https://www.sandiegohealthdirectory.com/kb en-us Genital HPV is the most common sexually transmitted disease in the United States. At least 50 percent of sexually active men and women get genital HPV at some time in their lives. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=173 Fri, 04 Aug 2006 08:22:27 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=173
Genital HPV is the most common sexually transmitted disease in the United States. At least 50 percent of sexually active men and women get genital HPV at some time in their lives.

Both high-risk and low-risk types of genital HPV can cause changes or growths on the tissue of a woman's cervix. The cervix is part of the uterus that opens to the vagina. Growths are usually flat and invisible. Some types of HPV can cause cervical cancer.

Approximately 10 of the 30 identified genital HPV types can lead, in rare cases, to development of cervical cancer. Most HPV infections do not progress to cervical cancer.

Having high-risk HPV is not the same as having cervical cancer. Usually, these high-risk HPV types cause no health problems at all and go away on their own. Persistent high-risk HPV (infection that does not go away) is the most important risk factor for cervical cancer. The good news is that cervical cell changes can be found with regular Pap tests, and treated to prevent cervical cancer from ever developing.

Low-risk types of HPV can cause genital warts. Warts can form weeks, months, or years after sexual contact with a person who has genital HPV.

Genital warts can grow inside and around the outside of the vagina, on the vulva – the "lips" or opening to the vagina and cervix, groin and in or around the anus. In men, genital warts can grow on the penis, scrotum, thigh, groin, or in or around the anus. While very rare, genital warts can grow in the mouth or throat of a person who has had oral sex with an infected person. The size of genital warts varies and some may be so small, you can't see them with your eyes. They can be flat and flesh-colored or look bumpy like cauliflower. They often occur in clusters or groups. They may cause itching, burning, and discomfort. It's also possible that warts may never appear. In fact, most people with low-risk types of genital HPV never know they are infected because they don't get warts or any other symptom.

Genital HPV is passed by skin-to-skin and genital contact, primarily during vaginal and anal intercourse. It might also be possible to pass it during oral sex.

A Pap test can find changes on the cervix, caused by an HPV infection. To do a Pap test, your doctor will use a small brush to take cells from your cervix. It’s simple and fast and the best way to find out if your cervix is healthy.

If you’re age 30 or older, your doctor may also do an HPV test with your Pap test. This is a DNA test that detects most of the high-risk types of HPV and is a test to help with cervical cancer screening. If you’re younger than 30 years old and have had a borderline (ASC-US) Pap test result, your doctor may give you an HPV test. This test will tell you if HPV caused the abnormal cells on your cervix.

Another way to tell if you have an HPV infection is if you have genital warts. Genital warts can grow inside and around the outside of the vagina, on the vulva - the "lips" or opening to the vagina and cervix, groin and in or around the anus. In men, genital warts can grow on the penis, scrotum, thigh, groin, or in or around the anus. Most of the time, people who have HPV infections never know they have it.

How often should I get a Pap test?

Follow these guidelines:
1. Begin getting Pap tests every one to three years if you have been sexually active or are older than age 21. Talk to your doctor about when and how often to get a Pap test.
2. If you are older than 65 years and have had normal Pap tests and are not at risk for cervical cancer, you may be able to stop getting Pap tests. Talk to your doctor or nurse about what is best for you.
3. If you had a total hysterectomy (removal of the uterus and cervix), you do not need to get a Pap test if the hysterectomy was done for a noncancerous condition.
Some experts differ on how often women need Pap tests. Talk to your doctor or nurse to find out when you should begin testing, how often you should be tested, and when you can stop.

What happens if I have an abnormal test?
If your Pap test doesn’t come back as normal, your doctor may tell you that you have an “abnormal” Pap test. An abnormal result does NOT mean you have HPV or cervical cancer. There could be many other reasons for an abnormal Pap test result, such as a yeast infection, irritation, or hormone changes.

If your Pap test is abnormal, your doctor may repeat the Pap test, do an HPV test, have a follow-up later, or do the following tests:
1. Colposcopy. A device is used to look closely at your cervix to get a better look at the abnormal areas.
2. Schiller test. The test involves coating the cervix with an iodine solution. Healthy cells turn brown and abnormal cells turn white or yellow.
3. Biopsy. A small amount of cervical tissue is removed and looked at under a microscope to figure out if abnormal cells have cancer.

You can have HPV but still have a normal Pap test. Changes on your cervix may not appear right away or they may never appear. For women over the age of 30 that get an HPV test and a Pap test, a negative result on both the Pap and HPV tests means that no cervical changes or HPV was found on the cervix. This is great news, because it means there is an extremely low chance of developing cervical cancer in the next few years.

There is no treatment or cure for HPV. However, there is treatment for the changes that HPV can cause on the cervix, as well as treatment for genital warts.

If you have abnormal cells on the cervix, it is very important to follow up with your doctor. If the problem is mild, your doctor may want to closely watch your condition to see if the cells heal on his or her own. Or your doctor may recommend removing the abnormal tissue.
These are the treatment options:
1. Cryosurgery. Abnormal tissue is frozen off.
2. Loop electrosurgical excision procedure (LEEP). Tissue is removed using a hot wire loop.
3. Laser treatment. A beam of light destroys the abnormal tissue.
4. Cone biopsy. A cone-shaped sample of tissue is removed from the cervix.
5. After these treatments, you may have vaginal bleeding, cramping, a brownish-black discharge, or a watery discharge. Even after treatment, it is important to follow up as recommended, to make sure the abnormalities do not come back.

Genital warts can be treated or not treated. Some people may want warts removed if they cause itching, burning, and discomfort. Others may want to clear up visible warts. If you decide to have warts removed, do NOT use over-the counter medicines meant for other kinds of warts. There are special treatments for genital warts. Your doctor may treat genital warts by applying a chemical in the office. Or your doctor may prescribe a cream that you apply at home. Surgery is also an option.
Surgical treatments include:
1. Electrocautery. An electric current is used to burn off the warts.
2. Laser treatment. Light is used to destroy warts.
3. Cryosurgery. Warts are frozen off.
4. Cutting them out.

Even after the warts are treated, the virus (genital HPV) may remain, and warts can return. For this reason, it is not clear if treating the genital warts lowers a person's chance of giving the virus - genital HPV to a sex partner or not. If left untreated, genital warts may go away, remain unchanged, or increase in size or number. They will not turn into cancer. It is not fully known why low-risk HPV causes genital warts in some cases and not in others.

HPV is just as common in men as in women. Fortunately, HPV rarely causes serious health problems in men, with the exception of anal cancer in men who have sex with men. There is no test for HPV in men.

HPV infection can infect male and female genital areas that are covered by a condom, as well as areas not covered by the condom. Using condoms may reduce the risk of getting genital warts and cervical cancer. But condoms may not completely protect you. The best way to protect yourself from HPV is to not have sex, or to only have sex with one uninfected partner who also only has sex with you.

There are many types of HPV, and it is possible to get HPV again.

Even if you think the warts have disappeared, you may still have a wart or warts you can’t see. Even after the warts are treated, the virus, HPV, may remain. Using condoms may reduce your risk of passing on genital warts, which are caused by HPV.

Women who had genital warts in the past, but no longer have them, will most likely not have any problems during pregnancy or birth. However, for women who have genital warts during pregnancy, the warts may grow, or may become larger and bleed. In rare cases, a pregnant woman can pass HPV to her baby during vaginal delivery. A baby that is exposed to HPV very rarely develops warts in the throat or voice box.
If the warts block the birth canal, a woman may need to have a cesarean-section delivery. However, HPV infection or genital warts are not a sole reason for C-section.

Other factors, in addition to having HPV, can raise the risk of developing cervical cancer. Some of these factors are not getting Pap tests, smoking, and having a weakened immune system.
Take these steps to prevent cervical cancer:
1. Get regular Pap tests. The best time to get a Pap test is between 10 and 20 days after the first day of your last period. Do not have the test done when you have your period. Don’t have sex or use douches, vaginal medicines unless your doctor tells you to, spermicide foams, creams, or jellies two days before your Pap test. Talk to your doctor about how often to get Pap tests.
2. Eat a healthy, balanced diet with delicious fruits and vegetables. In particular, carotene and vitamins C and E may reduce the risk of cervical and other cancers. Carotene is found in tomatoes, carrots, sweet potatoes, and broccoli. You can get vitamin C by eating fruits, especially citrus fruits, and vegetables. The darker the color of the fruit or vegetable, the more vitamin C. Load up on oranges, green and red peppers, broccoli, papayas, and strawberries. Good sources of vitamin E include oils such as safflower and corn, wheat germ, and sunflower seeds and nuts, such as almonds, peanuts, and hazelnuts.
3. Don’t smoke. Smoking can raise your risk of cervical cancer.
4. Be faithful. Be faithful to your partner, meaning that you only have sex with each other and no one else.
5. Protect yourself with a condom EVERY time you have vaginal, anal, or oral sex. HPV infection can infect male and female genital areas that are covered by a condom, as well as areas not covered by the condom. Using condoms may reduce the risk of getting genital warts and cervical cancer. But condoms may not completely protect you.]]> Results of a nationally representative study show that genital herpes infection is common in the United States. Nationwide, at least 45 million people ages 12 and older, or one out of five adolescents and adults, have had genital HSV infection. Between the late 1970s and the early 1990s, the number of Americans with genital herpes infection increased 30 percent. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=117 Tue, 27 Jun 2006 03:34:20 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=117
Results of a nationally representative study show that genital herpes infection is common in the United States. Nationwide, at least 45 million people ages 12 and older, or one out of five adolescents and adults, have had genital HSV infection. Between the late 1970s and the early 1990s, the number of Americans with genital herpes infection increased 30 percent.

Most people infected with HSV-2 are not aware of their infection. However, if signs and symptoms occur during the first outbreak, they can be quite pronounced. The first outbreak usually occurs within two weeks after the virus is transmitted, and the sores typically heal within two to four weeks. Other signs and symptoms during the primary episode may include a second crop of sores, and flu-like symptoms, including fever and swollen glands. However, most individuals with HSV-2 infection may never have sores, or they may have very mild signs that they do not even notice or that they mistake for insect bites or another skin condition.

Genital HSV-2 infection is more common in women, approximately one out of four women than in men, almost one out of five. This may be due to male-to-female transmissions being more likely than female-to-male transmission.

Anyone who is sexually active can get genital herpes. Additionally babies can become infected with genital herpes if the mother is infected at the time of delivery.

In addition, genital HSV can cause potentially fatal infections in babies. It is important that women avoid contracting herpes during pregnancy because a first episode during pregnancy causes a greater risk of transmission to the baby. If a woman has active genital herpes at delivery, a cesarean delivery is usually performed. Fortunately, infection of a baby from a woman with herpes infection is rare.

Genital herpes is transmitted through skin contact with an infectious lesions; this includes vaginal, anal, and oral sexual intercourse. Genital herpes is generally transmitted from the genitals of an infected sexual partner. About 70% of genital herpes are transmitted when the infected person has no signs or symptoms of genital herpes. Additionally, babies can become infected during childbirth if their mother is infected.

The first symptom to occur with genital herpes infection is generally a cluster of painful and itchy blisters or open sores on and around the genital area. During this initial outbreak, the blisters may spread, break, leak and crust over. The fluid from these sores contains herpes virus and is very infectious. Other symptoms associated with an outbreak include fever, swollen glands, aches, and pain during urination. This initial outbreak usually heals in 2-3 weeks. Recurring outbreaks are almost always less uncomfortable, shorter, and not as severe as the first outbreak. These recurrences may be triggered by stress, fatigue, and lack of sleep, menstruation, and genital friction.

Genital herpes can cause recurrent painful genital sores in many adults, and herpes infection can be severe in people with suppressed immune systems. Regardless of severity of symptoms, genital herpes frequently causes psychological distress in people who know they are infected.

Nearly 66% of those infected with genital herpes have no symptoms. Of those who develop symptoms, they usually appear 2 to 12 days after exposure.

No, herpes is a chronic infection, which means that the virus lives inside your body even when you have no symptoms. However, medication is available to decrease symptoms associated with genital herpes infection or to prevent recurrences. However, you may still be able to infect others with herpes virus even if you are taking medications for herpes.

Genital herpes is an infection that should be taken seriously. While genital herpes infections are rarely dangerous, many who are infected develop psychological stress as a result of infection. Women who are pregnant and have a first outbreak of genital herpes near the time of delivery may transmit the herpes virus to their baby, which can be dangerous to the child. For recurrent outbreaks, the risk of herpes transmission to the baby is much smaller.

Trained clinicians can diagnosis the initial outbreak of herpes by the appearance of the sores. Blood tests for the virus that usually causes genital herpes (HSV-2) are also available in some clinics. If you think you may have been exposed to herpes, you should visit a doctor to discuss testing and possible herpes therapy.

The signs and symptoms associated with HSV-2 can vary greatly. Health care providers can diagnose genital herpes by visual inspection if the outbreak is typical, and by taking a sample from the sore(s) and testing it in a laboratory. HSV infections can be difficult to diagnose between outbreaks. Blood tests, which detect HSV-1 or HSV-2 infection, may be helpful, although the results are not always clear-cut.

A positive blood test for genital herpes (HSV-2) means that you have been infected with the herpes virus sometime in the past; it cannot tell you when you were infected. Many people are infected with genital herpes and do not develop symptoms, so it is possible for you to be infected and transmit genital herpes without having any symptoms.

If you are infected with genital herpes, you can infect your partners with genital herpes even when you do not have an outbreak. You are most likely to infect your sex partners if you have sexual contact with them when you are having an outbreak - symptoms.

Before having sex with your current or new partner(s), you should discuss with them your herpes diagnosis. They may want to have a blood test for herpes to see if they already are infected.

Abstinence or not engaging in sexual activity is the only sure way to avoid getting sexually transmitted infection. Use of male condoms protects women from getting genital herpes from their male partners. However, it is not 100% effective. Also, taking herpes medication can reduce the chances of infecting a sex partner with herpes virus.

Persons with herpes should abstain from sexual activity with uninfected partners when lesions or other symptoms of herpes are present. It is important to know that even if a person does not have any symptoms he or she can still infect sex partners. Sex partners of infected persons should be advised that they might become infected. Sex partners can seek testing to determine if they are infected with HSV. A positive HSV-2 blood test most likely indicates a genital herpes infection.

Talk to your partner before sexual intercourse; suggest a STD test before you begin having sex and discuss ways in which to reduce your risk of infection – SAFE SEX.

There is no treatment that can cure herpes, but antiviral medications can shorten and prevent outbreaks during the period of time the person takes the medication. In addition, daily suppressive therapy for symptomatic herpes can reduce transmission to partners.

Note:
Herpes may play a role in the spread of HIV, the virus that causes AIDS. Herpes can make people more susceptible to HIV infection, and it can make HIV-infected individuals more infectious.]]> Active ingredient in broccoli, indole-3-carbinol, inhibits virus replication of HSV1 and HSV2. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=11 Sun, 19 Mar 2006 15:08:17 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=11 conducted by researchers at theNortheastern Ohio
Universities College of Medicine in Rootstown,
Ohioshow that a compound found naturally in broccoli, cabbage, and brussels sprouts-- indole-3-carbinol--may be a key to inhibiting the herpes simplex virus. And it works really well. The compound blockedthe virus from reproducing by an amazing 99.9 percent -- essentially 100
percent effectiveness.

The indole-3-carbinol compoundworks by interfering with factors that help cells reproduce. It inhibits the herpes simplex virus in the same way, since the virus needs those same factors as the cells to reproduce, reports WebMD and the Philadelphia Inquirer

The study: The researchers treated human and monkey cells with indole-3-carbinol. Then they infected them with one of two strains of the herpes virus: HSV-1,which can cause oral or genital herpes, and HSV-2, which causes genital herpes. The cells were also infected with a herpes virus strain that is known to be
resistant to medication.

The results: The indole-3-carbinol compound blocked the virus from reproducing by atleast 99.9 percent. Best of all, since the compound is found in food,it's safe.

Herpes differs markedly from other viruses. Once
a person contracts it, the virus lives in the body for a lifetime. The American Social Health Association estimates that as many as 80 percent of adults in the United States have oral herpes, while 20 percent have genital herpes. Fully 90 percent are unaware they havethe virus. There is no cure.

While this research news is promising, caution is
advised until further studies are done. What works in the lab doesn't always work on humans in the real world. Still, eating more broccoli is a good idea not only to prevent herpes, but also to possibly ward off cancer, cataracts, andstroke.

The research findings were presented to the Interscience Conference on Antimicrobial Agents and Chemotherapy.]]> Cimetidine demonstrates as an effective anti-viral for the treatment of genital HSV-2 and labial herpes and HSV-1, and shingles. Cimetidine has anti-viral and immune response enhancing effects. Available for more than twenty years, it is sold over the counter as Tagamet. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=1 Mon, 16 Jan 2006 03:34:09 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=1
With a majority of the population infected with oral herpes (i.e., cold sores), and almost one in five persons carrying antibodies to genital herpes, and the ulcers that each produce a portal for HIV infection, it is curious why the medical community continues to promote expensive treatments when effective and inexpensive solutions are available. Novartis sells the Famvir product, and Glaxo Smith Kline promotes its Valtrex product, but the generic version of Tagamet is virtually ignored. Direct evidence dating back more than 20 years demonstrates that the drug cimetidine (sold over-the-counter as Tagamet) is highly effective in shortening the duration or preventing the outbreaks of herpes and shingles. The problem is that virtually no physicians are prescribing cimetidine to their herpes (or shingles) patients, despite persuasive findings in peer-reviewed scientific journals.

Herpes simplex and herpes zoster are viral diseases that can be kept in remission by a healthy immune system. Direct evidence for this can be seen in cancer patients who undergo immune-suppressing chemotherapy and experience severe herpes outbreaks as a result.(1) Similar herpes flare-ups occur in other immune-comprising situations such as normal aging, where a latent herpes zoster virus can reemerge to cause painful shingles.

In 1988, The Life Extension Foundation recommended that certain cancer patients take the drug cimetidine (Tagamet) for the purpose of enhancing immune function. Cimetidine favorably modulates immune function via several mechanisms, but its best documented property is its inhibitory effect on T-suppressor cell function. The immune system is weakened when T-suppressor cells prematurely shut down immune function. Since cimetidine inhibits T-suppressor cell function, it can significantly enhance immune surveillance in some people.


Herpes simplex outbreaks have been shown to go into remission in response to the proper dose of cimetidine. In cases of herpes zoster (shingles) which targets the older population, cimetidine has been successfully used to lessen the debilitating pain and intensity of the skin rash and eruptions

Cimetidine (Tagamet) is a histamine2 (H2) receptor antagonist and, as such, can contribute to the enhancement of immune function. The first case observation occurred in August 1977 when a patient developed shingles just before commencing a course of cimetidine for a chronic stomach ulcer. The patient experienced dramatic relief of the shingles pain and rapid disappearance of the eruption. On the basis of this observation, cimetidine was prescribed to 21 patients with herpes zoster (shingles). The results were encouraging in 18 out of these 21 patients. The trial was then extended to other herpes virus infections. In six out of seven patients with herpes labialis (lip), the blisters were aborted, and in one patient with herpes keratitis the result was also encouraging, with the attacks being markedly shortened in duration and reduced in frequency. The results of these preliminary trials showed the potential role of cimetidine in the treatment of herpes virus infection.(2)

In 1996, a clinical trial was conducted on 221 patients with herpes zoster who were treated daily with cimetidine at 3 x 200 mg during the day and 1 x 400 mg at night. The results showed that cimetidine shortened the period of disease duration. The authors suggested using cimetidine in the treatment of shingles during the earliest stages of the disease.(3)

A case reported in Canada resulted in the statement that cimetidine therapy appeared to reduce the expected length of the active phase of herpes zoster from 35 days or more to just 10 days.(4)

At the Golda Medical Center in Israel, in 1994, a double-blind placebo-control study of cimetidine treatment versus placebo was conducted for one week in 22 patients with herpes zoster (shingles). Those who were treated with cimetidine were found to recover much more quickly from skin rash and pain than those who were given the placebo.(5)

At the Department of Neurology at Lady Davis Carmel Hospital in Israel, a randomized study evaluated the effect of cimetidine in the treatment of herpes zoster virus. The conclusion was that cimetidine treatment “shortened the median interval until the first decrease in pain, shortened the median interval until the complete resolution of pain and promoted faster complete healing of skin lesions….”(6)

A paper presented by a researcher at Michigan State University in the Department of Pediatrics and Human Development (1990) stated7)

“Suppressor T lymphocytes possess histamine2 (H2) receptors and contribute significantly to the function of the immune system. Cimetidine has been shown to enhance a variety of immunologic functions both in vivo and in vitro because of its inhibitory effects on suppressor-cell function. Successful tumor immunotherapy has been reported in experimental animals. Patients who received cimetidine were shown to exhibit enhanced cell-mediated immunity as evaluated by increased response to skin-test antigens, restoration of sensitivity following development of acquired tolerance, and increased responses of lymphocytes to mitogen stimulation. Patients also demonstrated that patients with herpes zoster and herpes simplex who were given cimetidine may have benefitted therapeutically from the drug.”

The consensus from these studies is that when cimetidine is administered to those with herpes simplex or shingles, the result is a dramatic relief of the herpetic pain as well as rapid disappearance of the blisters.

Novel approach overlooked

Cimetidine is the generic equivalent of the popular OTC drug better known by the brand name Tagamet. It is used primarily to relieve symptoms of esophageal reflux such as heartburn. Tagamet functions as a histamine (H2) receptor antagonist. It seems that most doctors don't know that T-lymphocyte suppressor cells have the H2 receptor. By blocking this receptor (using an H2 receptor antagonist such as Tagamet), the immune system can be temporarily turned up to help combat certain cancers and herpes viral infections.

Tagamet is manufactured by SmithKline Pharmaceuticals, headquartered in Philadelphia. When Life Extension asked about Tagamet's potential use in herpes treatment and quizzed about the lack of promotion for same, Carl Friedman from SmithKline's Research and Development Department said, “It [cimetidine] went off patent in 1994. We aren't vested in it anymore, so there's nothing to gain from it.” Echoing his sentiments, Deborah Frutos, from the pharmaceutical company's Corporate Finance and Administration Department said, “There's no incentive for us to promote our less expensive generic [cimetidine]. If we were to do any study for that, it would take lots of time and money. Even if it proved to be a good study, most physicians have other products they'd rather prescribe.” She added, “A grant guarantees that if we prove the drug is indicated for that [treating herpes], the generic would be manufactured and once the patent is protected, anyone can manufacture it. Let's just say we're not going to do it.”



Cimetidine is the generic equivalent of the popular OTC drug better known by the brand name Tagamet. Pictured above is a microscopic view of cimetidine.

The unwillingness of drug companies to promote their own products unless a patent guarantees them a fat profit margin is one reason why many promising therapies are overlooked. A person suffering from a herpes simplex or shingles outbreak can obtain Tagamet (cimetidine) over-the-counter for $38 a month as opposed to over $200 a month for the new anti-viral drugs, e.g., Valtrex and Famvir, being promoted to doctors. While there are no side-by-side comparisons, published studies indicate that Tagamet (cimetidine) may be more effective than FDA-approved anti-viral drugs.

Here we have cimetidine right under our noses and offered at a fraction of the cost of anti-viral drug therapy. Why is the majority of the medical community ignoring it? When Life Extension asked three practicing pharmacists if physicians ever recommend cimetidine to herpes patients, all three responded in the negative: 1) “rarely,” 2) “not much” and 3) “uh…sometimes, but not very often.” Asking the same question of three physicians, the answers were equally noncommittal and nondescript.

Cimetidine functions as an immunomodulator. In a collaborative study by several universities worldwide, 125 patients who were scheduled to undergo surgical procedures for colon or rectal cancer were randomized to receive either placebo or cimetidine preoperatively during a five day regimen. The conclusion was that a short course of cimetidine appeared to effect patient survival.8 Their hypothesis was based on their knowledge of previous studies that showed cimetidine to be effective as an immunostimulant.

Herpes simplex

The herpes simplex (HSV) is sexually transmitted by direct contact. HSV1 causes fever blisters on the mouth, sometimes on the face. HSV2 affects the genital area and is more commonly known as genital herpes. Once a person is infected with herpes simplex, they can spend a lifetime waiting for an outbreak, or they may experience several outbreaks a year. There is no known cure. The virus may lie dormant for months or years. Some people don't even know they have it until they have their first outbreak that manifests itself by an itchy and painful irritating rash, which then erupts as unsightly blisters.

The Centers for Disease Control in Atlanta recently reported that 45 million adolescents (age 12-plus) and adults in the United States are infected with genital herpes. Slightly more prevalent in women, this disease lays its claim on one of every four women and one of every five men in the U.S.

In the past 20 years, the number of Americans with genital herpes has increased 30%, especially among white adolescents.

The infection becomes more pronounced in severity in people whose immune systems are compromised, e.g., in patients who have AIDS, cancer or other diseases, or who have undergone an organ transplant. HSV2 can be fatal to infants born to mothers who test positive for the disease and are experiencing an outbreak during delivery. (Physicians who are informed ahead of time normally perform a Caesarian section to prevent the mother from shedding the virus onto her baby.)

Herpes zoster (shingles)

The most common neurologic condition known is herpes zoster, usually referred to as shingles. The CDC says that up to one million people in the United States contract herpes zoster each year. David Cooper, M.D., a contributing editor to JAMA, stated in 1998 that shingles afflicts more than one million people every year.

Herpes zoster is a reactivation of the virus that causes chicken pox. Once a person has recovered from chicken pox, the virus (varicella) remains dormant, hiding among the connective nerve tissue in the body. No one seems to know why it occurs, although stress and/or a compromised immune system is thought to exacerbate the condition, but it usually activates in people over the age of 50. Traveling through the ganglia, it causes a tingling, stinging or burning sensation. A couple days later, once the virus has completed its journey to the skin, an irritating and painful rash and accompanying blisters may erupt. The resulting condition can be so painful, the patient may be unable to tolerate clothing or anything that touches the affected area.

Standard treatment for herpes

Anti-viral drugs are commonly used to treat herpes simplex and herpes zoster. Due to varying intensities of pain and other symptoms associated with herpes zoster, analgesics and various other medications are prescribed. The most popular drug of choice has been Zovirax. Retail cost: Zovirax can cost $ 112 for a month's supply (150 capsules of 200 mg dosage, five times a day). A stronger dosage, 400 mg, five times a day would be $206 for a month's supply. And there is yet a stronger dose, which naturally costs even more. (Some patients may only be required to undergo a two-week course of medication while others take it chronically to prevent outbreaks). More modern versions of acyclovir, such as desciclovir, famciclovir, valaciclovir and penciclovir, cost even more.

Cimetidine may not work against warts

It is important to understand that cimetidine is not a panacea for every disease that might be helped by improving immune function.

One study used cimetidine for three months to evaluate its effects on 54 people with warts. Cure rates obtained were 32% in the cimetidine-treated group and 30.7% in the placebo-treated group. Thus, no significant difference was found between cimetidine and placebo in effectiveness in the treatment of patients with common warts.(9)

In a much smaller study, the effect of cimetidine was investigated in the management of genital and perigenital warts in children. Four had extensive condylomata acuminata of the genital and perigenital areas. They were treated with high doses (30 to 40 mg./kg of cimetidine) in an attempt to eradicate the condyloma (in two patients) and avoid recurrence in the other two. Cimetidine was administered daily in three divided doses during a three-month period. At the 24-month evaluation, all four patients were free of condyloma. The conclusion of the authors was that cimetidine is effective for primary and adjunctive treatment of condyloma in young children. It also seems to be effective as first-line therapy.(10)

Conclusion


Studies indicate that viruses like herpes simplex and herpes zoster can be put into quick remission, or the breakouts prevented altogether, when T-lymphocyte suppressor cell function is inhibited. The best way of accomplishing this is to take 200 mg of cimetidine (Tagamet) three times a day and then 400 mg at bedtime. Tagamet is available in pharmacies over-the-counter.

Published studies indicate that viruses like herpes simplex and herpes zoster can be put into quick remission, or the breakouts prevented altogether, when T-lymphocyte suppressor cell function is inhibited. The best way of accomplishing this is to take 200 mg of cimetidine (Tagamet) three times a day and then 400 mg a bedtime. Tagamet is available in pharmacies over-the-counter. Suggested use is to initiate Tagamet as soon as symptoms of a herpes-related virus infection appear. Continue to take it for one to two weeks after all symptoms of the outbreak have abated.

One precautionary note, even though Tagamet (cimetidine) is sold over-the-counter, refer to the package insert to make sure it does not interact with prescription drugs you may already be taking.

Please note that if your doctor prescribes generic cimetidine, it may cost less to obtain it as a prescription drug (especially if you have prescription drug insurance) rather than buying the Tagamet name brand that is available without a prescription.


References

1. Devine SM, Wingard JR 1994, Viral infections in severely immunocompromised cancer patients. Support Care Cancer 1994 Nov;2(6):355-68.

2. Van der Spuy S, Levy DW, Levin W 1980. Cimetidine in the treatment of herpes virus infections. S Afr Med J Jul 19;58(3):112-6.

3. Kapinska-Mrowiecka M, Toruwski G: 1996. Efficacy of cimetidine in treatment of herpes zoster in the first 5 days from the moment of disease manifestation. Pol Tyg Lek Jun;51(23-26):338-9.

4. Hayne ST, Mercer JB 1983. Herpes zoster:treatment with cemetidine. Can Med Assoc J Dec 15;129(12):1284-5.

5. Komlos L, Notmann J, Arieli J, et.al. 1994. In vitro cell-mediated immune reactions in herpes zoster patients treated with cimetidine. Asian Pac J Allelrgy Immunol Jun;12(1):51-8.

6. Miller A, Harel D, Laor A, Lahat N 1989. Cimetidine as an immunomodulator in the treatment of herpes zoster. J Neuroimmunol 1989 Mar;22(1):69-76.

7. Kumar A, 1990. Cimetidine: an immunomodulator. DICP Mar;24(3):289-95.

8. Kelly MD, King J, Cherian M, Dwerryhouse SJ, Finlay IG, Adams WJ, King DW, Lubowski D, Morris DL. 1999. Randomized Trial of Preoperative Cimetidine in Patients with Colorectal Carcinoma with Quantitative Assessment of Tumor-Associated Lymphocytes. Cancer Journal 85: 1658-63.

9. Yilmaz, E, Alpsoy E, Basaran E. 1996. Cimetidine therapy for warts: a placebo-controlled, double-blind study. J Am Acad Dermatol Jun; 34(6):1005-7.

10. Franco I 2000. Oral cemetidine for the management of genital and perigenital warts in children. J Urol Sep;164(3 Pt 2):1074-5.

General References

Bense L., Marcusson JA, Ramsten T 1987. Effect of cimetidine on herpes zoster infection. Drug Intell Clin Pharm Oct;21(10);803-5.

Brockmeyer NH et.al. Immunomodulatory properties of Cimetidine in ARC patients. Clinical Immunology and Immunopathology, no.48, pp.50-60, 1988.

Cooper, David, M.D., Journal of the American Medical Association, Dec 9, 1998. (Contributing Editor: Comments on shingles.)

Fleming DT, McQuillan GM, Johnson RE, Nahmias AJ, Aral SO, Lee FK, St. Louis ME. Herpes Simplex Virus Type 2 in the United States, 1976 to 1994.

New England Journal of Medicine. 1997; 337:16:1105-1111.

New England Journal of Medicine, Nov 23, 2000: 343, No. 21: Editorial: C. Peter N. Watson, M.D., University of Toronto.

News Release: “NIAID: NIAID Spearheads Collaborative Network for Clinical Research on Immune Tolerance,” Oct 6, 1999.

Pharmaceutical Cost Quotes: SAV-ON Pharmacy in Orange County, CA.

Smith D 1989. Cimetidine (Tagamet) as Immunomodulator, Antitumor Treatment. AIDS Treatment News 80:June 2.

UCLA MedNet.: UCLA School of Medicine Library.

VZV Research Foundation: Newsletter: Vol.V, No. 1, Spring/Summer 2000.

Websites:

www.cdc.gov/nchstp/dstd/Genital_Herpes_facts.htm - Centers for Disease Control

www.intelihealth.com/IH

www.ljimm.org/immunobio.htm - La Jolla Institute for Molecular Medicine: Department of Immunobiology

www.niaid.nih.gov - The National Institute of Allergy and Infectious Diseases

www.niaid.nih.gov/shingles/cq.htm - The Shingles Prevention Study NIH Bethesda Team: Common Questions about Shingles

www.onhealth.webmd.com/conditions/resource/pharmacy

www.vzvfoundation.org - News for Scientists and Medical Professionals

Article by William Faloon and Kate Kitchen

Courtesy of San Diego Health Resource Directory www.sandiegohealthdirectory.com]]>