliance would be very difficult to control. However, suppressive therapy for herpes simplex 2 has shown benefits not only in the number of outbreaks in an affected person but also in their overall quality of life which could lead to many other health benefits. Hopefully research continues to be done to look for a cure for these diseases but until then people can be reassured that there are some great treatment options available.
Bibliography
Klausner, J. D. (2007). Current diagnosis and treatment of sexually transmitted diseases . New York: McGraw Hill Medical.
Peter A. Leone, S. T. (2002). Valacyclovir for Episodic Treatment of Genital Herpes: A Shorter 3-Day Treatment Course Compared with 5-Day Treatment. Clinical Infectious Diseases , 5.
R. Patel, S. T. (1999). Impact of suppressive antiviral therapy on the health related quality of life of patients with recurrent genital herpes infection. British Medical Journal , 5.
Spotswood L. Spruance, T. M.-C. (2002). High-Dose, Short-Duration, Early Valacyclovir Therapyn for Episodic Treatment of Cold Sores: Results of Two Randomized, Placebo-Controlled Multicenter Studies. American Society for Microbiology , 9.
Stanberry, L. R. (2006). Understanding herpes . Jackson: University Press of Mississippi.
.
Episodic vs. Suppressive Antiviral Therapy
Abstract
Herpes is a global problem that is becoming more prevalent as adolescents are becoming sexually active. This paper will talk about how herpes simplex 1 is often treated by each occurrence which is known as episodic treatment and how herpes simplex 2 can be treated both by the occurrence (episodically) and long term which is known as suppressive therapy. Research is now being done to determine whether episodic or suppressive antiviral therapy is more effective in decreasing the spread of the herpes simplex 1 and 2 viruses. Three journal articles are used to analyze this information. Keywords: Episodic and Suppressive
Herpes …show more content…
simplex 1 and simplex 2: Episodic vs. Suppressive Antiviral Therapy
Herpes is a global problem that is becoming more prevalent as adolescents are becoming sexually active. This is a major health concern especially for parents with soon to be or currently sexually active teens. There are three categories of herpes; herpes simplex 1 (oral), herpes simplex 2 (genital) and herpes zoster (shingles). Research is now being done to determine whether episodic or suppressive antiviral therapy is more effective in decreasing the spread of the herpes simplex 1 and 2 viruses.
Herpes Simplex 1 Oral
Herpes simplex 1, herpes labialis or cold sores, is most often treated by each occurrence with a cream and can also be treated with oral antiviral medication.
Treating each occurrence is known as episodic treatment and this can be a very useful way to treat the common cold sore because most people will not adhere to an every day, for the rest of their life, oral medication for suppressive antiviral therapy. Over the counter creams such as Abriva, Zovirax, and Zilactin are available for people affected by cold sores and make treatment easy because you don’t need to go to a doctor for a prescription. However, this treatment is not always successful if the affected person does not adhere to the directions which include applying the cream five times a day, every four hours and this schedule would last for up to 10 days. There is a study that was performed to see if a high dose short duration oral medication would have better results for people affected by cold sores. During the study two groups of people, men and women that had been affected by chronic cold sores were given either a 1 day high dose of valacyclovir therapy at the first sign of a cold sore or a 2 day high dose of valacyclovir therapy. The results showed that both of these regimens had significant benefits over the long dose episodic cream therapy and that the 2 day therapy did not have better results than the 1 day high dose valacyclovir therapy. (Spotswood L. Spruance, 2002) Trials to show if long term …show more content…
suppressive therapy for herpes simplex 1 have not been performed with any significant results to date.
Herpes Simplex 2 Genital
Genital herpes simplex 2 is one of the most prevalent sexually transmitted diseases in the world and can either be treated by suppressive or episodic antiviral medication. Episodic treatment with an oral medication aims to alleviate the acute symptoms and signs of an outbreak while suppressive therapy aims to prevent the reactivation and recurrent outbreaks of the herpesvirus. Valacyclovir is also the drug of choice for genital herpes as it was for oral herpes and a study was done to see if valacyclovir could be used in a 3 day treatment versus the usual 5 day treatment for episodic treatment. Men and women over the age of 18 and who had more than 4 herpes outbreaks in the last year were used in this study. The results showed that there was no statistical difference in the results when only taking the valacyclovir for 3 days versus the 5 day treatment. This is good news for people who want to treat their outbreaks only as they happen and not with long term therapy because they will only have to take 3 days worth of medication before they see the symptoms receding.
Valacyclovir is also given as a once a day suppressive antiviral therapy for people suffering from multiple simplex 2 outbreaks.
While it does not cure the disease it does greatly reduce the number of outbreaks and therefore reduces the risk of new cases of herpes in others. Suppressive therapy of herpes simplex 2 with valacyclovir is also showing to improve the quality of life for patients with recurrent genital herpes. This was shown when a questionnaire called the “Recurrent Genital Herpes Quality of Life Questionnaire (RGHQoL)” was given to a group of people in an international, multicentre, randomized, double blind placebo controlled parallel group study. Each participant who was undergoing therapy either with antiviral medication or with a placebo was given the same 20 question survey each month for a year to evaluate the effects of the drugs on their quality of life. The overall data showed that those receiving the antiviral therapy had reduced feelings of depression and fear of
rejection.
Episodic Vs Suppressive Therapy
Episodic treatment is very common and allows the patient to receive care with many over the counter antiviral creams or short term oral antiviral medications, while suppressive therapy requires long term use of oral antiviral medications. It seems that most people choose to treat an outbreak of herpes simplex 1 with over the counter creams as it is readily available and you don’t have to go to a doctor for a prescription. Suppressive therapy for both simplex 1 and 2 is a necessary option for people who have multiple outbreaks a year and are looking to reduce their chances of outbreak which could in turn reduce the number of newly infected people. Having both types of therapy available is necessary because not every person with herpes simplex 1 needs to treat it like they would if they had simplex 2.
Conclusion
The research that has been done has shown benefits to both suppressive and episodic antiviral therapy in the treatment of herpes simplex 2 and for herpes simplex 1 episodic still seems the best method. While it would be ideal for every affected person with either simplex 1 or simplex 2 to undergo suppressive therapy it is not a realistic thing as the cost would be very high as well as compliance would be very difficult to control. However, suppressive therapy for herpes simplex 2 has shown benefits not only in the number of outbreaks in an affected person but also in their overall quality of life which could lead to many other health benefits. Hopefully research continues to be done to look for a cure for these diseases but until then people can be reassured that there are some great treatment options available.
Bibliography
Klausner, J. D. (2007). Current diagnosis and treatment of sexually transmitted diseases . New York: McGraw Hill Medical.
Peter A. Leone, S. T. (2002). Valacyclovir for Episodic Treatment of Genital Herpes: A Shorter 3-Day Treatment Course Compared with 5-Day Treatment. Clinical Infectious Diseases , 5.
R. Patel, S. T. (1999). Impact of suppressive antiviral therapy on the health related quality of life of patients with recurrent genital herpes infection. British Medical Journal , 5.
Spotswood L. Spruance, T. M.-C. (2002). High-Dose, Short-Duration, Early Valacyclovir Therapyn for Episodic Treatment of Cold Sores: Results of Two Randomized, Placebo-Controlled Multicenter Studies. American Society for Microbiology , 9.
Stanberry, L. R. (2006). Understanding herpes . Jackson: University Press of Mississippi.
.