Acyclovir Prevents Reactivation of Herpes Simplex Labialis in Skiers

Spruance, Spotswood L.; Hamill, Michelle; Hoge, W S; Davis, L. Gray; Mills, John

doi:10.1001/jama.1988.03410110105036

Cited by 98 publications

(9 citation statements)

References 15 publications

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“…However, differences of less or comparable magnitude are regarded as both biologically and clinically significant in a variety of clinical studies of new antiviral drugs against herpes. 10,11,[39][40][41][42][43][44][45] Thus, the difference between 23% reactivation in COX-2-treated mice compared to 54% in control, untreated mice seen in our study is biologically and likely clinically significant if translated to humans. It may be that a combination of an antiviral drug, such as acyclovir, and celecoxib, a COX-2 inhibitor, would either additively or synergistically enhance the level of inhibition of viral reactivation.…”

Section: Discussionmentioning

confidence: 56%

Inhibition of Cyclooxygenase 2 Synthesis SuppressesHerpes simplexVirus Type 1 Reactivation

Gebhardt

Varnell

Kaufman

2005

Journal of Ocular Pharmacology and Therapeutics

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Recurrent herpes virus infection, in which the virus reactivates from the nervous system and causes painful lesions in peripheral tissues, is a significant clinical problem. Our recent studies showing that the amount of cyclooxygenase 2 (COX-2) in the trigeminal ganglia of heat-stressed untreated mice is higher than the amount in heat-stressed mice treated with the COX-2 inhibitor, celecoxib, have indicated that the prostaglandin synthesis pathway--and in particular COX-2--may be an intermediate in the pathway to herpes viral reactivation. To further study this process, we infected the corneas of mice using topical application to a lightly scratched epithelium and waited 30 days for Herpes simplex virus type 1 (HSV-1) latency to be established in the trigeminal ganglia. Prior to the induction of viral reactivation, the mice were treated orally with celecoxib. Treated and untreated mice were induced to undergo reactivation by immersion in 43 degrees C water for 10 min. The shedding of virus at the ocular surface was determined by culturing ocular swabs with indicator cells. The presence of infectious virus in the trigeminal ganglion was evaluated by incubating ganglion homogenates with indicator cells and observing for cytopathic effect. Celecoxib treatment significantly suppressed viral reactivation when given prophylactically by the gastrointestinal route. The numbers of corneas and ganglia containing infectious virus were significantly lower in the celecoxib-treated animals, compared to the placebo-treated mice. These experiments demonstrate that a selective COX-2 inhibitor can suppress hyperthermic stress-induced herpes viral reactivation in the nervous system. It may be possible to use COX-2 inhibitors to prevent viral reactivation in high-risk patients by drug prophylaxis.

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Section: Discussionmentioning

confidence: 56%

Inhibition of Cyclooxygenase 2 Synthesis SuppressesHerpes simplexVirus Type 1 Reactivation

Gebhardt

Varnell

Kaufman

2005

Journal of Ocular Pharmacology and Therapeutics

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“…276 In a study of 147 skiers, subjects taking 400 mg acyclovir twice daily, starting 12 hours before sun exposure and continuing up to 7 days, developed considerably fewer recurrences compared with control subjects (7% of subjects vs 26% of controls). 275 In another study of skiers, intake of 800 mg acyclovir twice daily started half a day to 1 day before sun exposure provided no significant protection against HSL recurrence compared with placebo. 277 Despite conflicting studies, preemptive therapy with topical or systemic antivirals should be offered to patients with known triggers who are at risk for recurrent HSL as a result of a transient stressful event or short-term exposure to intense sun (such as high-altitude skiing or beach vacation).…”

Section: Treatment Of Recurrent Herpetic Infectionsmentioning

confidence: 98%

“…12,36,72,90,274 Short-term prophylactic therapy a few hours to days before an event known to precipitate a recurrence may reduce the frequency and severity of a herpetic outbreak. 36,275 Evidence for preemptive therapy in the prevention of facial herpes remains equivocal. 36 Application of sunscreen before ultraviolet light exposure has proven protective against solar damage to the perioral region, herpetic Photoactivation, and HSL recurrence in susceptible patients.…”

Section: Treatment Of Recurrent Herpetic Infectionsmentioning

confidence: 99%

Human herpes simplex virus infections: Epidemiology, pathogenesis, symptomatology, diagnosis, and management

Fatahzadeh¹,

Schwartz²

2007

Journal of the American Academy of Dermatology

453

431

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“…A more profound effect was seen when oral acyclovir was used prophylactically [10][11][12]. Clearly for persons with frequent episodes or well-defined precipitating factors (e.g., sun exposure while skiing), suppressive oral therapy for prolonged or at-risk periods may be more appropriate.…”

mentioning

confidence: 99%

Valacyclovir in the Treatment of Facial Herpes Simplex Virus Infection

Laiškonis¹,

Thune

Neldam³

et al. 2002

J INFECT DIS

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The objective of this multicenter, randomized, double-blind, noninferiority trial was to investigate valacyclovir as treatment for facial herpes simplex virus (HSV) outbreaks. In total, 308 otherwise healthy outpatients self-initiated therapy with valacyclovir, either 1000 mg twice daily for 1 day or 500 mg twice daily for 3 days, for treatment of one facial HSV episode. Aborted lesions were the primary end point. Secondary end points included episode and pain resolution and lesion healing. By regimen (1 or 3 days), aborted lesions occurred in 42.2% versus 46.7% of patients, treatment difference, -4.5% (95% confidence interval, -16.3% to 7.4%; P=.49). Subgroup findings showed that about half the episodes aborted when therapy started during the prodrome/macule stages or within 6 h of first symptoms. Episode and pain resolved rapidly, with results similar for both treatments. Adverse events were infrequent and similar for the two regimens.

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Acyclovir Prevents Reactivation of Herpes Simplex Labialis in Skiers

Cited by 98 publications

References 15 publications

Inhibition of Cyclooxygenase 2 Synthesis SuppressesHerpes simplexVirus Type 1 Reactivation

Inhibition of Cyclooxygenase 2 Synthesis SuppressesHerpes simplexVirus Type 1 Reactivation

Human herpes simplex virus infections: Epidemiology, pathogenesis, symptomatology, diagnosis, and management

Valacyclovir in the Treatment of Facial Herpes Simplex Virus Infection

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