[Zinc sulfate and heparin for local therapy of herpes. Antiherpetic drugs, not leading to selection of HSV variants].

The massive widespread use of a substance to treat HSV could lead to the spread of resistant HSV strains and hence to a failure of treatment in a vital indication. In Germany, three defined substances suitable for treating HSV are available over the counter: Zinc sulfate, heparin and acyclovir. Experiments show that heparin retains its activity even after 20 passages whereas acyclovir produces a completely resistant virus after only a single passage. The inactivation of free HSV by zinc sulfate is reduced after serial passages. However, this partial resistance disappears again spontaneously and may be considered clinically irrelevant. With respect to drug efficacy and resistance, therefore, a combination of zinc sulfate and heparin would appear superior to zinc sulfate alone. The use of the genotoxic DNA polymerase inhibitor acyclovir should be restricted to severe cases of HSV.