Genital herpes is a sexually transmitted disease caused primarily by herpes simplex virus type 2. This disease is characterized by an outbreak of blisters on the genital mucosa occurring shortly after primary infection. There may be associated flu-like symptoms. This disease has periods of latency and reactivation which vary with each invididual. Recurrent episodes are usually shorter in duration and less severe than the initial outbreak, but do tend to recur at the same site as the initial infection. Patients can frequently predict an outbreak by prodromal symptoms such as itching, tingling, or redness of the skin at the site of the initial infection. It is estimated that 20-30% of American adults have serological evidence of infection with the HSV-2 virus that is most commonly associated with genital herpes, 25 million of whom suffer from recurrent outbreaks of genital herpes. Currently, the 3 FDA approved treatments for recurrent genital herpes are acyclovir, famciclovir and valaciclovir. Oral acyclovir has been proven to be clinically effective, however, relatively poor oral bioavailavility, frequent dosing regimen and modest in vitro activity indicate the need for a more potent agent. Famciclovir and valaciclovir offer no efficacy advantage over oral acyclovir and still must be administered twice a day. Lobucavir has been shown to have a broad spectrum of antiviral activity in vitro. Although the mechanism is unclear, it does inhibit HSV replication in infected cells. It has also been shown to be effective in a variety of HSV infected animals. The safety and efficacy of Lobucavir is currently being evaluated in genital herpes.
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