From the Guidelines
No, herpes cannot be cured, but it can be effectively managed with antiviral medications to improve quality of life and reduce transmission risk. Herpes simplex virus (HSV-1 and HSV-2) infections establish lifelong latency in nerve cells, making complete elimination of the virus from the body impossible with current medical technology 1. According to the guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents, daily anti-HSV therapy can prevent most recurrences of genital herpes, and this is recommended for persons who have frequent or severe recurrences 1.
For outbreak treatment, medications like acyclovir, valacyclovir, or famciclovir can reduce symptoms and shorten outbreak duration. For people with frequent outbreaks, daily suppressive therapy with these medications can reduce outbreak frequency by up to 80% and lower transmission risk. The option for suppressive therapy should be discussed with every HSV-2-infected patient, and the recommended dosage for suppressive therapy with valacyclovir is 500 mg twice daily in HIV-infected persons 1.
While not curative, proper management can significantly improve quality of life and reduce transmission risk to partners. It is essential to note that suppressive treatment with acyclovir reduces but does not eliminate asymptomatic viral shedding, and the extent to which suppressive therapy may prevent HSV transmission is unknown 1. However, the most recent and highest quality study suggests that daily anti-HSV suppressive therapy in HIV-infected persons also results in a decrease in HIV concentration in plasma and anal and genital secretions 1.
Key points to consider:
- Herpes simplex virus (HSV-1 and HSV-2) infections are lifelong and cannot be cured with current medical technology
- Antiviral medications like acyclovir, valacyclovir, or famciclovir can effectively manage herpes outbreaks and reduce transmission risk
- Daily suppressive therapy can reduce outbreak frequency by up to 80% and lower transmission risk
- The recommended dosage for suppressive therapy with valacyclovir is 500 mg twice daily in HIV-infected persons
- Proper management can significantly improve quality of life and reduce transmission risk to partners.
From the FDA Drug Label
Patients should be informed that famciclovir is not a cure for cold sores. Patients should be informed that famciclovir is not a cure for genital herpes. The herpes simplex virus (HSV) infection is not curable with famciclovir, as the drug label explicitly states that it is not a cure for cold sores or genital herpes 2 2.
From the Research
Herpes Simplex Virus Infection
- Herpes simplex virus (HSV) infection is a global problem, and there is currently no cure available 3.
- The virus persists in a latent form for the life of its host, periodically reactivating and often resulting in significant psychosocial distress for the patient 3.
- Antiviral therapy is the main treatment modality, used either orally, intravenously, or topically to prohibit further replication of the virus and thereby minimize cellular destruction 3, 4.
Treatment Options
- Various antiviral compounds, such as acyclovir, penciclovir, famciclovir, and valacyclovir, have been introduced to reduce healing time, lesion size, and associated pain 4, 5, 6.
- Topical application of a cream containing an antiviral agent is still the most convenient method of treating herpes simplex labialis/facialis in the general population 5.
- Penciclovir cream has demonstrated efficacy against HSV types 1 and 2 and seems to have a pharmacological advantage due to a prolonged half-life of its active form in HSV-infected cells 5.
Emerging Antivirals
- Significant advances have been made towards the design and development of novel antiviral therapeutics during the last decade 7.
- Pharmaceutical companies are moving forward with several new compounds into various phases of clinical trials, which may provide new treatment options for HSV infections 7.