Genital herpes can reactivate despite high-dose antiviral therapy

Discussion in 'Your Living Room' started by Vicki615, May 8, 2014.

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  1. Vicki615

    Vicki615 New Member

    Those of us on Avs know that they don't work well all the time and better Avs need to be developed:[tt_news]=176612&cHash=75ffc802cc5fb70e54085e7885c2bd9c

    The antivirals aciclovir and valaciclovir are clinically effective,
    a new study confirms—but they do not prevent shedding
    of the virus, even at a high dosage

    February 2012 · Vol. 24, No. 2

    Janelle Yates,
    Senior Editor

    A study of antiviral therapy to treat herpes simplex virus type 2 (HSV-2) demonstrated that the virus can reactivate in “breakthrough episodes” even when doses of antiviral therapy are high.

    The study, published last month in The Lancet, combined three trials:
    •In Trial 1, participants were randomized to standard-dose aciclovir (Zovirax, Zovir, etc.) (400 mg twice daily) or no medication for 4 weeks, followed by a 1-week wash-out period and crossover to the opposite group for another 4 weeks.
    •In Trial 2, participants were randomized to standard-dose valaciclovir (Valtrex) (500 mg daily) or high-dose aciclovir (800 mg three times daily) for 7 weeks, followed by a 1-week wash-out period and crossover to the opposite group for 7 additional weeks.
    •In Trial 3, subjects were randomized to standard-dose valaciclovir or high-dose valaciclovir (1 g three times daily) for 5 weeks, followed by a 1-week wash-out period and crossover to the opposite group for 5 additional weeks.1

    All three trials demonstrated that short episodes of subclinical shedding persist with both standard-dose and high-dose aciclovir and valaciclovir. Although shedding of HSV-2 decreased 50% in participants who took the highest dose of valaciclovir, compared with standard-dose valaciclovir, the rate of breakthrough shedding did not change—about 16 to 20 episodes every year.

    “Despite the increased use of antiviral therapy in the past two decades,” the authors observe, “the prevalence of, and complications from, HSV-2 infection have changed little.”

    “Daily antiviral therapy,” they go on to say, “reduces genital lesions and suppresses detection of HSV on genital mucosal surfaces (shedding),” but daily valaciclovir reduces the risk of sexual transmission by only 48%. Furthermore, aciclovir does not reduce the risk of HIV transmission or acquisition, which is heightened in people who have HSV-2.

    “The discrepancy between potent suppression of clinical symptoms and failure of antiviral agents to fully prevent HSV transmission is not well understood. Intensive genital secretion collection shows that HSV shedding episodes are three times more frequent than was previously realized.”
  2. vasu

    vasu New Member

    Very interesting. Even when Famciclovir was working for me back in 2009, I got a few episodes of CH while taking it, and always wondered why.
  3. Angelea

    Angelea New Member

    Also important to remember that there are several classes of herpes virus and different AVs, dosages, and administration methods (oral vs IV) are required to effectively treat them.
  4. Philosopher

    Philosopher New Member

    Bottom line is when you take a medication chronically and for extended periods of times it loses its effectiveness as the body becomes accustomed to it. Look at the anti-biotic crisis taking place. Due to over-prescription for many years, scientists now claim that in about 10 years new strains of bacteria resistant to anti-biotics will plague the western world. I am sure the same is happening with anti-virals.
  5. Brownrecluse

    Brownrecluse New Member

    It is good of you to post this Vicki. I went through three rounds of different AVs for Menieres None worked. One made it worse. The heaviest was a month on 2000mg of acyclovir a day. I also did a heavy round of Prednisone as an experimental treatment. Not only made my MM much worse, almost made me psychotic (not sure I am not in any event, LOL, just because of MM.)

    But, I hasten to add, AVs DO work for some of us. Sadly, especially for most on this forum who have SEVERE MM in different forms, we are all unique little guinea pigs. We just have to keep trying stuff until something works or we die. Not to be depressing, just to emphasize that MM affects each of us in different ways, in terms of symptoms suffered, degree, and duration. Among other variables.

    We try to live with it as best we can. I am pretty much where I expect to me. Having already had a laby, even getting the hearing back in my badly deafened right ear would not restore me to normal life unless it took care of the severe vertigo (four broken ribs in the last seven months from falls and counting), the sometimes unendurable tinnitus, the brain fog, the eye issues, the horrible sound sensitivity. There is no magic bullet anyone has found. I hope for future generations of MM sufferers, they do some day. Including as many readers of this board as possible.

    May all of you reach the day when you no longer need to post here, except to support other sufferers, as JOH and others who have managed to beat this monster do.
  6. Vicki615

    Vicki615 New Member

    Hi Brownrecluse,
    I am not sure if you every tried antifungals, but antifungals have a warning not to take any steroids it will make symptoms worse. So if anyone gets worse on a steroid they may want to try an antifungal..just a thought
  7. Vicki615

    Vicki615 New Member

    sorry correction If you have a fungal infection a steroid will make it worse..

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