Treatment of Recurrent Genital Herpes Simplex Infections With Oral Acyclovir

Reichman, Richard C.; Badger, Gary J.; Mertz, Grégory; Corey, Lawrence; Richman, Douglas D.; Connor, James D.; Redfield, David C.; Savoia, Maria C.; Oxman, Michael N.; Bryson, Yvonne J.

doi:10.1001/jama.1984.03340400031020

Cited by 269 publications

(52 citation statements)

References 11 publications

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“…A sample size of 40 per group would have 98% power to detect a difference of 3 days in mean time to healing between the resiquimod and vehicle groups, assuming a common standard deviation of 3.1 (17). This was estimated by using a two-group t test with a 0.05 two-sided significance level (nQuery 5.0; Statistical Solutions, Saugus, MA).…”

Section: Methodsmentioning

confidence: 99%

Effect of Resiquimod 0.01% Gel on Lesion Healing and Viral Shedding When Applied to Genital Herpes Lesions

Fife

Meng

Ferris

et al. 2008

Antimicrob Agents Chemother

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Resiquimod, a Toll-like receptor 7/8 agonist developed as a topical treatment to decrease recurrences of anogenital herpes, induces proinflammatory cytokines that may delay lesion healing. Adults with frequently recurring anogenital herpes were randomized within 24 h of onset of a recurrence to vehicle or resiquimod 0.01% gel two times per week for 3 weeks. Subjects underwent daily lesion assessments and sampling for herpes simplex virus DNA PCR for 21 days or until investigator-determined healing of lesion(s). Eighty-two subjects with a mean age of 39 ؎ 10.5 years and a median of seven recurrences per year were enrolled in the study. The qualifying recurrence was positive by PCR for herpes simplex virus in 68% of subjects. No difference was observed between the vehicle (39 subjects) and resiquimod (43 subjects) groups with respect to time to healing (median of 7.0 days versus median of 6.5 days, respectively; Cox proportional hazard model ratio of 1.229; 95% confidence interval, 0.778 to 1.942; P ‫؍‬ 0.376). The distributions of maximum severity scores for any investigator-assessed local skin signs and for subject-assessed local symptoms were similar between treatment groups (P ‫؍‬ 0.807 and P ‫؍‬ 0.103, respectively). For subjects with at least one positive PCR result, no difference was observed for time to cessation of viral shedding (median of 7 days versus median of 5 days for vehicle and resiquimod groups, respectively; Cox proportional hazard model ratio of 1.471; 95% confidence interval, 0.786 to 2.754; P ‫؍‬ 0.227). Application of resiquimod 0.01% two times per week for 3 weeks did not delay the healing of genital herpes lesions or reduce acute viral shedding.

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Section: Methodsmentioning

confidence: 99%

Effect of Resiquimod 0.01% Gel on Lesion Healing and Viral Shedding When Applied to Genital Herpes Lesions

Fife

Meng

Ferris

et al. 2008

Antimicrob Agents Chemother

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“…Patient-initiated treatment has been shown to lead to a significantly faster healing time in recurrent genital HSV infections than clinic-initiated therapy. 9,11 In all of the studies in which acyclovir treatment was patient initiated, the mean lesion healing time was reduced by approximately 1 to 2 days compared with placebo. 9,11,20 In the present study, the median lesion healing time was likewise reduced by approximately 1 day (4.8 days vs 6.0 days with placebo) in the acyclovir treatment group.…”

Section: Commentmentioning

confidence: 99%

A Randomized, Placebo-Controlled Comparison of Oral Valacyclovir and Acyclovir in Immunocompetent Patients With Recurrent Genital Herpes Infections

et al. 1998

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“…In nine fully evaluable patients, oral acyclovir (2 g/day in three doses for 10 days) initiated during the earlist phase of a recurrence reduced the mean durations (± standard deviation) of clinkal symptoms from 10.1 (±3.6) to 3.7 (±3.0) days (P = 0.008), signs from 11.1 (±3.7) to 6.2 (±3.3) days (P = 0.024), and viral positivity from 5.3 (+3.8) to 0.6 (±1.1) days (P = 0.011).Effective treatments for most human herpes simplex virus (HSV) infections have been well documented (7,(9)(10)(11)(12). However, recurrent HSV infection of the band, which can be frequent, painful, and cosmetically unacceptable, has attracted little therapeutic attention (1-3, 5, 6, 8).…”

mentioning

confidence: 99%

“…Effective treatments for most human herpes simplex virus (HSV) infections have been well documented (7,(9)(10)(11)(12). However, recurrent HSV infection of the band, which can be frequent, painful, and cosmetically unacceptable, has attracted little therapeutic attention (1-3, 5, 6, 8).…”

mentioning

confidence: 99%

“…However, the dosage of acyclovir, duration of therapy, and timing of intervention can likely be further optimized to give results equal or even superior to those described above. Other studies have suggested that lower doses of acyclovir are effective in the early treatment of recurrences of HSV-2 infections at other sites (10). The 10-day course of therapy was chosen to be longer than the anticipated duration of a recurrence.…”

mentioning

confidence: 99%

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Oral acyclovir therapy of recurrent herpes simplex virus type 2 infection of the hand

Gill

Bryant

1991

Antimicrob Agents Chemother

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Acydovir was evaluated as treatment of recurrent herpes simplex virus type 2 infection of the hand in a double-blind, placebo-controed crossover study. In nine fully evaluable patients, oral acyclovir (2 g/day in three doses for 10 days) initiated during the earlist phase of a recurrence reduced the mean durations (± standard deviation) of clinkal symptoms from 10.1 (±3.6) to 3.7 (±3.0) days (P = 0.008), signs from 11.1 (±3.7) to 6.2 (±3.3) days (P = 0.024), and viral positivity from 5.3 (+3.8) to 0.6 (±1.1) days (P = 0.011).Effective treatments for most human herpes simplex virus (HSV) infections have been well documented (7,(9)(10)(11)(12). However, recurrent HSV infection of the band, which can be frequent, painful, and cosmetically unacceptable, has attracted little therapeutic attention (1-3, 5, 6, 8). After an earlier uncontrolled observation, we evaluated in this double-blind, placebo-controlled crossover study the effects of early intervention with oral acyclovir on the durations of symptoms, signs, and virl culture positivity of recurrent HSV type 2 (HSV-2) infection of the hand (4).Fourteen patients (11 males and 3 females) with documented HSV-2 infection of the hand participated in a study that was approved by the University of Calgary Committee on Medical Bioethics. All the patients were between 18 and 50 years old and had between 2 and 12 recurrent infections per year. They were otherwise in good health with no evidence of any underlying immunodeficiency. All the females were using a recognized form of contraception and were not pregnant at the time of treatment.A double-blind, placebo-controlled crossover design was adopted in view of the limited number of eligible patients. Due to uncertainties about the bioavailability of acyclovir at the time of the study design, a high-dose regimen was selected. Active drug or placebo (provided by Burroughs Weilcome, Kirkland, Quebec, Canada) was randomized to either cycle A or B by a computer program. The patients were given written instructions and a bottle of 100 tablets (cycle A). They were advised to take four tablets when prodromal symptoms which they felt likely to result in HSV infection of the hand were first noticed, followed by two doses each of three tablets in a 24-h period. A total of 10 tablets per day in three doses was given for a total of 10 days. The patients were reviewed within 24 h of initiating therapy and then daily until the episode resolved. After the first course of therapy, the patients returned the cycle A bottle and were given a second bottle (cycle B) with identical instructions.The presence and severity of symptoms (pain, swelling, tingling, tenderness, and discomfort) and both local and systemic signs of infection (erythema, papule, vesicle, pustule, scab, lymphangitis, and lymphadenopathy) were recorded at each visit. analyzed by using within-patijnt paired t tests.

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Treatment of Recurrent Genital Herpes Simplex Infections With Oral Acyclovir

Cited by 269 publications

References 11 publications

Effect of Resiquimod 0.01% Gel on Lesion Healing and Viral Shedding When Applied to Genital Herpes Lesions

Effect of Resiquimod 0.01% Gel on Lesion Healing and Viral Shedding When Applied to Genital Herpes Lesions

A Randomized, Placebo-Controlled Comparison of Oral Valacyclovir and Acyclovir in Immunocompetent Patients With Recurrent Genital Herpes Infections

Oral acyclovir therapy of recurrent herpes simplex virus type 2 infection of the hand

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