Reducing Genital Herpes Transmission Using Antiviral Therapy.

Abstract

Introduction: Herpes simplex virus (HSV) type 1 or 2 can cause chronic genital viral infections, most of which are asymptomatic [1,2]. HSV-2 is the more likely of the two types to cause genital herpes (GHSV) and is more commonly associated with recurrent clinical infection than is HSV-1. HSV-2 is now the leading cause of genital ulcer disease worldwide [3]. For example, in the United States there are approximately 1.6 million new cases each year against a background prevalence of 22% in adults [4]. When coupled with the association of genital ulcer disease with the acquisition and transmission of HIV infection, these high incidence and prevalence rates [5,6] represent a public health imperative to identify effective mechanisms to prevent transmission. Although it is known that acyclovir, its prodrug valacyclovir, and other antivirals can reduce clinical recurrence of GHSV [7] and asymptomatic viral shedding [8], it is unknown if this observed reduction translates into reduced risk for sexual transmission of the virus.