Randomized, double-blind, placebo-controlled, patient-initiated study of topical high- and low-dose interferon-alpha with nonoxynol-9 in the treatment of recurrent genital herpes

Article Abstract:

There are two types of herpes simplex virus (HSV), type 1 (HSV-1) and type 2 (HSV-2). HSV-1 is common and produces fever blisters or cold sores on or around the mouth. HSV-2 is sexually transmitted and produces lesions on the genital organs. Herpes is difficult to treat because it has a high rate of recurrence. The antiviral agent acyclovir has had limited success in treating recurrent HSV infections. In animal studies, interferon-alpha increased the survival of animals with HSV-2 infection. Topical application of interferon has allowed the use of higher doses than could be used systemically because of the systemic toxicity associated with the substance. To test the effectiveness of topical interferon-alpha in treating recurrent genital herpes, 188 patients with HSV-2 positive cultures received high- or low-dose topical applications of interferon-alpha. The interferon was in a gel made of methylcellulose and nonoxynol-9, and was applied three times a day for five days. In the high-dose group, an average of 2.5 days of drug therapy were required until patient culture samples tested negative for HSV-2 infection. In the placebo group (receiving methylcellulose gel with no interferon), an average of 3.9 days of drug therapy were required until patient culture samples tested negative for HSV-2. This effect of interferon was related to the dose administered. The antiviral effects of the drug treatment were more prominent in men than in women. The placebo group had symptoms of HSV-2 for an average of 3.7 days, while the high-dose interferon group had symptoms averaging 2.7 days. The reduction in the duration of symptoms was more pronounced among women. It is concluded that early topical interferon in high doses is an effective treatment for patients with recurrent genital herpes. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Dosage and administration, Interferon alpha, Nonoxynol 9

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Randomized, double-blind, placebo-controlled, clinic-initiated, Canadian multicenter trial of topical edoxudine 3.0 % cream in the treatment of recurrent genital herpes

Article Abstract:

Herpes simplex virus type 2 (HSV) is the virus that causes genital herpes. This infection can be transmitted through sexual contact and is a major public health concern. Primary infections tend to be the most severe, but recurrent infections are common. At the present time, oral acyclovir is the only medication approved for the treatment of recurrent herpes infections. However, in a recent study, patients with genital herpes showed a favorable response to treatment with interferon-alpha applied directly to the skin. Another drug, called edoxudine, has been shown to kill HSV in laboratory animals. This articles describes the results of a study designed to evaluate the effectiveness of a 3.0 percent topical cream containing edoxudine in treating patients with recurrent genital herpes. During the course of the study 102 patients were treated with edoxudine (six times a day for five days) and 97 were treated with a placebo cream. Treatment with edoxudine reduced viral shedding (the amount of virus) and healed the skin lesions faster than treatment with the placebo cream. In women, treatment with edoxudine reduced the formation of new skin lesions and relieved tenderness. Treatment with edoxudine was well tolerated and produced few side effects; itching and burning sensations were reported by eight subjects. These results demonstrate that edoxudine cream has antiviral activity against HSV; patients with recurrent genital herpes may benefit from this treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects

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Patient-initiated, twice-daily oral famciclovir for early recurrent genital herpes: a randomized, double-blind multicenter trial

Article Abstract:

Patient-initiated famciclovir appears to be effective in healing the lesions of genital herpes and reducing viral shedding. A total of 467 people with recurrent genital herpes were taught to culture their lesions at the first sign of an outbreak and to begin treatment with various dosages of famciclovir or a placebo. Famciclovir was significantly better than placebo in reducing viral shedding, symptoms and the time it took the lesions to heal. The twice-daily dosages ranged from 125 to 500 milligrams and higher doses provided no benefit over smaller doses.

Evaluation, Antiviral agents

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