RT Journal
A1 Engel JP
T1 ANtiviral therapies for long-term suppression of genital herpes—reply
JF JAMA
JO JAMA
YR 1999
FD April 7
VO 281
IS 13
SP 1169
OP 1170
DO 10-1001/pubs.JAMA-ISSN-0098-7484-281-13-jbk0407
UL http://dx.doi.org/10-1001/pubs.JAMA-ISSN-0098-7484-281-13-jbk0407
AB 
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.