Treatment of first episodes of genital herpes simplex virus infection with oral acyclovir. A randomized double-blind controlled trial in normal subjects
YJ Bryson, M Dillon, M Lovett, G Acuna, S Taylor, JD Cherry, BL Johnson, E Wiesmeier, W Growdon, T Creagh-Kirk, and R Keeney
We performed a double-blind placebo-controlled trial of oral acyclovir in the treatment of first episodes of genital herpes simplex virus infections in 48 young adults (31 women and 17 men). Subjects were randomized to receive either placebo or acyclovir (200 mg per dose) five times daily for 10 days; they were examined on at least eight visits until healed and at monthly visits thereafter. Acyclovir treatment, as compared with placebo, significantly reduced virus shedding, new lesion formation after 48 hours, and the duration of genital lesions in both men and women. The total duration and severity of clinical symptoms (such as pain, adenopathy, dysuria, and malaise) were significantly reduced by acyclovir in both men and women by the third and fourth day, respectively (P less than or equal to 0.025), as compared with placebo. No toxicity was observed. Recurrence rates have so far been similar in placebo and acyclovir recipients. Oral acyclovir treatment of first-episode genital herpes simplex virus infections is clinically effective, but it does not seem to prevent virus latency or associated recurrent disease.
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Vickerman, P, Ndowa, F, Mayaud, P
(2008). Modelling the cost per ulcer treated of incorporating episodic treatment for HSV-2 into the syndromic algorithm for genital ulcer disease. Sex. Transm. Infect.
84: 243-248
[Abstract][Full Text]
Fisman, D N, Hook, E W III, Goldie, S J
(2003). Estimating the costs and benefits of screening monogamous, heterosexual couples for unrecognised infection with herpes simplex virus type 2. Sex. Transm. Infect.
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Bacon, T. H., Levin, M. J., Leary, J. J., Sarisky, R. T., Sutton, D.
(2003). Herpes Simplex Virus Resistance to Acyclovir and Penciclovir after Two Decades of Antiviral Therapy. Clin. Microbiol. Rev.
16: 114-128
[Abstract][Full Text]
Tyring, S. K., Douglas, J. M. Jr, Corey, L., Spruance, S. L., Esmann, J., for the Valaciclovir International Study Group,
(1998). A Randomized, Placebo-Controlled Comparison of Oral Valacyclovir and Acyclovir in Immunocompetent Patients With Recurrent Genital Herpes Infections. Arch Dermatol
134: 185-191
[Abstract][Full Text]
Goldberg, L. H., Kaufman, R., Kurtz, T. O., Conant, M. A., Eron, L. J., Batenhorst, R. L., Boone, G. S., the Acyclovir Study Group,
(1993). Long-term Suppression of Recurrent Genital Herpes With Acyclovir: A 5-Year Benchmark. Arch Dermatol
129: 582-587
[Abstract]
Koelle, D. M., Benedetti, J., Langenberg, A., Corey, L.
(1992). Asymptomatic Reactivation of Herpes Simplex Virus in Women after the First Episode of Genital Herpes. ANN INTERN MED
116: 433-437
[Abstract]
Elion, G.
(1989). The purine path to chemotherapy. Science
244: 41-47
[Abstract]
Mertz, G. J., Jones, C. C., Mills, J., Fife, K. H., Lemon, S. M., Stapleton, J. T., Hill, E. L., Davis, L. G., the Acyclovir Study Group,
(1988). Long-term Acyclovir Suppression of Frequently Recurring Genital Herpes Simplex Virus Infection: A Multicenter Double-blind Trial. JAMA
260: 201-206
[Abstract]
Rompalo, A. M., Mertz, G. J., Davis, L. G., Benedetti, J., Critchlow, C., Stamm, W. E., Corey, L.
(1988). Oral Acyclovir for Treatment of First-Episode Herpes Simplex Virus Proctitis. JAMA
259: 2879-2881
[Abstract]
WHITLEY, R. J.
(1988). Ganciclovir--Have We Established Clinical Value in the Treatment of Cytomegalovirus Infections?. ANN INTERN MED
108: 452-454
[Abstract]
DORSKY, D. I., CRUMPACKER, C. S.
(1987). Drugs Five Years Later: Acyclovir. ANN INTERN MED
107: 859-874
[Abstract]
Kaplan, L. D., Wofsy, C. B., Volberding, P. A.
(1987). Treatment of Patients With Acquired Immunodeficiency Syndrome and Associated Manifestations. JAMA
257: 1367-1374
[Abstract]
Guinan, M. E.
(1986). Oral Acyclovir for Treatment and Suppression of Genital Herpes Simplex Virus Infection: A Review. JAMA
255: 1747-1749
[Abstract]
Balfour, H. H. Jr
(1986). Acyclovir Therapy for Herpes Zoster: Advantages and Adverse Effects. JAMA
255: 387-388
[Abstract]
SHEPP, D. H., NEWTON, B. A., DANDLIKER, P. S., FLOURNOY, N., MEYERS, J. D.
(1985). Oral Acyclovir Therapy for Mucocutaneous Herpes Simplex Virus Infections in Immunocompromised Marrow Transplant Recipients. ANN INTERN MED
102: 783-785
[Abstract]
Marlowe, S. I.
(1985). Medical Management of Genital Herpes: Advances in Antiviral Treatment. Arch Dermatol
121: 467-470
[Abstract]
Dolin, R
(1985). Antiviral chemotherapy and chemoprophylaxis. Science
227: 1296-1303
[Abstract]
Mertz, G. J., Critchlow, C. W., Benedetti, J., Reichman, R. C., Dolin, R., Connor, J., Redfield, D. C., Savoia, M. C., Richman, D. D., Tyrrell, D. L., Miedzinski, L., Portnoy, J., Keeney, R. E., Corey, L.
(1984). Double-blind Placebo-Controlled Trial of Oral Acyclovir in First-Episode Genital Herpes Simplex Virus Infection. JAMA
252: 1147-1151
[Abstract]
JORDAN, M. C., JORDAN, G. W., STEVENS, J. G., MILLER, G.
(1984). Latent Herpesviruses of Humans. ANN INTERN MED
100: 866-880
[Abstract]
Laskin, O. L.
(1984). Acyclovir: Pharmacology and Clinical Experience. Arch Intern Med
144: 1241-1246
[Abstract]
Reichman, R. C., Badger, G. J., Mertz, G. J., Corey, L., Richman, D. D., Connor, J. D., Redfield, D., Savoia, M. C., Oxman, M. N., Bryson, Y., Tyrrell, D. L., Portnoy, J., Creigh-Kirk, T., Keeney, R. E., Ashikaga, T., Dolin, R.
(1984). Treatment of Recurrent Genital Herpes Simplex Infections With Oral Acyclovir: A Controlled Trial. JAMA
251: 2103-2107
[Abstract]