Herpes; drug eases symptoms, but still no cure - acyclovir

FDA Consumer, April, 1985 by Bill Rados

There is no consensus on whether the use of condoms helps reduce the risk of transmitting or catching herpes.

The virus can also be transmitted when a person touches herpes sores on his or her own body and then touches another site, such as the mouth, eyes or a break in the skin. Therefore, it is important to avoid touching the sores whenever possible, and to wash ones hands immediately afterward if sores are touched.

In fact, good personal hygiene, good nutrition, and plenty of rest are essential in helping patients recover from active outbreaks of herpes, so that the body's natural defenses can fight the virus. The affected area should be kept clean and dry. Bathing with soap and water and using a drying agent such as epsom salts may help relieve the pain and itching and hasten healing.

An active genital herpes infection during pregnancy is a cause for special concern. Some studies have shown that women with such infections run a greater risk of spontaneous abortion. Aso, about 90 percent of cases of herpes in newborns can be traced to infection from the mother, usually during the baby's passage through an infected birth canal. An infant delivered vaginally during an active case of genital herpes in the mother has a 40 to 50 percent chance of being infected. The chances for a baby so infected aren't good. Some 50 to 60 percent of newborns with herpes simplex infections die, and half to two-thirds of the survivors suffer permanent visual or neurological damage.

Until recently, it was generally recommended that a woman with a history of herpes infections deliver by Caesarean section to reduce the chance of the baby being infected. However, the Committee on Infectious Diseases of the American Academy of Pediatrics has determined that if weekly testing during the pregnancy shows no sign of active infection during the two weeks before delivery, and if the membranes have been ruptured for less than four to six hours, the mother can deliver vaginally with a high degree of safety. Recently, scientists at the National Institutes of Health have developed a test that can provide more rapid detection--one day compared to a week for other methods--of an active herpes infection, Allowing closer monitoring of pregnant women as they near the time of delivery.

Women with genital herpes also appear to have an increased risk to developing cervical cancer. Since this form of cancer can be cured if detected early, women with genital herpes should have routine cervical cancer checks (Pap smears), preferably twice a year.

Until the approval of oral acyclovir in January 1985, the intravenous and ointment forms of the medication were the only drugs approved by FDA as safe and effective for treating outbreaks of genital herpes. The ointment was approved in March 1982 for treating initial episodes of the disease. In studies of the ointment, female patients with initial infections had faster healing of sores and reduced viral growth. There was, however, no significant decrease in the pain associated with the disease in women. In men using the ointment for initial infections, studies showed a significant decrease in the healing time of sores and in the pain. In both men and women with recurrences of the disease, acyclovir ointment showed no important benefits.