"A Must Read Review of HSV"

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Rattus	Mar-16-00, 08:44 PM (CST)
"A Must Read Review of HSV"
Some parts are technical but the gist can be easily understood. http://www.journals.uchicago.edu/CID/journal/issues/v30n3/981676/981676.html Rattus
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Table of contents

Great Article, Ben Franklin, Mar-16-00, (2) RE: Great Article, Ben, Mar-18-00, (3) RE: Great Article, Sal, Mar-18-00, (4) RE: Great Article, J, Mar-18-00, (5) Theory, Ben Franklin, Mar-18-00, (6) Ya like that theory?, Sal, Mar-18-00, (7) I gotta ask...., Ben, Mar-18-00, (10) RE: I gotta ask...., Sal, Mar-19-00, (11) RE: I gotta ask...., Rajah, Mar-19-00, (14) RE: Great Article, Sal, Mar-18-00, (8) Well, Sal, you *asked*...., M'sMom, Mar-19-00, (17) RE: Well, Sal, you *asked*...., Sal, Mar-20-00, (20) I get 68% from this abstract...., M'sMom, Mar-20-00, (22) 80-90% Number, Ben, Mar-20-00, (21) RE: 80-90% Number, windy, Mar-20-00, (24) RE: 80-90% Number, Rattus, Mar-20-00, (26) 500,000 new cases a year....., Ben Franklin, Mar-21-00, (27) chlamydia vs. herpes - rate of infe..., M'sMom, Mar-21-00, (28) RE: 500,000 new cases a year....., Sal, Mar-21-00, (29) Reporting cases, Ben Franklin, Mar-21-00, (31) RE: Reporting cases, Rattus, Mar-22-00, (32) RE: Reporting cases, Rattus, Mar-22-00, (33) RE: 80-90% Number, Sal, Mar-21-00, (30) RE: Great Article, A, Mar-23-00, (34) RE: A Must Read Review of HSV, Sal, Mar-19-00, (12) Comment, Rattus, Mar-19-00, (13) RE: Comment, Rajah, Mar-19-00, (15) Rattus Post, Ben Franklin, Mar-19-00, (16) general comment, Keyser Soze, Mar-20-00, (18) RE: A Must Read Review of HSV, Betty, Mar-20-00, (19) RE: A Must Read Review of HSV, Rattus, Mar-20-00, (23) Acyclovir and Valtrex better than v..., Ben Franklin, Mar-20-00, (25)

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Ben Franklin	Mar-16-00, 11:59 PM (CST)
2. "Great Article"
Thanks for the link Rattus. Great contribution. I don't know if I misread, but I thought the article said HSV1 infection rates in the general population was between 20%-40%. I often read here that the number is much higher, like 80%-90%. Did I misread the article? Or are the higher numbers wrong? The conclusion seems to be that no vaccine is likely to prevent infection, just lessen or eliminate the consequences of an infection. Does this conclusion apply to the Cantab DISC vaccine as well? Thanks again Rattus.
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	Ben	Mar-18-00, 09:32 AM (CST)
	3. "RE: Great Article"
	Ben: The varible numbers come from the varied sources avaliable to the writer. There are thousands of papers which have prbably directly tested the prevelance of HSV1 in thousands of different poulations (which may or may not be representative of the US as a whole). Often times these reviewers find the most recent paper with such statictics and quote it even though the population (and thus HSV1 prevalence)may not be attributable to the whole. The only way to know for sure would be to check the reference they used for the HSV1 prevalence and see how large and representative their sample size was.
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	Sal	Mar-18-00, 03:03 PM (CST)
	4. "RE: Great Article"
	Hi Ben What an interesting mish-mash of ideas in that article! - On one hand they are talking about vaccines - yet on the other hand they are couching a lot of it in 70'd data. - The references they use to support the HSV 1 incidence rates quoted are from 1960, 1975 and two from 1976. (pre Western Blot) The site only gives access to the abstracts of two of them, but in those two the numbers were derived by people reporting that they had had cold sores - So the higher numbers we have seen bantered about may not be because of any particular change in HSV 1 prevalence - but as a result of blood antibody testing. . . . at least the references they cite for vaccine issues (the topic!) are more current! I have a theory though - I might as well air it here - I think the incidence of oral/facial HSV1 has been declining throughout the course of recent generations - It's really only been in the last hundred years that we've begun to understand how viruses are spread, and to avoid contact with potential to infect. I think this newer understanding could be a major contributing factor to the increase in genital HSV1 - The recipients have avoided contracting in their childhood - and so have no immunity when exposed genitally as an adult. . . Seems like a logical contributing factor anyway. . . of course it's only been in recent years we've been able (or interested) to test for type anyhow. And that's your ramble for today! . . so far. . . love, Sal
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	J	Mar-18-00, 03:32 PM (CST)
	5. "RE: Great Article"
	http://www.racoon.com/dcforum/GeneralNew/238.html#36 Hey Sal! I think your theory may be right What I want more information on, is the neurological complications. "Because HSVs are neurotropic, HSV infections can cause neurological complications. Recognized complications include aseptic meningitis, autonomic nervous system dysfunction, transverse myelitis, sacral radiculopathy, and Bell's palsy <68, 144, 145>." Anyone?????? We've discussed aseptic meningtis, radiculopathy, Bell's palsy but not transverse myelitis nor autonomic nervous system dsyfuction. Has anyone read this reference... " Corey L, Wald A. Genital herpes. In: Holmes KK, Sparling PF, Mardh P-A, et al., eds. Sexually transmitted diseases. New York: McGraw-Hill, 1999:285312. " Anyone with information on what type of autonomic nervous system dysfunction would be great. J
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	Ben Franklin	Mar-18-00, 04:47 PM (CST)
	6. "Theory"
	Hi Sal, The theory makes sense to me, but how do you prove it? If it is true, oral/facial infections should be less common now than decades ago and should continue to decline in the future. The increase in genital hsv 1 & 2 should also level off if awareness modifies behaviour. Hope for the future?
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	Sal	Mar-18-00, 08:25 PM (CST)
	7. "Ya like that theory?"
	Hi Ben, That's just it. . I can't prove it (I don't think - Have you got any ideas ?) . . .I'm just running on intuition. . . . But it's my favorite theory . . . Wanna See Theory Number 2 ? . . . . . . ahh. . . . . . glad you asked. . . How about : "More people indulge in oral sex these days than they did in previous generations" naaahhh.. .. . 'nuther tough one to prove. . . Some say : "My Parents would NEVER do a think like that !!!" {horrors!} . . . but just as many say with a knowing grin- "oh yes they would. . . ." I'm pretty sure I've heard anecdotal references to various acts of sexuality being more or less prevalent in various cultures too . . . (sorry - nothing I can recall to quote) Anybody else? > hope for the future? YES! There surely is hope for the future - Even as I value the Vaccine studies, drugs for suppression and so on - I think you got it right Ben - The biggest hurdle will be overcome when awareness modifies behaviour! Your phrase "awareness modifies behaviour" (very succinct BTW) inspires me to digress . . . It's not exactly the same, but it reminds me of Roger's Famed Quote : "Let your actions lead your feelings"* - Where taking a positive step in the direction we'd like to see ourselves 'utopicly' - effectively acts to create the desired result. * or something like that, Correct me Roger if I'm wrong. kinda like when you do: <-- this I trust you are smiling, and it really does make me smile back. love, Sal
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	Ben	Mar-18-00, 09:49 PM (CST)
	10. "I gotta ask...."
	Who is Roger?
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	Sal	Mar-19-00, 05:20 AM (CST)
	11. "RE: I gotta ask...."
	g'morning Ben, Roger is the forum's Rajah!! love, Sal
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	Rajah	Mar-19-00, 02:23 PM (CST)
	14. "RE: I gotta ask...."
	There you go, Sal, giving away my secrets. The illusion of my being a slim and handsome mystic from an exotic place. Oh, well.. (((((HUG))))) Rajah
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	Sal	Mar-18-00, 08:36 PM (CST)
	8. "RE: Great Article"
	Hi J, >Anyone?????? We've discussed aseptic meningtis, >radiculopathy, Bell's palsy but not >transverse myelitis nor autonomic nervous >system dsyfuction. >Has anyone read this reference... >" > Corey >L, Wald A. Genital herpes. >In: Holmes KK, Sparling PF, >Mardh > P-A, >et al., eds. Sexually transmitted >diseases. New York: McGraw-Hill, > 1999:285312. >" > >Anyone with information on what type >of autonomic nervous system dysfunction >would be great. Man-o-Man - That book, an annual edition it seems, is 179.00 Bucks at Amazon - AND THAT'S LAst years edition!!! (1998) Yikes! Do you think a Borders store in big city might have the 1999 edition stocked ? My library contact is off on March Break - but it sure would be nice for you to find someone with equal interest and backround to bounce the thoughts with J - Hopefully with access to a Medical Library! Where is Windy ? love, Sal
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	M'sMom	Mar-19-00, 10:52 PM (CST)
	17. "Well, Sal, you *asked*...."
	.... so I dug this up out of the depths of the technical forum. It seems relevant to your musings. MM ===== TITLE: Seroprevalence of herpes simplex virus infections in a family medicine clinic AUTHORS: Oliver L; Wald A; Kim M; Zeh J; Selke S; Ashley R; Corey L AUTHOR AFFILIATION: Department of Family Medicine, University of Washington, Seattle. SOURCE: Arch Fam Med 1995 Mar;4(3):228-32 CITATION IDS: PMID: 7881604 UI: 95187360 COMMENT: Comment in: Arch Fam Med 1995 Mar;4(3):207 ABSTRACT: OBJECTIVES: To determine the prevalence of herpes simplex virus (HSV) antibody in a general medical practice setting and to assess the frequency of subclinical infection. DESIGN: Prevalence study. SETTING: A family practice clinic at the University of Washington Medical Center, Seattle. PARTICIPANTS: Five hundred randomly selected patients between the ages of 18 and 45 years. MAIN OUTCOME MEASURES: Serum samples were tested by Western blot assay to detect the presence of antibody to HSV type 1 (HSV-1) and HSV-2. Demographic information and clinical history of oral and genital herpes were obtained. RESULTS: One hundred fourteen patients (23%) were seropositive for HSV-2 antibody, 277 patients (56%) were seropositive for HSV-1 antibody, 59 patients (12%) were seropositive for both HSV-2 and HSV-1 antibodies, and 163 patients (33%) were seronegative for both. Women were almost twice as likely as men to be seropositive for HSV-2 antibody (28% vs 15%, P < .001). Blacks had the highest rates of HSV-2 antibody seropositivity (60%) compared with whites (20%) and Asians (6%) (P < .001). Other demographic correlates of seropositivity included being older, having fewer years of education, and having public insurance. The specificity of a clinical history of genital herpes or sores for HSV-2 infection was high (99%), but the sensitivity was low (27%). CONCLUSIONS: Herpes simplex virus infection is common among patients seeking primary care. Women, blacks, and patients of lower socioeconomic status are most likely to be seropositive for HSV-2 antibody. The high frequency of unrecognized HSV infection has implications for primary care physicians in counseling patients regarding HSV infection and transmission.
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	Sal	Mar-20-00, 10:51 AM (CST)
	20. "RE: Well, Sal, you *asked*...."
	Thanks Mom, Yes - this paper is among those subject to my musings. Ben and I wondered why the article rattus cited quotes HSV 1 at a rate of 20-40 % Whereas, this article gives us 56% and the participants on the forum often cite 80-90% What do you think accounts for these differences? - A real difference in the incidence? - over time? - over population group studied? - as a result of testing methods? - other factors? or some combination of these. - and, if a remarkable difference does exist - what are the reasons for the differences? This is the stuff I like to muse about. . . I'm aways interested when somebody offers their comments, observations and insights on these aspects. love, Sal PS - Just for fun, and because I think it is Very important to read any and all of the research articles with these kinds of variables in mind. . . . and since I have the full text associated with the abstract you've offered - I was thinking, for the sake of our amusement (and to demonstrate the challenge of interpreting statistical analysis) - Perhaps later today myself and a friend will offer an 'alternative analysis'. . . just give us a little time to get it together. . . Yours, Sal
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	M'sMom	Mar-20-00, 12:55 PM (CST)
	22. "I get 68% from this abstract...."
	.....if you include people who are seropositive for both hsv1 and hsv2. About the 90%, I'll have to see if I can find it again, but where I've seen that number is in a statement that your chances of contracting hsv1 by the time you're 55 are ninety-plus percent, which isn't the same thing as 90% of the population sharing it - although I *do* like the statement that "Ninety percent of the American Association of Retired Persons has herpes." It has a nice ring, doesn't it. MM
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	Ben	Mar-20-00, 11:15 AM (CST)
	21. "80-90% Number"
	The skeptical part of me believes that the 80%-90% numbers come from us wanting to believe that is so prevalent. On the other hand, I think I read somewhere that the % in the general population increases as our age increase. That makes sense, the older we are, the greater the number of chances we have had to be exposed. So tests done with higher age populations have higher percentages. Like I said, I think I read this...
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	windy	Mar-20-00, 07:41 PM (CST)
	24. "RE: 80-90% Number"
	Yes, Ben, you probably did read it. I recall a study that showed the seroprevalence of HSV1 increased with age, and the number I recall is 90% by age 80. windy
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	Rattus	Mar-20-00, 11:40 PM (CST)
	26. "RE: 80-90% Number"
	Ben: The most likely answer to your question about HSV-1 prevalence variablility is that: 1). It is variable and depends on the population studied 2). Authors often pick any darn reference if the issue is only worth a sentence or two in a paper. One question I looked at one day while bored with class is now authors always say "there are 500,000 new genital HSV infections per year." So I went into the bowels of my medical library and dusted off books as far back as 1889 to find out what people have thought about incidence over the years. One would think that with a lifelong infection and thus an ever increasing prevalence that the incidence would change--especially over 30 years. But in text and journals from 1962 and 1996-7 they quoted the same 500,000 incidence/year. Granted its not a reportable infectious disease, but one would think the authors would begin to question this statistic considering the virus' mode of transmission and permanence. (Although I did see one author using some mathmatical model predict in 1984 that by 2012 or something that everyone should be infected) So the point of this rambling is that the numbers are screwy but with the advent of Western Blot and large scale studies we may have generalizable numbers some day soon. Herpetically, Rattus
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	Ben Franklin	Mar-21-00, 07:38 AM (CST)
	27. "500,000 new cases a year....."
	I have also been suspicious about the claim of 500,000 new cases a year. It doesnt make sense that the number would stay the same. Sal's theory is that the number of genital hsv1 infections is increasing because we are more aware and therefore more careful about transmitting oral hsv. Because we are not as frequently infected with oral hsv, we are more susceptible to genital hsv1. I think that the numbers might be wrong altogether. They don't make sense to me when you compare them with other reportable STD's like chlamydia. The annual newly reported cases of chlamydia are many times higher than new genital HSV. But these types of bacterial infections are easily treatable with antibiotics, and therefor you would presume an individually usually is only contageous for a matter of weeks or months tops. Yet there are millions of new cases a year. Its just a hunch, but I think the number of genital HSV cases a year is grossly under reported. I know comparing chlamydia with herpes is apples and oranges, but the method of transmission is the same. Just my two cents.
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	M'sMom	Mar-21-00, 09:33 AM (CST)
	28. "chlamydia vs. herpes - rate of infection"
	The other side of that coin is that you can actually contract chlamydia multiple times - and people do so frequently, especially if both partners aren't treated. I don't know how much re-infection slants the stats, but there might be some impact. MM Oh, I've got a question: Is this getting too tecchie? Should we move the discussion to the technical forum? Or is it o.k. here?
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	Sal	Mar-21-00, 09:46 AM (CST)
	29. "RE: 500,000 new cases a year....."
	Hi Ben, But, but, but, BEN - I hold that the incidence of HSV 1 is DEcreasing That 80% figure is quoted in the ASHA summary : It is in a para of it's own - but it looks like it is credited to Spruance - He says : "By the time they're teenagers or young adults, about 50% of Americans have HSV-1 antibodies in their blood. By the time they are over age 50, some 80-90% of Americans have HSV-1 antibodies. " And as both you and windy pointed out it is discussed in terms of a gradual progression over the life of the population. - HOWEVER - I have not seen any other old or new reference or research to back up this 80% number. I contend 80% is an 'OLD' number. Sal's theory is : That in future generations, we will see the number of HSV1 infectees continue to decline - and I feel that this is at least partially demonstrated but the increase in Genital HSV 1 we are seeing in the younger generation. - it is possible that changes in sexual expression (increased practise of oral sex?) may also be partly attributed to this. Brugha cites the decline in Oral HSV 1 as a reason for the increase in Genital HSV 1 - (as J offered us earlier in the thread) Brugha also cites an increase in neo-natal HSV 1 in the UK as a parallel example, Saying that the reduction of numbers of mothers with HSV1 antibodies has contributed to the vulnerablity of the infant. (among other factors he cites). love, Sal
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	Ben Franklin	Mar-21-00, 05:18 PM (CST)
	31. "Reporting cases"
	What criteria is used to determine if a particular disease might be required to be reported. I suppose that Herpes is probably not percieved as a serious enough to warrant mandatory reporting. Just a thought, what are the criteria?
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	Rattus	Mar-22-00, 11:53 PM (CST)
	32. "RE: Reporting cases"
	Infectious dieases that are reportable are determined by each state or county public health department or some, such as botulism are reportable to the CDC. HSV encephalitis is reportable and I am not sure about neonatal HSV (I do not think so). To make the list, the infectious agent usually must be quite a health threat and at risk of doing the same serious damage to others who can easily contract it and the diagnosis must be able to be confirmed with a high degree of certainty. What epidemiologists do now is search the national ICD9 codes for the diagnosis of "genital herpes" which will count all persons with GH who come to a doctors attention and are given the right diagnosis--which we all know is a small minority. Rattus
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	Rattus	Mar-22-00, 11:53 PM (CST)
	33. "RE: Reporting cases"
	Infectious dieases that are reportable are determined by each state or county public health department or some, such as botulism are reportable to the CDC. HSV encephalitis is reportable and I am not sure about neonatal HSV (I do not think so). To make the list, the infectious agent usually must be quite a health threat and at risk of doing the same serious damage to others who can easily contract it and the diagnosis must be able to be confirmed with a high degree of certainty. What epidemiologists do now is search the national ICD9 codes for the diagnosis of "genital herpes" which will count all persons with GH who come to a doctors attention and are given the right diagnosis--which we all know is a small minority. Rattus
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	Sal	Mar-21-00, 09:51 AM (CST)
	30. "RE: 80-90% Number"
	Hi Rattus, I'd like to take this opportunity to say how wonderful I think you are too, and pay my dues to the rattus fan club. I remember when you first appeared on this forum, and for me personally I was most impressed by your attitude to the virus, to your love, and to your life. These are what I consider to be the most important defining characteristics of a person, and so for me- I think you are a clear thinking and good man. - Why I'd go so far as to say I think you're right up there with the charm and intelligence of say - Ben Franklin, windy, or heck - even our much revered Ocean birthday boy. *grin* I do think you will make a very fine Doctor - AND that we here on the forum are very fortunate to have you here - I am very grateful for your participation. I would like to humbly suggest for your consideration, that when it comes to research - Some researchers may seek "the most current data" - Some researchers may "Take any darn reference they can find" - But, that MOST researchers will look long and hard for a reviewed reference to Back Up Their Thesis. In the case of this paper you offered us at the top, I believe the intention was not to define all herpetics - But that the researchers deliberately sought references from a population in advance of the anti-viral medications, AND in advance of serum testing - Precisely because of the title of the work : "Prospects for Control of Herpes Simplex Virus Disease through Immunization" Their goal is to define a potential market for the vaccine and they found 20-40 percent of University students will have a conspicuous out break and/or memorable reoccurance during the years they spend in university. This is a population who would be motivated to be vacinated. An excellent "must read" review that I'd like to recommend, J also refered us to : Genital Herpes Infection : A review" R Brugha, K Kkeersmaekers, A Renton and A Meuheus. International Journal of Epidemiology, Vol 26, No. 4 (1997) It has an EXCELLENT bibliograpy of source research material. I sure would be interested in seeing the Book J is looking for - THAT sounds like a good review . . . so I gotta thank the guys in 'your' the SKB article for refering us to it! With love, Sal
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	A	Mar-23-00, 08:14 AM (CST)
	34. "RE: Great Article"
	This is from Wald's presentation (page 2 in the news forum)in November 1999. "Previous HSV-1 infection did not reduce the rate of HSV-2 infection, but it did increase the likelihood of asymptomatic seroconversion, as compared with symptomatic seroconversion, by a factor of 2.6 (P<0.001). Of the 19 new HSV-1 infections, 12 were symptomatic. The rates of symptomatic genital HSV-1 infection and oropharyngeal HSV-1 infection were the same (0.5 case per 100 person- years). Conclusions: Nearly 40 percent of newly acquired HSV-2 infections and nearly two thirds of new HSV-1 infections are symptomatic. Among sexually active adults, new genital HSV-1 infections are as common as new oropharyngeal HSV-1 infections." PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: ENG
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	Sal	Mar-19-00, 05:53 AM (CST)
	12. "RE: A Must Read Review of HSV"
	Dear THN, I understand your irritation over having a post deleted. But you gotta understand THN, people, myself included, grow tired of abrubt attacks - even if they share your opinion! - Interestingly, I think, - your comment did and still does "toss out the whole article" - (baby with the bath water so to speak) - and even may have been interpreted as an attack on the person who recommended reading it. - And your reward? - the Result of your first post? - An administrator felt the "knee-jerk' just as you did - and in a desire to remove the rudeness, chose to throw your comment out too. While I often don't appreciate your tone THN, I do value your input. In my opinion, THN, you'd really 'up your ratings' a lot if you'd take your time, and indicate your concerns in a civil tone, and so, stay on the record. with love, Sal PS - Look at this: (reprinted from the article) Financial support: This work was supported, in part, by the National Institutes of Health (AI22667 and AI45252) and SmithKline Beecham Biologicals. The authors are members of the SmithKline Beecham Biologicals Herpes Vaccine Advisory Board. The authors developed the concept for this paper at a meeting of the advisory board. The contents of this paper reflect the independent views of the authors. - End Quote. Care to talk about it? - It's not a crime thought I guess, it's what makes the world go round - but it does look like a re-hash - probably on SKB's request. . . . . - I'll bet we'll be seeing new works on the as yet unaddressed question "The Economic Burden of HSV" - What do you think??? - And it makes sense in the context of trying to identify the likely population/demand for the vaccine to use the old data on HSV1 - . . thereby identifying those people who are cosmeticly affected and aware. . . We've always had to be vigilent for sensationaized abstracts when the researchers are heading to the funding/grants table. . . But if anything, the article IS - a tidy summary of research papers on the Vaccine projects. - Would you agree with that?
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	Rattus	Mar-19-00, 12:29 PM (CST)
	13. "Comment"
	I have to comment on the argument that "this is not original research". By its very nature of being a "Review Article" it stays away from claiming any new discoveries. Its purpose is to supplement journals (and thus their readers) with a review of all published data. It then serves as a mini-text to those in related fields who do not read the herpes literature weekly. To THN and all others who well-read on HSV topics, clearly this is a recapitulation of old stuff. This shouldn't anger anyone as a review of lets say primary sclerosing cholangitis would be helpful to you if you were unfamiliar with the topic or were a busy doctor and wanted to refrsh his/her understanding. I post these references more for the persons who are not-so-well informed on HSV issues and for the lurkers who have a million questions but are afraid to ask. And maybe the techies can entertain themselves too. My deepest motivation is to help those who visit this site learn to discern adnecdotal internet information (sometimes wrong and harmful) from reality. Moreover, a common theme at Racoon is "my doctor sucks and doesn't know crap about HSV!" By posting these reviews perhaps the patient can print it and give it to their all too often uninformed MD who has not read about HSV since medical school in 1970. And to J, the autonomic instability is a vague way of saying HSV infections can cause difficulty in the neuromuscular coordination of urination and defecation. Regards, Rattus
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	Rajah	Mar-19-00, 03:13 PM (CST)
	15. "RE: Comment"
	Rattus, there are all levels of expertise represented here on the HHP and not all of us have the time or inclination to do the in depth research. The reviews and summaries are worthwhile so always feel free to post them. Thanks Rajah
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	Ben Franklin	Mar-19-00, 08:11 PM (CST)
	16. "Rattus Post"
	Rattus, I am a non techie that finds your posts and comments very helpful. If I see your name as the author of a post I don't hesitate to read it regardless of the title. Thank you for your contributions. Same goes for J. Thanks to both of you. Ben
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Keyser Soze	Mar-20-00, 01:26 AM (CST)
18. "general comment"
I would just like to make a general comment for all who complain about the lack of "current" research. Most of the research you see in journals that is dated 1999 was actually complete in 1996 or 7 and written up in 1997 and 98. Of course there is the occasional journal article that finished the actual lab work 2 months before the article was published, but those are exceedingly rare and tend to be less comprehensive, less well written, and more general. I am in the process of having some of my research published and it is a time-consuming process--the article goes out to the journal and gets peer-reviewed, then gets mailed back with a million corrections on it, then you send it back in and if they don't feel like making any more corrections, it gets considered for publication, or it gets mailed back again and again...there are some articles that are submitted a full 2 years before they get published! Yes the vaccine process is a slow one, but there are many many scientists working day and night on treatments and vaccines for hundreds of diseases. I am confident that a cure for AIDS will be found within the next decade, and with it will come a vaccine for herpes. Hang in there y'all! Keyser Soze
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Betty	Mar-20-00, 09:22 AM (CST)
19. "RE: A Must Read Review of HSV"
Thanks for the article. Being a non-techie, I love your posts. I found a financial article re the upcoming merger, and it said that the regulatory committee may insist that Glaxo SmithKline may not be able to keep two vaccines under development and may have to get rid of one of their products(Famvir, Valtrex, Zovirax) for anti-competitive reasons. Since you're obviously well-versed on the subject, I was wondering which vaccine, if any, do you think has a chance of coming to market, and when? It'll just be your opinion -- I won't hold you to it
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	Rattus	Mar-20-00, 07:06 PM (CST)
	23. "RE: A Must Read Review of HSV"
	Betty: Although I regulary scan the literature for HSV-related stuff, I do not look very hard (any more) at vaccine development. I know a bit about the Cantab vaccine and really nothing about the SKB vaccine. My personal salvation is valacyclovir (its relatively cheap and works like a charm)and I do not put too much hope in these vaccines treating or preventing recurrances in humans in any significant way any time soon. I think more liberal dosing with valacyclovir and/or combination drugs (like HIV drugs) will be the wave of the future. I like imiquimod's (interferon inducing creme made by 3M no in PhaseII I think) prospects as a stand alone or adjunct to acyclovir. Just my personal thoughts based on a hunch Regards, Rattus
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	Ben Franklin	Mar-20-00, 08:09 PM (CST)
	25. "Acyclovir and Valtrex better than vaccines"
	Rattus, I tend to agree with you that acylovir or valtrex or some future advancement in that family of drugs will be more effective in supression and treatment of herpes. The use of these drugs to limit transmission during child birth seems to be very suggestive that these drugs not only limit outbreaks but also inhibit asymptomatic transmissionn. Thanks again for your contributions.
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