Debate: This house believes that genital herpes is managed optimally by the use of episodic rather than suppressive therapy: for the motion

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Debate: This house believes that genital herpes is managed optimally by the use of episodic rather than suppressive therapy: for the motion

Presented by: George Kinghorn. Royal Hallamshire Hospital, Sheffield, UK.

Herpes simplex virus (HSV) infections are ubiquitous and affect a majority of the adult population worldwide. Most are unaware of having been infected. For those who develop primary episodes of genital herpes, which in the UK is equally likely to be due to HSV-1 as by HSV-2, episodic treatment is indicated and will shorten the illness significantly. Continuation of suppressive treatment thereafter has no impact upon the natural history of disease.

Of those with established infection, only a minority will be aware of symptomatic infection and only a small proportion of the symptomatic will have very frequent recurrences. Many recurrences require no more than symptomatic treatment. For those who experience significant local or systemic symptoms, selfinitiated episodic treatment shortens the attack.

Thus, optimal treatment for the vast majority of patients infected with HSV is episodic rather than suppressive. The prevention of transmission of HSV infection within populations will require the development of an effective prophylactic vaccine and cannot be effected by antiviral treatment alone.


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Last Updated : 01/12/2006 16:22:48