The University of Texas Medical Branch at Galveston
Office of University Relations
phone (409) 772-2618
fax (409) 772-6216
DATE SENT: Feb. 9, 1998
CONTACT:
Alana Mikkelsen, Science Writer
(409) 772-8782 or (800) 228-1841
[email protected]
-------EMBARGOED------
until 3 p.m. Central Time, Thursday, Feb. 12, 1998
For interviews with Tyring or with patients who have contracted herpes from partners who didn't know they could pass it on: Call Stephen Tyring at (281) 333-2288
CHOCOLATES, FLOWERS, LOVE NOTES? HERE'S WHAT NOT TO GIVE YOUR VALENTINE
GALVESTON, Texas--Dermatologist Stephen Tyring has two words for those whose fancies turn to romance this Feb. 14:
Watch out!
As prologue to a soon-to-be-published study that confirms the effectiveness of a new drug in treating outbreaks of genital herpes, Tyring, the study's lead author and a professor of dermatology, microbiology and immunology at the University of Texas Medical Branch at Galveston, stresses a generally overlooked fact: Although drugs can help clear up the painful genital sores or blisters that appear after infection with herpes virus type 2, being free of signs or symptoms does not mean that a person is unable to spread the virus.
In fact, says Tyring, "most herpes is transmitted when there is no outbreak--when people think its safe to have sex."
In the February Archives of Dermatology, Tyring and colleagues at 52 other medical centers worldwide report that a new, more convenient drug, valacyclovir, worked as quickly as an older drug, acyclovir, to clear up a herpes outbreak. That's good news for those who develop symptoms, says Tyring, because valacyclovir is more potent and thus more cost-effective than acyclovir, which requires patients to take pills up to five times a day. Valacyclovir, on the other hand, only requires patients to take pills twice a day.
But for the 45 million Americans estimated to be infected with the virus--and for everyone else--Tyring recommends extreme caution when having sex. Although he says even many doctors don't know it, recent studies have shown that 80 percent of herpes infections are passed by people who exhibit no outward signs or symptoms of the disease at the time of transmission. And a recent study by the Centers for Disease Control and Prevention suggests that up to 91 percent of infected Americans may not know they carry the virus.
"About half the people who are exposed to the virus will develop symptoms within two weeks," Tyring explains, adding that symptoms may be so mild that they go unrecognized. "The other half may develop symptoms later in life--often after exposure to chemotherapy or immunotherapy--or never."
After infection, the herpes virus hides in the nervous system until triggered to surface at the skin. A person can carry the virus for decades with no symptoms. And that, says Tyring, increases the danger of the virus being passed to someone who may be more susceptible to the virus and may become very sick indeed.
Because everyone responds differently to viral infection, Tyring urges anyone who has been sexually active--especially those who are considering having children--to get tested for herpes. Pregnant women can pass the virus to their newborn babies, who can die from the infection.
Tyring recognizes that complete abstinence, although offering the best protection against sexually transmitted disease, is an unrealistic goal for many people who test positive. Hence, like most physicians, he advises using a condom during sex. But he also warns that condoms may not stop people from passing herpes to their partners. That's because the virus may be present in the mucous membranes surrounding the genitals as well as in skin cells that are infected but haven't produced visible lesions. "Condoms, at best, can only protect what they cover," Tyring notes.
Three medicines--acyclovir, valacyclovir and famciclovir--are now available to treat herpes symptoms and suppress outbreaks. (The drugs are sold as Zirovax, Valtrex and Famvir, respectively.) Recently, acyclovir has been shown to reduce by 90 percent "asymptomatic viral shedding," the release of virus from cells that are infected but do not visibly demonstrate that fact. But Tyring says today's real public health question is: Can drug treatment prevent or reduce transmission of genital herpes? Researchers, including Tyring, are currently doing studies aimed at answering that question. Until then, he and other doctors are stressing that avoiding sex during visible outbreaks of the disease is not enough. And they are recommending that everyone practice sex with the utmost caution.
"There's one worse thing than having herpes," Tyring says, "and that's giving it to your partner."
###
EDITOR'S NOTE: The Archives of Dermatology study will be published on Feb. 12. The results of that study are embargoed until that date.
REFERENCES:
1. Fleming, D.T.; McQuillan, G. M.; Johnson, R.E., et al. (October 16, 1997.) Herpes simplex virus type 2 in the United States, 1976-1994. The New England Journal of Medicine. Vol. 337; pp. 1105-1111.
2. Wald, A. et al. (1995.) Virologic characteristics of subclinical and symptomatic genital herpes infections. The New England Journal of Medicine. Vol. 333; pp. 770-775.
3. Wald, A. et al. (1996.) Suppression of subclinical shedding of herpes simplex virus type 2 with acyclovir. Annals of Internal Medicine. Vol. 124; pp. 8-15.
RSS