Titre du document / Document title

Comparative efficacy of famciclovir and valacyclovir for suppression of recurrent genital herpes and viral shedding

Auteur(s) / Author(s)

WALD Anna ^{(1 2 3)} ; SELKE Stacy ⁽³⁾ ; WARREN Terri ⁽⁴⁾ ; AOKI Fred Y. ⁽⁵⁾ ; SACKS Stephen ⁽⁶⁾ ; DIAZ-MITOMA Francisco ⁽⁷⁾ ; COREY Lawrence ^{(1 3 8)} ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Medicine, School of Medicine and School of Public Health and Community Medicine, University of Washington, Seattle, Washington, ETATS-UNIS
⁽²⁾ Department of Epidemiology, School of Medicine and School of Public Health and Community Medicine, University of Washington, Seattle, Washington, ETATS-UNIS
⁽³⁾ Department of Laboratory Medicine, School of Medicine and School of Public Health and Community Medicine, University of Washington, Seattle, Washington, ETATS-UNIS
⁽⁴⁾ Westover Heights Clinic, Portland, Oregon, ETATS-UNIS
⁽⁵⁾ Viridae Clinical Sciences Inc, Vancouver, BC, CANADA
⁽⁶⁾ Department of Pharmacology and Therapeutics, University of Manitoba, Winnipeg, Manitoba, CANADA
⁽⁷⁾ Department of Pathology and Laboratory Medicine, University of Ottawa, Ontario, CANADA
⁽⁸⁾ Fred Hutchinson Cancer Research Center, Seattle, Washington, ETATS-UNIS

Résumé / Abstract

Background: Daily antiviral therapy with famciclovir and valacyclovir has been shown to be effective in reducing both symptomatic and asymptomatic reactivation of herpes simplex virus type 2 (HSV-2) when compared to placebo. However, few comparative studies between the 2 antivirals have been performed. Objectives: To compare the clinical and virologic effects of famciclovir and valacyclovir administered as daily suppressive therapy for persons with genital herpes. Study Design: Two randomized, double-blind, placebo-controlled studies comparing daily famciclovir 250 mg bid with valacyclovir 500 mg qd were performed. Study 1 randomized 320 participants and compared the clinical effect of the drugs given for 16 weeks, and study 2 enrolled 70 HSV-2 seropositive subjects and compared the virologic effect of the drugs given for 10 weeks. Results: In study 1, the time to first recurrence was similar in famciclovir and valacyclovir recipients, hazard ratio (HR) 1.17 (95% CI, 0.78-1.76), but time to first virologically confirmed recurrence was shorter among famciclovir recipients, HR = 2.15 (95% CI, 1.00-4.60). In study 2, HSV was detected on 3.2% of days among famciclovir recipients and 1.3% of days among valacyclovir recipients, relative risk 2.33 (95% CI, 1.18-4.89). Conclusion: Valacyclovir appear to be somewhat better than famciclovir for suppression of genital herpes and associated shedding. Further comparative trials of antiviral drugs for various indications should be performed as acyclovir and penciclovir appear to have different ability to abrogate HSV reactivation.

Revue / Journal Title

Sexually transmitted diseases   ISSN 0148-5717   CODEN STRDDM 

Source / Source

2006, vol. 33, n^o9, pp. 529-533 [5 page(s) (article)] (20 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lippincott, Hagerstown, MD, ETATS-UNIS  (1977) (Revue)

Mots-clés anglais / English Keywords

Acyclic nucleoside ; Nucleoside analog ; Purine nucleoside ; Infection ; Viral disease ; Prodrug ; Antiviral ; Viral load ; Relapse ; Suppression ; Comparative study ; Sexually transmitted disease ; Genital herpes ; Valaciclovir ; Famciclovir ;

Mots-clés français / French Keywords

Nucléoside acyclique ; Analogue nucléoside ; Purine nucléoside ; Infection ; Virose ; Promédicament ; Antiviral ; Charge virale ; Récidive ; Suppression ; Etude comparative ; Maladie sexuellement transmissible ; Herpès génital ; Valaciclovir ; Famciclovir ;

Mots-clés espagnols / Spanish Keywords

Nucleósido acíclico ; Análogo nucleósido ; Purina nucleósido ; Infección ; Virosis ; Promedicamento ; Antiviral ; Carga vírica ; Recaida ; Supresión ; Estudio comparativo ; Enfermedad de transmisión sexual ; Herpes genital ; Valaciclovir ; Famciclovir ;

Localisation / Location

INIST-CNRS, Cote INIST : 18921, 35400014218953.0010