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Suppressive treatment of chronic herpes simplex virus type 2 (HSV-2) infection lowers the incidence of genital lesions by 70% to 80%, but cuts the rate of HSV-2 transmission to uninfected partners by only about half. Recent evidence suggests that most HSV-2 reactivations are asymptomatic and last <12 hours, but how well these brief events are suppressed by standard antiviral therapy is unclear.
To investigate whether higher-dose antiviral therapy would suppress viral shedding more effectively than standard regimens, Seattle researchers conducted three open-label crossover trials involving 113 HIV-negative patients with symptomatic or asymptomatic HSV-2 infection. The investigators compared standard-dose regimens (acyclovir [400 mg twice dail…