Herpes simplex asymptomatic shedding: Difference between revisions
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{{CMG}}, '''Associate Editor(s)-In-Chief:''' {{CZ}}; [[Lakshmi Gopalakrishnan, M.B.B.S.]] | {{CMG}}, '''Associate Editor(s)-In-Chief:''' {{CZ}}; [[Lakshmi Gopalakrishnan, M.B.B.S.]] | ||
Revision as of 21:49, 15 September 2011
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Herpes simplex Microchapters |
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Patient Information |
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Classification |
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Herpes simplex asymptomatic shedding On the Web |
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Risk calculators and risk factors for Herpes simplex asymptomatic shedding |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Lakshmi Gopalakrishnan, M.B.B.S.
Overview
HSV asymptomatic shedding occurs at some time in most individuals infected with herpes.
Frequency of Viral Shedding
- Asymptomatic shedding can occur more than a week before or after a symptomatic recurrence in 50% of cases. However, it is believed to occur on 2.9% of days while on antiviral therapy, versus 10.8% of days without and is estimated to account for one third of the total days of viral shedding.[1]
- Asymptomatic shedding is more frequent within the first 12 months of acquiring HSV, and concurrent infection with HIV also increases the frequency and duration of asymptomatic shedding.[2]
- There are some indications that some individuals may have much lower patterns of shedding, but evidence supporting this is not fully verified - no significant differences are seen in the frequency of asymptomatic shedding when comparing persons with 1 to 12 annual recurrences to those that have no recurrences.[1]
Treatment
Aciclovir, famciclovir, and valaciclovir all suppress symptomatic and asymptomatic viral shedding. These drugs have been shown in clinical trials to reduce asymptomatic HSV shedding by about 80% to 90%. Although the threshold for infection from asymptomatic shedding has not been established, small studies have shown that valaciclovir appears to suppress asymptomatic shedding better than famciclovir. Aciclovir (400 mg twice daily) has been shown to suppress asymptomatic shedding at least as well as valaciclovir (1000 mg daily).
References
- ↑ 1.0 1.1 Leone P (2005) Reducing the risk of transmitting genital herpes: advances in understanding and therapy. Curr Med Res Opin 21 (10):1577-82. DOI:10.1185/030079905X61901 PMID: 16238897
- ↑ Kim H, Meier A, Huang M, Kuntz S, Selke S, Celum C, Corey L, Wald A (2006). "Oral herpes simplex virus type 2 reactivation in HIV-positive and -negative men". J Infect Dis. 194 (4): 420–7. PMID 16845624.