A History of Research and Treatment For Herpies
The two herpies types, facial and genital, were being diagnosed and treated by physicians in Greece more than 2,000 years ago. Hippocrates used the term 'herpes' to describe lesions that appeared to creep or crawl along the skin. Herpetic eruptions on the lips (cold sores) were subsequently referred to by the Roman physician Herodotus around AD100.
Genital lesions due to the herpies simplex virus (HSV) were not described until 1736, when Astruc recorded cases in both men and women. No treatments were mentioned and another century passed before other French physicians, such as Alibert, de Boret and Unna began to classify different clinical presentations of genital herpes.
The first book on the subject of genital herpes, Les Herpes Genitaux, was published in 1886(3). Various treatments were suggested, including bismuth and starch poultices, and herpies patients were advised to avoid sexual excess, alcohol and tobacco.
Early Herpies Research And Treatment
Research into the genital herpies HSV virus began in earnest in the late19th and early 20th centuries. One of the milestones occurred in the 1930s, when Andrews and Carmichael observed that unlike other known infectious agents, recurrent infections with the herpies virus only occurred in those who carried antibodies to the virus.
This publication generated a huge debate and led to the first understanding of the nature of latency, the process by which HSV lies dormant in the nerve roots and is subsequently reactivated. It was several decades before Professor Schneweis of the Institute of Medical Microbiology and Immunology, Bonn, and Andre Nahmias MD, Professor of Pediatrics (Infectious Diseases) at the Emory University School of Medicine, Atlanta, went on to propose in 1971 that facial herpes (cold sores) and genital herpes are caused by two different types of HSV.
The Development of Research and Treatment For Herpies
The introduction of aciclovir in the early 1980s represented a significant milestone in the treatment for herpies virus infections. Gertrude Elion and George Hitchings were awarded the Nobel Prize in Medicine in 1988 for their research work involving a number of compounds, including aciclovir.
Prior to the advent of aciclovir, the antiviral therapies available to the medical community, such as cytosine arabinoside and idoxuridine, had significant side effects because of their non-specific activity. Aciclovir provided physicians with the first specific, effective and well-tolerated oral antiviral. It set the standard for anti herpes therapy and has since become a widely used treatment for herpies and prevention of herpes virus infections.
Treatment options have continued to improve over the past decade. Two new treatments for herpies, valaciclovir and famciclovir, have been licensed in many countries and offer the benefit of more convenient dosing regimens than aciclovir.
Both types of herpies treatment can be used either as episodic therapy (treatment started at the first signs of an attack and continued for a few days only) or as suppressive therapy (this treatment for herpies is continued for a few months or years in order to reduce the frequency of recurrences).
During the past decade, considerable research has been carried out to improve diagnosis of herpies. Blood tests which can detect HSV antibodies but which cannot differentiate between the two herpies types have been commercially available for years.
This makes it difficult to distinguish what may be cold sores (HSV-1) from what is almost certainly genital herpies (HSV-2). The newer Western blot test is more accurate and sensitive than most other tests but is costly and only available in a limited number of centres.
More recently, a new generation of type-specific blood tests have been introduced. These are less costly than the Western Blot test and faster and in some cases easier to administer.