International Herpes Week 2007 (29th July–4th August 2007)

Treatment and Testing – better than ever

Reliable tests for genital herpes are now widely available and treatments are more effective and more convenient to take than ever. This means there is every reason for anyone who thinks they may have been infected with genital herpes to seek medical advice. These are the key messages of International Herpes Week 2007, a regular awareness campaign run by the International Herpes Alliance.

Genital herpes is very common and can affect anyone who is sexually active – it is estimated that in many countries, around one in five people is infected.1 However, up to 90% of those affected have no idea that they are carrying the HSV virus.2 Genital herpes can be spread to sexual partners even when the person infected shows no symptoms. Therefore, many people transmit the disease on to other people without ever being aware of it.

Charles Ebel, Chair of the IHA, the organisation that runs International Herpes Week, highlights the importance of being tested for genital herpes: “In many cases, the only way to be sure whether you have genital herpes is to be tested. Accurate, reliable tests are now widely available in many countries via family physicians and health clinics. If you do find that you have been infected, the really good news is that treatments are more effective and simpler to take than ever and there is now data about the precautions you can take to protect partners. More and more people with genital herpes are arming themselves with the facts, taking control of their condition, and getting on with living life to the full.”

Facial herpes (cold sores) and genital herpes are caused by two closely related types of herpes simplex virus, HSV-1 and HSV-2. HSV-1 is the most common strain and usually causes facial herpes, while HSV-2 is more frequently associated with genital herpes. However, cross infection between the two types of virus does occur and in some regions of the world, genital herpes infections are increasingly caused by HSV-1.3,4

Reliable and accurate tests for herpes are now widely available. Viral cultures (swabs) are recommended when visible symptoms are present and a range of blood tests can be used when no symptoms are obvious. It is important to be tested for both the HSV-1 and HSV-2 types of herpes virus. The most accurate blood tests detect IgG antibodies and can show whether a person is infected with the HSV-1 or HSV-2 virus. Many older tests, particularly those that test for IgM antibodies, are less reliable. For an accurate result, it is important to wait for 3–4 months after exposure to the virus, and whenever possible, the result should be discussed with a qualified health professional in a face-to-face appointment so that any questions or concerns can be dealt with immediately.

29-year old Sophie from France describes what prompted her to get tested for genital herpes: “An ex partner told me that he had genital herpes, and although I had no signs or symptoms, I decided it would be sensible to get tested. I was really surprised when the test showed that I did have genital herpes, but I’m pleased that I found out, because I now know how to treat it if I do have symptoms and I can take precautions to reduce the risk of passing the virus on to future partners. I really appreciate my ex being honest with me – his attitude has made me realise that talking about sexual health is a normal, adult thing to do.”

Although there is no known cure for genital herpes, treatments are better than ever before. Antiviral therapy can reduce the frequency, severity and duration of outbreaks. It can be taken for a few days at the first sign of an outbreak (episodic therapy) and, in the case of famciclovir, a new single-day treatment option is now available. For those who wish to reduce the chances of further outbreaks or limit viral shedding (periods of time when the virus is present on the skin) antiviral therapy can be taken on a daily basis for a number of months or years (suppressive therapy).5 Suppressive therapy with valaciclovir has been shown to significantly reduce the risk of transmitting genital herpes to an uninfected partner, when used with safer sex practices.6

The IHA provides a wealth of information about herpes. The ‘All about herpes’ section on the website, www.herpesalliance.org, includes detailed information in a number of languages on a variety of herpes-related topics. These include: signs and symptoms; diagnosis; treatment options; talking to partners about herpes; reducing the risk of transmission; and pregnancy. Further support and information is available from health professionals and also from local support groups around the world, details of which can be found on the IHA website.

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For further information please contact:

Gayle Sawyer, IHA Secretariat

herpes@packerforbes.com

Tel: + 44 20 8772 1551 Fax: +44 20 8 772 1552

References:

1. National Health and Nutrition Examination Surveys (NHANES III:1988–1994)

2. American Social Health Association (ASHA). Learn about Herpes: signs and symptoms. Downloaded from http://www.ashastd.org/herpes/herpes_learn_symptoms.cfm

3. Scoular A et al. Longitudinal study of genital infection by herpes simplex virus type 1 in Western Scotland over 15 years. BMJ 2002; 324: 1366-1367

4. Coyle PV, O’Neill HJ, Wyatt DE, McCaughey C, Quah S, McBride MO. Emergence of herpes simplex type 1 as the main cause of recurrent genital ulcerative disease in women in Northern Ireland. J Clin Virol 2003 May; 27(1): 22–29

5. Managing Genital Herpes. A primary Care Toolkit. IHMF

6. Corey LC, Wald A, Patel R et al. Once-daily valacyclovir to reduce the risk of transmission of genital herpes. N Engl J Med 2004; 350: 11–20

Preventing Cervical Cancer

There is great news for young women and girls in Australia - a new vaccine that can protect them against the cause of most cervical cancers.

The vaccine protects women against certain strains of the human papillomavirus (HPV), which are known to cause 7 out of 10 cases of cervical cancer and 9 out of 10 cases of genital warts.

Starting in April 2007, the Australian Government will be providing the new vaccine free to all women and girls aged between 12 and 26 through the National HPV Vaccination Program.

>> Read more 

Genital infection with the herpes simplex viruses (HSV) 1 or 2 is not just an inconvenience, doctors note. It is a painful, recurrent illness that causes psychological distress, raises health risks for newborns, and boosts the carrier's odds for a much more deadly virus, HIV.

And even as the Herpevac trial -- the first major publicly funded trial of a preventive vaccine -- is set to get under way, a leader of that trial says the vaccine, even if successful, would not be the solution to the herpes epidemic.

"The Herpevac trial is a vaccine that is only going to affect the [uninfected] adolescent woman," said Dr. Lawrence Corey, head of infectious diseases and virology at the University of Washington, in Seattle. "It is not going to be effective in men or in those who are HIV-positive. We need to do better."

>> Read the full story here

Anti-herpes treatment found to reduce genital and plasma HIV levels in women infected with both HIV and herpes viruses

Scientists find potential 'off-switch' for HIV by Chad Boutin

While there is no cure for lingering viral infections such as HIV and herpes, a recent study at Princeton University suggests it may be possible to deactivate such viruses indefinitely with the flick of a genetic switch.

>> Read the full story here

Study Will Test New Vaginal Microbicide for Herpes and HIV 
 
A team of researchers at UCSF is seeking young women to participate in the first U.S. study of the safety of a new a vaginal gel designed to prevent herpes and HIV infection.
If it is effective and approved by the U.S. Food and Drug Administration, the gel would be an important weapon in the fight against HIV because it would allow women to protect themselves from infection rather than relying on their partners to use condoms.

"The significance of the gel is that it potentially gives the power back to the woman to protect herself against infection," said Anna-Barbara Moscicki, MD, professor of pediatrics at UCSF and lead investigator for the study.

The gel is not a contraceptive, but a microbicide. Microbicidal gels or creams are inserted into the vagina solely to prevent the spread of HIV and other sexually transmitted diseases. There are currently no such products on the market. Women who have herpes are at increased risk of contracting HIV, so diminishing the risk of getting herpes also diminishes the risk of HIV infection.

The generic name of the gel is "3 % w/w SPL7013" (brand name VivaGel). Following this safety trial, other trials will be conducted to determine its effectiveness at fighting off herpes and HIV infection. But Moscicki said that trials in animals have found the gel to be nearly 100 percent effective and have few side effects.

"There has been an important move supported by the National Institutes of Health and World Health Organization to support the development of vaginal microbicides," said Moscicki, who also is the director of Teen Clinics in the Division of Adolescent Medicine at UCSF Children's Hospital. "Herpes infection is the number one attributable cause of HIV infection in the United States and worldwide."

The gel is designed to prevent herpes and HIV infection through the use of a molecule called a dendrimer. Dendrimers have molecular structures that resemble the branches of a tree. The herpes and HIV molecules are "caught" in the dendrimer branches and prevented from entering and infecting human cells, Moscicki said.

To participate in the study, women must be between 18 and 24 years old, sexually active, healthy and free of any sexually transmitted disease. They cannot be pregnant or breast feeding. They must either have regular menstrual periods or not have them at all.

Moscicki said that the safety trial is important because earlier spermicidal microbicides like nonoxynol 9, which was an ingredient in a variety of contraceptive products from condoms to contraceptive creams and gels, was eventually found to increase rather than decrease HIV infection rates.

"Nonoxynol 9 was used commonly and was thought to be an extremely safe type of anti-microbial spermicide. But researchers found that it actually increased the rate of HIV infection in women. So now we realize that we must approach new microbicides a little more carefully," Moscicki said.

According to the U.S. Centers for Disease Control and Prevention, women account for more than one quarter of all new HIV/AIDS diagnoses. Women of color are especially affected by HIV infection and AIDS. In 2002, the most recent year for which data are available, HIV infection was the leading cause of death for African American women aged 25 to 34 years. It was the third leading cause of death for African American women aged 35 to 44 years and the fourth leading cause of death for African American women aged 45-54 years and for Hispanic women aged 35 to 44.

In the same year, HIV infection was the fifth leading cause of death among all women aged 35 to 44 and the sixth leading cause of death among all women aged 25 to 34. The only diseases causing more deaths of women were a variety of different types of cancer and heart disease.

Moscicki said that if the gel is approved by the FDA, women would use it about an hour before having intercourse. "If a woman has occasional sex it could be several times a month. If she were a sex worker it could be several times a day," she said.

The study is being conducted in collaboration with the gel's manufacturer, Starpharma Holdings, Ltd., of Melbourne, Australia, and is being underwritten by the Sexually Transmitted Infection Clinical Trials Group, which is funded in part by NIH and CDC.

Development of the gel has been given fast-track status by the FDA. Fast track status is granted when a drug has the potential to treat a serious or life-threatening condition and demonstrates the potential to address unmet medical needs for that condition.

One of the nation's top children's hospitals, UCSF Children's Hospital creates an environment where children and their families find compassionate care at the healing edge of scientific discovery, with more than 150 experts in 50 medical specialties serving patients throughout Northern California and beyond.

UCSF is a leading university that advances health worldwide by conducting advanced biomedical research, educating graduate students in the life sciences and health professions, and providing complex patient care.

Source 

In 1998, a big pharmaceutical company completed a pair of clinical studies comparing rival drugs for treating genital herpes. But the results weren't published until last month.

>> Read the full article here

The first Australian women have been injected with a world-first vaccine protecting them against most cervical cancers.

Designed by Australian of the Year Ian Frazer, Gardasil halts the spread of sexually-transmitted human papilloma virus (HPV), which causes 70 per cent of cervical cancer.

>> Read the full article here

NEW YORK - Infections with the virus that causes genital herpes are common among teen girls, a new study shows.

While none of the young women in the study had oral or genital herpes symptoms, some of those who tested positive for the virus were shedding it in their vaginal area, meaning it would be possible for them to transmit the infection to others, Dr. Kenneth H. Fife of the Indiana University School of Medicine in Indianapolis and colleagues report.

“It was something that we sort of expected to find based on the incidence of other sexually transmitted infections in this population,” Fife told Reuters Health in an interview.

>> Read more here

Zogby via BBSNews 2006-08-05 -- China's adult population is engaging in behavior that puts them at risk of infection with HIV/AIDS and other sexually transmitted diseases at a time when infections in Asia-Pacific countries are on the rise, a new survey by Zogby International finds.

>> REad the full article here:  http://bbsnews.net/article.php/20060805002330172