Vol.54 No.3 May 2006
Suppressive therapy for genital herpes is not a standard therapy in Japan
Department of Virology, University of Toyama
2630 Sugitani, Toyama, Japan
Abstract
It is important to learn the pathogenesis herpes simplex virus (HSV) and the difference between bacterial and viral infection in order to understand the biology of HSV and the need of suppressive therapy. HSV infection in the skin and mucosa results in the retrograde axonal transport of the virus to the sensory ganglia and spread of infection in the ganglia. Then the HSV causes lesions in the region innervated by the ganglia and the virus in ganglia becomes latent and supplier for the reactivation in future. Recent study shows the possibility of reduction of reaction frequency by the reduction of the number of latent HSV genomes by the acyclovir treatment of the primary HSV infection. Reactivation of HSV from the ganglia is inevitable and the suppressive therapy alone is the standard way to suppress reactivation in patients with frequent reactivation. Suppressive therapy does not cause acyclovir-resistant HSV as suspected from the apprearence of drug-resistant microbes in infection with bacterial and human immunodeficiency virus. The mode of HSV infection and the fidelity of HSV DNA polymerase render HSV infection exceptional to generate acyclovir-resistance during suppressive therapy. Thus the suppressive therapy should be included as the standard therapy for frequent genital herpes in the repertoire of the chemotherapy in Japan.
Key word
herpes simplex virus, reactivation, recurrence, acyclovir, resistance
Received
June 14, 2005
Accepted
March 20, 2006
Jpn. J. Chemother. 54 (3): 217-220, 2006
