Herpes Relief

The headline on the New York Post screamed U.S. APPROVES HERPES SUPER-DRUG. While that description was exaggerated, the approval of oral acyclovir capsules last week by the Food and Drug Administration marked a big step forward in the treatment of genital herpes. Though the drug will not cure the pesky venereal disease, which afflicts some 5 million to 20 million Americans, it can reduce both the severity and the frequency of recurring attacks.

Acyclovir, developed by the Burroughs Wellcome Co. of Research Triangle Park, N.C., works against herpes infections by inhibiting the ability of the virus to replicate. In 1982 the company was given permission to market the drug in the U.S. in two forms, both under the name Zovirax. As an ointment, the medication somewhat reduced the pain and duration of the outbreaks. In a more potent intravenous solution, it could be administered to patients hospitalized with severe cases. For those sufferers, the drug offered some respite from continual outbreaks and the flu-like symptoms that often accompany major herpes attacks.

Zovirax capsules are much more effective, as was demonstrated by two recent studies sponsored by the National Institutes of Health on people who suffered a dozen or more genital-herpes infections annually. Taken several times daily for four months, the capsules reduced the recurrences or their severity, or both, in more than 95% of the cases. Between 40% and 75% of the herpes victims had no recurrences at all during the period. (But afterward, in all cases, the herpes attacks resumed.) For most of those who had less frequent herpes episodes, use of the capsule for five days--beginning as soon as the initial tingling symptoms appeared--effectively reduced the outbreaks.

The FDA is proceeding cautiously, however. In the absence of any long-term studies, it has limited daily use of the capsules to six months and has warned against their use during pregnancy. Also, the agency noted, use of the capsules does not guarantee that a herpes victim will not infect a sexual partner.

When Zovirax becomes available in mid-February, there will be another restraint: price. A five-day regimen of the capsules will cost from $15 to $18; the tag for six months of use will be a hefty $360. Despite the costs and the limitations as a treatment, health officials are enthusiastic about the new form of acyclovir. "It is a very useful tool," says Mary Guinan, an associate director at the Centers for Disease Control in Atlanta. "We welcome it as part of our armamentarium in our war against sexually transmitted diseases."