White PJ, Garnett GP. Use of antiviral treatment and prophylaxis is unlikely to have a major impact on the prevalence of herpes simplex virus type 2.
Sex Transm Infect 1999;
75:49-54. [PMID:
10448343 PMCID:
PMC1758177 DOI:
10.1136/sti.75.1.49]
[Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND
Genital infection with herpes simplex virus (HSV) is common and can cause severe morbidity, over many years in some cases. Aciclovir provides suppressive therapy but there is debate over the effects of its use on the spread of infection.
OBJECTIVES
To explore the influence of the natural history of genital HSV and the impact of antiviral therapy.
METHODS
A simple mathematical model of HSV-2 transmission dynamics was developed, and parameter values estimated from published data.
RESULTS
The relative durations of the risk of transmitting HSV-2 and the duration of therapy generate a non-linear relation between the duration of antiviral therapy and the reduction in prevalence infection. If there is a wide distribution of risk of HSV-2 transmission over the course of an infection then practicable aciclovir use is unlikely to have any great impact on disease transmission dynamics.
CONCLUSIONS
There are still many uncertainties in the transmission dynamics of HSV-2. In particular, infectiousness over the course of an infection requires more detailed exploration. To have a significant impact on the prevalence of HSV-2 aciclovir use would have to be widespread and for a long duration.
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