Existing Drugs to Treat Herpes Are Very Effective

Anthony L. Komaroff, M.D.

Q: Are there any new treatments for herpes?

A: There are no new treatments approved in the past few years, but there were many new treatments in the past few decades.

When I was in medical school, there were no treatments for herpes at all. Today, there are five treatments that are very effective.

Herpes is a condition caused by an infection of nerves that lead to the mouth, lips and nose area, or nerves that lead to the genital organs. The infection is caused by a virus called Herpes simplex virus (also human herpesvirus-1).

This virus causes a permanent infection of the nerves and remains latent or "asleep" inside the nerves most of the time. But sometimes it "wakes up" and starts multiplying. This leads to the sores that we call "herpes."

This same virus can cause much more serious disease than cold sores or genital sores. So the drugs that were developed to treat common herpes infections also can be life-saving with more serious infections.

The reason there were no treatments for herpes when I was in medical school is that medical science was just beginning to understand how viruses do their mischief. To cause disease, a virus has to enter a cell, multiply wildly, and then leave the cell and spread to other cells. To enter a cell, multiply and leave a cell, a virus has to activate a series of chemical processes.

Molecules (chemicals) that are part of the virus interact with certain molecules in cells. With Herpes simplex virus, scientists had to understand those chemical processes before they could design drugs to interrupt the processes. One of the first triumphs of the science of molecular biology in generating a treatment for human disease was the development of the first drug to treat herpes, acyclovir.

There are new drugs under development that may prove superior to the drugs currently available, but we'll have to wait and see. Meanwhile, the good news is that the herpes drugs that are available today are very effective at making herpes go away faster, and at making recurrent attacks happen less often.

Anthony L. Komaroff, M.D. is the Steven P. Simcox/Patrick A. Clifford/James H. Higby Professor of Medicine at Harvard Medical School and Senior Physician at Brigham and Women's Hospital, Boston, MA. Dr. Komaroff is Editor-in-Chief of Harvard Health Publications at Harvard Medical School.

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