I read on AOL WebMD today, health section, article August 29, 2003 -
titled: "Valtrex Approved for Herpes Prevention" - WebMD Medical News
Archive  Reviewed By Michael Smith, MD
 
Question/Issue:  I am trying to find more information about the drug
Valtrex [or any new drug] being now able to "prevent the spread of
herpes".  I googled this and nothing came back.  NOT necessarily info
on the drug "Valtrex", BUT ON THE FACT that it NOW can "prevent" the
spread of herpes.

You see, as far as I knew, there was not a drug on the market that
could "prevent the spread of herpes."

Your help would greatly be appreciated!!

Thanks!!!!!!!!!!
Date of approval: Aug. 29, 2003. 


What is approved: The FDA has approved a new use for Valtrex (generic:
valacyclovir). Valtrex reduces the risk of heterosexual transmission
of genital herpes. When taken by a person infected with herpes simplex
virus it makes it harder for that person to infect their sex partner.

Hello edloe1,
 
  The first line of the Aol WebMD site tells it all:
?Valtrex reduces the risk of heterosexual transmission of genital
herpes. When taken by a person infected with herpes simplex virus it
makes it harder for that person to infect their sex partner.?
The word ?reduces? is pivotal here! Valtrex does seem to greatly
reduce the transmission, but it is no magic bullet! It can not promise
to completely prevent the transmission of herpes.
http://aolsvc.health.webmd.aol.com/content/article/73/81983.htm

  If I may digress from herpes transmission for a moment -- A few
years after the spread of HIV/AIDS became so prevalent, most of my
hospital colleagues were somewhat worried about dirty needle sticks.
We were told not to worry, as even if we were stuck with an infected
needle, our chances of contracting HIV was 1 in 200. I don?t know
about you, but those odds are frightening to me. OSHA then mandated
that we observe ?Universal Precautions?. This meant we were to assume
ALL patients and specimens were HIV and/or Hepatitis positive. We were
to take precautions as if each patient could infect us. This makes
sense, since often one does not know who is harboring an infectious
disease. I would apply this kind of thinking to being exposed to a
herpes infected person, even on Valtrex.

  While the studies on Valtrex seem promising, it is not totally
effective. It will NOT completely prevent spreading the herpes virus
to a partner.  The current medical advice is to still use condoms and
to advise any partners of the presence of herpes. Even though the
WebMD report says partners of the herpes infected participants gave
their partners a herpes infection 48% less than those not taking
Valtrex, that number would not be high enough for me. WebMD states
?Study participants taking Valtrex gave the infection to their
partners 48% less often than those getting a placebo.?

  Valtrex is not without benefits however, although touting it as a
drug that will *prevent* the spread of herpes seems erroneous. I
noticed that no where (that I could find) on the GlaxoSmithKline site,
the makers of Valtrex, was found the claim that Valtrex *completely
prevents* the transmission of herpes.

  As a suppressive therapy, Valtrex ?can? prevent or lessen outbreaks
in an infected person. Using Valtrex as a suppressive treatment where
one of a couple has the infection and the other is herpes-free,
particularly if they have had unprotected sex already, may prove
useful. One of two beneficial aspects of the drug that I don?t see
mentioned in the WebMD article, would be a great decrease in the
spread of herpes through non-sexual viral shedding, such as on shared
clothing and towels. The other would be to get more people tested for
herpes. Because, as you will read further on, many cases of herpes are
asymptomatic.

One warning: Valtrex is meant for patients already infected, and not
to be taken prophylactically to prevent getting infected.
?Valtrex is approved for use only by individuals with genital herpes.
There is no indication that it has any efficacy as a preventative
medication, so the uninfected partner should not take it.?
And importantly ?It's important to remember that Valtrex reduces, but
does not eliminate, the risk of transmission.?
http://www.goaskalice.columbia.edu/2492.html

?The drug is not 100 percent effective at preventing transmission, so
people with herpes should still tell potential partners about their
infection, emphasized Dr. Anna Wald, medical director of the UW
Virology Research Clinic and co-author of the study.?
http://seattletimes.nwsource.com/html/health/2001827633_herpes01m.html

http://admin.urel.washington.edu/uweek/archives/issue/uweek_story_small.asp?id=1591

?Most people who have HSV-2 infection are unaware that they have it.
Only about 20% of those infected with HSV-2 have symptoms that are
recognized as genital herpes. Most do not recognize the symptoms. Much
of this lack of recognition is due to the unfamiliarity with the signs
and symptoms of herpes which are often mild and are easily confused
with other conditions.?
http://www.herpesdiagnosis.com/guidelines.html

This is the article you mention in your question.
AOL WebMD
http://aolsvc.health.webmd.aol.com/content/article/73/81983.htm
And an older version
http://my.webmd.com/content/article/79/96057.htm

The GlaxoSmithKline site, found here, 
http://www.gsk.com/products/prescriptionmedicines.jsp#medicines 
(Click the word ?Valtrex?) states the following on Page 7  ?When
VALTREX is used as suppressive therapy in immunocompetent individuals
with genital herpes, the risk of heterosexual transmission to
susceptible partners is reduced. Safer sex practices should be used
with suppressive therapy?



http://www.gsk.com/products/prescriptionmedicines.jsp#medicines
Then click on ?Valtrex?. (I am unable to give you a link, as the
document is in a pop-up window.)
This document does NOT state anywhere that Valtrex will PREVENT
transmission of the herpes virus.
http://www.gsk.com/products/prescriptionmedicines.jsp#medicines

National Institutes of Health:
NIH says ?How can I protect myself or my sexual partner?
If you have early signs of a herpes outbreak or visible sores, you
should not have sexual intercourse or oral sex until the signs are
gone and/or the sores have healed completely. Between outbreaks, using
male latex condoms during sexual intercourse may offer some protection
from the virus. When used with these precautions, Valtrex can also
help prevent infecting your partner during heterosexual sex.

Additionally ?other researchers are devising methods to control the
virus' spread. Two important means of preventing HSV infection are
vaccines and topical microbicides. Several different vaccines are in
various stages of development. These include vaccines made from
proteins on the HSV cell surface, peptides or chains of amino acids,
and the DNA of the virus itself.
NIAID and GlaxoSmithKline Biologicals are supporting a large clinical
trial in women of an experimental vaccine that may help prevent
transmission of genital herpes. The trial is being conducted at more
than 20 sites in 15 states nationwide.
Topical microbicides, preparations containing microbe-killing
compounds, are also in various stages of development and testing.
These include gels, creams, or lotions that a woman could insert into
the vagina prior to intercourse to prevent infection.?
http://www.niaid.nih.gov/factsheets/stdherp.htm

The study above, mentioned also on this AEGIS site  
http://www.aegis.com/news/ap/2002/AP020929.html
is discussed more in depth, concluding that ?Just half of 1 percent of
those whose infected partners took Valtrex got herpes sores, compared
with 2 percent in the comparison group.?

This site also discusses Valtrex?s ability to *help* prevent the
transmission of the herpes virus ?"Valtrex reduces the risk of
heterosexual transmission of genital herpes to susceptible partners
with healthy immune systems when used as suppressive therapy in
combination with safer sex practices," the FDA said in a statement.?
And ?The FDA said a study of 1500 monogamous, heterosexual couples
showed that, over 8 months, patients who took Valtrex were 48% less
likely to pass the virus to their partners.?
http://www.journals.uchicago.edu/CID/journal/news/030908-4.text.html

http://www.pharmacist.com/articles/h_ts_0446.cfm


Herpes Vaccine
Not an oral drug, but the herpes vaccine seems to be the most
promising way to prevent the spread of herpes virus in the near
future. The vaccine will be only for females, however.

NIH HerpeVac Trials
?What is known about the effectiveness of the herpes vaccine?
Among the 7,400 subjects in earlier studies, the vaccine was shown to
decrease the risk of developing symptomatic HSV infection in women who
were not previously infected with herpes simplex. For these women, the
risk of contracting genital herpes and developing symptoms was reduced
by about three quarters. The risk of developing antibodies to herpes
(representing infection) was reduced by about 40%. Unfortunately,
however, women who were already infected with herpes simplex virus
type 1 (HSV-1), the usual cause of cold sores, did not benefit from
the herpes vaccine in these earlier studies, and the vaccine was not
effective in men.?
http://www.herpesvaccine.nih.gov/dmid/stds/herpevac/studyover_faqs.htm#1
Home Page
http://www.herpesvaccine.nih.gov/dmid/stds/herpevac/

??This vaccine may prove to be the first vaccine of any sort to
prevent a sexually transmitted disease,? Dr. Heineman says. Early
studies suggest it only works in women and that it?s effective 75
percent of the time.?
http://www.ivanhoe.com/channels/p_channelstory.cfm?storyid=6969

http://www.cnn.com/2002/HEALTH/11/20/herpes.vaccine/

GlaxoSmithKline is working on the herpes vaccine too.
http://www.nih.gov/news/pr/nov2002/niaid-20.htm

?The vaccine will not be available commercially for at least five
years but already some doctors believe all girls should be given the
vaccine along with the other childhood vaccines.?
http://www.cnn.com/2002/HEALTH/11/20/herpes.vaccine/

Hopefully, this answer has answered your question to your
satisfaction. If not, or if any part of this answer is unclear, please
request an Answer Clarification, before rating. This will enable me to
assist you further, if possible.

Regards,
crabcakes


Search Terms
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preventing herpes
drug research herpes prevention

Your answer was SUPERIOR!!  Super job --- thank you very much for your
work and time, this is great info.  Now, I need to re-read!  Thanks.

Thank you edloe, for the 5 star rating and generous tip! Both are appreciated!
Sincerely,
crabcakes

Valacyclovir (Valtrex) is a chemically modified version of the older
drug Acyclovir.  Once ingested, Valacyclovir is converted on first
pass by the intestine and liver into acyclovir.  Otherwise said, soon
after a pill of Valtrex is swallowed, the body will change nearly 100%
of the drug into acyclovir.  Supposedly, Valacyclovir has better oral
absorption and higher, more prolonged blood concentrations than oral
acyclovir, but experimental trials fail to find a difference in the
effect that each drug provides.

Each drug can significantly shorten the time that someone is actively
shedding virus (the time in which someone is contagious).  In
addition, the time until lesions (cold sores) heal is also shortened
by a couple of days.  Also the drugs significantly decrease the
likelihood that someone will have a recurrence of lesions if taken
prophylactically.  Usually these drugs are only prescribed if you have
a problem of frequent out breaks, but you need to speak to your
physician.

You should note that the term "herpes" covers a fairly wide range of
viruses from the cause of chickenpox and shingles (Varicella Zoster
Virus) to the causes of oral and genital herpes (both can be caused by
Herpes Simplex Virus (HSV) 1 or 2, though the HSV1 usually causes the
oral version, and HSV2, the genital version).

The phrase "prevents the spread of Herpes" may lead you to believe
that Valtrex offers an absolute protection from transmission of
herpes.  This is not the case.  This drug is nothing new in antiviral
therapy.  It lowers the chances one has of being contagious for as
long as one is taking it, but open cold sores will still be
infectious.  Additionally people may still go through times in which
they are infectious and not know it.

If you are interested in how Valtrex can lower one's chance of
spreading herpes, it is because acyclovir makes it difficult for the
virus to make copies of iteslf.  The fewer virus copies produced, the
less chance of transmission and the easier job the body has of keeping
the virus quiescent.  That is the theory anyway.

As always speak to your physician before making any medical decisions.

Sites:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15378428

http://rxlist.com/cgi/generic3/valacyclovir_ids.htm

http://www.emedicine.com/ped/topic995.htm

http://www.emedicinehealth.com/articles/17311-2.asp

thanks crabcakes for adding this additional info... ya see I have had
herpes since age 22, am 34 now, have learned to live with it... but I
have a girlfriend who is only 25 and very, very afraid of "catching"
it... I have been trying to find all the info I can on "prevention"
and what if any "cures" are out there... AND how to calm her fears --
its sucks, but such is LIFE.

Thank you for all your work, again APPRECAITED. :)

If you can add any additional research or point me in another
direction, I'd add $ to my account!! :)