Re: 10 day herpes cure

THIS IS VERY TRUE..I found an article about a case study using this therapy and it works. here is the website......http://www.medscape.com/viewarticle/520252....
Also here is the article:

Very Short-Course Antiviral Therapy for HSV-2: An Expert Interview With Fred Aoki, MD
Posted 12/28/2005


Editor's Note:
Experts have reported that the annual incidence of new genital herpes infections in the United States is greater than that of all other sexually transmitted infections combined. The infection creates a number of physical and psychological concerns for patients, and it can increase the risk for HIV infection and cause serious clinical complications to a fetus/newborn during pregnancy or delivery. Antiviral therapy has been shown to decrease viral shedding and symptoms associated with the disease, as well as transmission of HSV-2 between sexual partners. At the 45th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), held in Washington, DC, December 15-19, 2005, Dr. Fred Aoki, Member, Section of Infectious Diseases, Health Sciences Centre; Professor of Medicine, Medical Microbiology, Pharmacology, and Therapeutics, University of Manitoba, Winnipeg, Manitoba, Canada, presented new data from a large prospective study that evaluated the efficacy and safety of a very short course of patient-initiated antiviral therapy. He agreed to speak with Medscape about his study findings.

Medscape: This morning at ICAAC, you reported results from a large prospective study[1] that evaluated the efficacy and safety of 1 day of patient-initiated famciclovir therapy for immunocompetent patients with onset of prodromal symptoms or genital herpes lesions. First, how does this famciclovir dosing schedule differ from that normally recommended for episodic treatment of genital herpes outbreaks for this agent and other antivirals?

Dr. Aoki: This dose, which was 1000 mg twice a day, is bigger than the conventional regimen for famciclovir, which is 125 mg twice a day for 5 days. There is a 2-day acyclovir regimen that's been shown to be effective that involves 800 mg 3 times a day for 2 days. There are standard regimens approved by the FDA for valacyclovir that involve 500 mg twice a day for 3 days. Going back to the 1980's, the first course that was approved was acyclovir 200 mg 5 times a day for 5 days. In a relative sense, what we're seeing is a progressive shortening of the duration of therapy without an apparent loss of efficacy. We're now down, with this regimen of famciclovir, to a single-day treatment.

Medscape: You described the rationale for the single-day treatment in the study this morning. The herpes viral load is highest at onset of symptoms, which is why your team thought that 1 day of treatment might be efficacious, correct?

Dr. Aoki: We extrapolated from the elegant studies of Dr. Spruance,[2] who looked at the time course-excretion of the virus from cold sores. He demonstrated that in cold sores the virus is only increasing in the sores over the first 24 hours. After that, the natural defense of the body actually makes the virus disappear on its own. Therefore, if the drug is going to work by stopping the virus, it could really only contribute to shortening the course of the recurrence if one introduced it very early in the first 24 hours. So that's the virologic explanation of why famciclovir ought to be effective if given early.

The other reason is that we know that famciclovir persists as an active molecule [the famciclovir triphosphate] for quite a long time within the cells that are infected. Thus, even though we stop the medicine after 2 doses, there is some enduring antiviral effect inside infected cells for well beyond that 24-hour period.

Medscape: What were the most important findings of your study?

Dr. Aoki: There were 4 important findings from the study. First, this course of famciclovir hastened the resolution of symptoms. It made people feel better by about 30% faster on average for any given symptom. Second, it caused recurrences to abort: It tripled the number of instances in which people sensed they were about to have a recurrence, which then didn't go on to progress or to blister. Third, in those people who went on to develop blisters, it shortened the duration of the blisters by about almost 2 days. Finally, this particular regimen of famciclovir was well tolerated and safe.

Medscape: So this is a very effective regimen. But your findings have additional implications for clinicians in terms of patient education, as early intervention would be required. What are your suggestions in this regard?

Dr. Aoki: This research study will further enable doctors who look after patients with recurrent genital herpes further empower patients to treat themselves. This involves helping patients understand how and when they should start the drug, and giving the patient a prescription that they fill on their way home, which gives them medicine that they carry in their pocket in anticipation of the next episode. They should have instructions to start the medication at the earliest inkling of a recurrent symptom. That's the way in which this study can be practically useful for both patients and their doctors. I think patients will benefit, and physicians will also benefit by getting better results for their patients.

Medscape: Did you observe any drawbacks or risks associated with this 1-day treatment course compared with other episodic treatment schedules for HSV-2?

Dr. Aoki: We couldn't say with certainty, because this was a study in which we only compared 2 doses of placebo vs 2 doses of famciclovir. So I can't say how it compares to any other regimen. I think we have to acknowledge that there was a trend towards more headaches in people who took this dose of famciclovir than among those who took placebo. Some patients may find that that's very acceptable given the very good benefits.

Medscape: Let's move on to a broader context for your study. Some experts have identified genital herpes as the most prevalent STD in the United States. In what particular demographic groups in terms of race, gender, etc, do we see a greater prevalence of HSV-2?

Dr. Aoki: There are very good data on this from the NHANES (National Health and Nutrition Examination Surveys) study.[3,4] This is the big national survey done in a representative sample of Americans, and it's clear that there are differences between genders and between races as well. Women are, across races, more commonly infected with HSV-2, and across races, blacks also demonstrate a higher prevalence of HSV-2 infection than do whites.

Medscape: Do you find that most patients with HSV-2 are aware of their infection before they are diagnosed? And if so, do patients more often choose to forego therapy altogether or do they generally prefer episodic or suppressive antiviral therapy?

Dr. Aoki: I think we have to accept that, given the serologic surveys, that the majority of people who have genital herpes infection are unaware that they have the infection. The proportion of people whose blood tests showed they have antibodies of HSV-2 who ever admit to experiencing symptoms compatible with genital herpes ranges from 10% to 35%. In other words, of all the people who have serologic evidence of infection, 65% to 90% of them have only serologic evidence of infection. They don't have symptomatic disease. So the vast majority of patients aren't aware of their infection. Among patients who get symptoms, I think there's an increase in awareness of what constitutes genital herpes, so that people are more able, based on that [awareness], to refer themselves to a doctor to seek help. But the vast majority of people are simply unaware that they have the infection.

Medscape: What do you think is the patient preference in terms of episodic or recurrent antiviral therapy?

Dr. Aoki: I think it depends on the patient population. The average patient experiences 4 recurrences of genital herpes a year. For them, I think the preference probably is for episodic treatment because it's discrete, it's limited, and it's economically probably preferable. For individuals who have frequently recurring disease, which is arbitrarily defined as those who have more than 6 recurrences a year or 1 recurrence more than every 2 months, studies show that there is a preference for suppressive treatment.

Medscape: For patients who do choose to forego therapy altogether or treat episodically, what is the efficacy of condoms in preventing HSV-2 transmission?

Dr. Aoki: There have been studies showing that condoms do reduce the transmission of genital herpes.[5] The effect seems to be more certain in preventing transmission from men to women than in preventing transmission from women to men and depends in part on the compliance of the individual in using condoms in the way they are supposed to be used.

But I think there's a definite effect [of using condoms], and when we add that effect to what drugs can provide, we've got a reasonable set of preventative measures that can help people protect themselves and their partners.

Medscape: There's obviously overlap in terms of the clinical symptoms of a genital herpes outbreak, so it's often misdiagnosed. In your clinic, what is currently the preferred method to diagnose genital herpes? Do you use swab testing or serologic testing, and what are the pros and cons of each approach?

Dr. Aoki: In my practice I depend primarily on culture as the definitive diagnostic method. There's no doubt that a positive culture is definitive, and one simply can't deny the diagnosis if it's proved by culture. The value of it, in my practice, has been that it has forced my patient and me to simply deal with reality and move on with planning the management of what is, undoubtedly, proven disease. Type-specific serologic testing has a place, however.

I currently depend upon a Western blot assay if I'm going to do serologic testing. This helps ascertain whether or not a person has got HSV-2 or HSV-1. The role of non-Western blot serologic assays is perhaps limited by availability and by some uncertainties in terms of sensitivity and specificity. So they are useful, but they're less gold standard than culture and less certain than Western blot serologic testing.

References
Aoki F, Tyring S, Diaz-Mitoma F, Gao J, Hamed K. Patient-initiated high-dose oral famciclovir for 1 day shortens the duration of recurrent genital herpes lesions. Program and abstracts of the 45th Interscience Conference on Antimicrobial Agents and Chemotherapy; December 15-19, 2005; Washington, DC. Abstract V-1389.
Spruance SL, Overall JC Jr, Kern ER, Krueger GG, Pliam V, Miller W. The natural history of recurrent herpes simplex labialis: implications for antiviral therapy. N Engl J Med. 1977;297:69-75.
Fleming DT, McQuillan GM, Johnson RE, et al. Herpes simplex virus type 2 in the United States, 1976 to 1994. N Engl J Med. 1997;337:1105-1111.
US Centers for Disease Control and Prevention. NHANES III data files. Series 11, Number 1A. Available at:
http://www.cdc.gov/nchs/about/major/nhanes/nh3data.htm.
Accessed April 5, 2005.
Wald A, Langenberg AG, Link K, et al. Effect of condoms on reducing the transmission of herpes simplex virus type 2 from men to women. JAMA. 2001;285:3100-3106.