United Press International; Tuesday June 16 8:17 PM EDT
Ed Ungar in Toronto

Clinical trials conducted at the University of Alberta have found that Famvir, generically known as famciclovir, was as effective as acyclovir, the other common oral treatment for herpes and cold sores in AIDS patients. However, an effective dose of Famvir required only two pills a day whereas acyclovir requires five for herpes, which affects nearly all AIDS patients.

"This gives a quality of life advantage when that's all you have left," said lead researcher Barabara Romanowski of the Division of Immunology of the University of Alberta.

The fact that only two pills a day are required rather than five also increases the chances patients will actually take them, said Sorana Segal-Maurer an attending physician at New York Hospital Medical Centre of Queens, a front line AIDS physician.

Actually taking the medicine prescribed is called compliance. Compliance "is probably good with five times a day medicine in the first day or two when people are in a lot of pain then they cut down the number of pills they take and the infection keeps going and they end up with a lot of problems," Segal-Meyer told United Press International.

However, it is not clear whether these advantages will convince other front line AIDS doctors to prescribe Famvir more often. Famvir is not a new drug. It has been available for the treatment of herpes and shingles in the general population since 1995. Thus any physician could, and some have prescribed the drug for AIDS patients before now.

Dr. Philip Berger, Medical Director of the Inner City Program of St. Michael's Hospital in Toronto and a pioneer front line AIDS specialist has prescribed the drug routinely for some time. He prescribes it when acyclovir doesn't work in a particular patient or if that patient developed a resistance to the older drug. SmithKline Beecham, Philadelphia, which received the FDA's marketing approval, noted the drug is the first and only herpes drug approved for use in AIDS patients. But herpes drugs already approved for other groups of patients have also been used for sometime.

"All these drugs are used even if they are not necessarily approved for specifically AIDS. It's the nature of HIV care" said Berger. But Famvir was and still is Berger's second choice because Famvir is no more effective in most cases than the older drugs and it is twice as expensive. Berger says patients comply with the treatment for the period of a herpes outbreak.

"I use acyclovir routinely period. I'm not going to change," said Berger. Whatever drug physicians use, physicians advise that herpes gets properly treated in AIDS patients. Outbreaks of herpes last longer for AIDS patients and occur more often than for those in the general population. AIDS's outbreaks are more painful and can even lead to disfigurement. AIDS's patients must sometimes under go plastic surgery in the genital area to counteract the ravages of herpes.

Nearly all people with HIV _ 95 percent _ are infected with one of two types of herpes, HSV-1 or HSV-2, which cause cold sores and genital herpes. Studies suggest that genital herpes is a major co-factor in the spread of HIV.

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