December 2006 Newsletter
HSV InfectionsTreatment OptionsDiagnostic TestingHerpes & PregnancyOral Herpes InfectionsAsymptomatic Viral SheddingSmart LivingVaccines for Herpes

Herpes.org Newsletter- December 2006 by Dr. H., Medical Director and Sally G, MSW www.herpes.org posted December 16, 2006 Welcome to the Herpes.org Newsletter. In this, issue, we invite you to read our newest articles: Alternatives in Intimacy. The Psychology of Herpes. ---------------------------------------------------------------------- Herpes and HPVin the News- A patient-friendly summary of recent medical developments in Genital Herpes and HPV treatment. New Vaginal Microbicide for Herpes And HIV being tested December 5, 2006 (Source: Medical News Today) A team of researchers at UCSF is seeking young women to participate in the first U.S. study of the safety of a new vaginal microbicide gel, "VivaGel", designed to prevent Herpes and HIV infection. If it is effective and approved by the U.S. Food and Drug Administration, women would insert it into the vagina about an hour before having intercourse. The gel is not a contraceptive but instead works solely to prevent the spread of sexually transmitted disease. Women who have herpes are at increased risk of contracting HIV, so diminishing the risk of getting Herpes also diminishes the risk of HIV infection. As well, the gel would be an important weapon in the fight against Herpes and HIV because it would allow women to protect themselves from infection rather than relying on their partners to use condoms. Earlier spermicidal microbicides like nonoxynol 9, used in many contraceptive products, was eventually found to increase rather than decrease both Herpes and HIV infection rates. But "VivaGel" works differently through the use of a molecule called a dendrimer. Dendrimers have molecular structures that resemble the branches of a tree which "catch" Herpes and HIV molecules, preventing them from entering and infecting human cells. To participate in the study, women must be between 18 and 24 years old, sexually active, healthy and free of any sexually transmitted disease. They cannot be pregnant or breast feeding. They must either have regular menstrual periods or not have them at all. If you are interested in enrolling in this study, please contact Phyllis Brown www.ucsf.edu ---------------------------------------------------------------------- Valacyclovir prophylaxis to prevent recurrent herpes at delivery: a randomized clinical trial. Sheffield JS, Hill JB, et al. Obstetrics and Gynecology, July 2006, 108(1):141-7. Department of Obstetrics & Gynecology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-9032,USA. Jeanne.Sheffield@utsouthwestern.edu OBJECTIVE: To measure the efficacy of valacyclovir suppression in late pregnancy to reduce the incidence of recurrent genital herpes in labor and subsequent cesarean delivery. METHODS: A total of 350 pregnant women with a history of genital herpes were assigned randomly to oral valacyclovir 500 mg twice a day or an identical placebo from 36 weeks of gestation until delivery. In labor, vulvovaginal herpes simplex virus (HSV) culture and polymerase chain reaction (PCR) specimens were collected. Vaginal delivery was permitted if no clinical recurrence or prodromal symptoms were present. Neonatal HSV cultures and laboratory tests were obtained, and infants were followed up for 1 month after delivery. Data were analyzed using chi2 and Student t tests. RESULTS: One hundred seventy women treated with valacyclovir and 168 women treated with placebo were evaluated. Eighty-two percent of the women had recurrent genital herpes; 12% had first episode, nonprimary genital herpes; and 6% had first episode, primary genital herpes. At delivery, 28 women (8%) had recurrent genital herpes requiring cesarean delivery: 4% in the valacyclovir group and 13% in the placebo group (P = .009). Herpes simplex virus was detected by culture in 2% of the valacyclovir group and 9% [corrected] of the placebo group (P =.02). No infants were diagnosed with neonatal HSV, and there were no significant differences in neonatal complications. There were no significant differences in maternal or obstetric complications in either group. CONCLUSION: Valacyclovir suppression after 36 weeks of gestation significantly reduces HSV shedding and recurrent genital herpes requiring cesarean delivery. Dr. H. Comments: This study follows on with previous evidence that acyclovir could reduce the need for caesarian section in women with herpes. So, now two similar drugs are available to reduce the need for caesarian section in women with herpes who are pregnant. Note that there were no cases of neonatal herpes infections in either the placebo or the study drug group. Remember that women with their first herpes outbreaks during the last trimester of pregnancy must be monitored very carefully to decrease the risk of transmitting the virus to the fetus. For any other questions, contact Dr. H at HERPES.ORG THIS PAPER WILL BE UPDATED AT PERIODIC INTERVALS AS SCIENTIFIC LITERATURE, APPROVED THERAPIES, AND FEEDBACK FROM USERS OF THIS SITE SUGGEST NEW INFORMATION THAT SHOULD BE CIRCULATED. HERPES.ORG DOES NOT PURPORT TO ESTABLISH A PHYSICIAN-PATIENT RELATIONSHIP. ALL TREATMENT DECISIONS SHOULD BE MADE BETWEEN A PATIENT AND HIS/HER PRIVATE PHYSICIAN. NO TREATMENTS SHOULD BE ATTEMPTED WITHOUT A FIRM AND CONVINCING DIAGNOSIS OF THE CONDITION BEING TREATED.