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Letters
April 7, 1999

Antiviral Therapies for Long-term Suppression of Genital Herpes—Reply

Author Affiliations
 

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(13):1169-1170. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-13-jbk0407

In Reply: Drs Wald and Corey's criticisms of the table in my Editorial of antiviral therapies for the long-term suppression of genital herpes are valid and emphasize the need for head-to-head clinical trials of these drugs. Since these studies are lacking, I nevertheless felt that it was necessary to juxtapose the published clinical outcomes (with costs) of placebo-controlled trials in a comparison table so that, at least, providers could be assisted in forming their own conclusions when selecting a drug. Clinical trials measure outcomes in patient populations, but the individual patient is concerned about 1 outcome: how many recurrences of genital herpes will I experience while taking this drug? One point of my Editorial was to underscore the frustration clinicians face when deciding on a drug regimen when there are no comparison data of 3 drugs that seem to have similar activity. I, too, look forward to the results of the famciclovir vs valacyclovir trial, and agree that a study evaluating the effect of antiviral suppression on transmission of HSV type 2 in serodiscordant couples is necessary.

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