Recurrent Genital Herpes Suppressed by Oral Acyclovir: A Multicentre Double Blind Trial

INTERVENTIONS: Patients self-initiated oral therapy with 1000 mg of valacyclovir hydrochloride twice daily, 200 mg of acyclovir 5 times daily, or placebo for 5 days. Early self-initiated treatment may abort a recurrent attack of genital herpes without progression to the ulcerative or crusting stage. Some patients take the drug daily to reduce the frequency of attacks. The effect of time from symptom recognition to treatment initiation on aborted lesions was assessed in a post hoc analysis. Median times to recurrence after the end of both courses were similar. Long-term use of acyclovir for up to 10 years for HSV suppression is effective and well tolerated. A total of 33% of daily acyclovir recipients and 27% weekly acyclovir recipients were free of recurrences for two years.

Twice-daily valaciclovir and acyclovir were similar in effectiveness. Failures on the weekend regimen were more frequent as the week progressed (P = 0.005). These are all taken in pill form. Moving walls are generally represented in years. There was good evidence that prophylaxis with antiviral agents during the last month of pregnancy was effective in reducing the rate of HSV outbreaks during the perinatal period in mothers with HSV infections (15 of 424 in the acyclovir group versus 58 of 375 in the placebo group had HSV outbreaks during the perinatal period, absolute risk reduction [ARR] = 11%, number needed to treat [NNT] = 9). Acyclovir 200 mg five times daily for five days aborted 44% of recurrences and shortened 38% by greater than or equal to 50%, giving useful response in 82% of 34 recurrences. The mean time to first recurrence after treatment with acyclovir ceased was 16 days.

All other pharmacokinetic characteristics are similar to those of acyclovir (Nadal et al. Genitourinary medicine 64 (4): 249–54. Genital herpes is extremely common, with up to one in four adults who are sexually active having genital herpes, although approximately 80 remain unaware that they are infected. During acyclovir therapy, recurrences were completely prevented in 17 patients (71%) and the remaining seven patients had nine recurrences as compared to 18 recurrences while receiving placebo. In double blind studies in over 100 recipients with first episode HSV, oral ACV treatment (200 mg, 5 times daily) significantly reduced virus shedding, new lesion formation, duration of genital lesions and clinical symptoms in both men and women when compared with placebo recipients. These references are in PubMed. In both groups, however, the first untreated recurrence produced a rise in mean antibody concentrations.

6.0 days) and cessation of HSV shedding (HR=1.88, p=0.008; mean 3.0 vs. capsule Acyclovir 400 mg-APO. After the end of treatment the recurrence rate was similar in the two groups. for 6 months and the other placebo. Median times to recurrence after the end of both courses were similar. At present it should be used only in carefully selected cases with seriously debilitating symptoms to prevent recurrences during a short period. However, the relapses seem to occur with the same rate as before, when the suppressive acyclovir treatment is stopped.

The reported incidence of adverse events was similar in both acyclovir and placebo groups. However, the protection is only partial (approximately 50 percent), likely because these drugs neither completely inhibit genital viral shedding (when the virus is active and potentially transmissible to sexual partners). In this report we have examined the effect of acyclovir on ultraviolet radiation-induced recurrent genital herpes. A viral culture should be obtained prior to initiating treatment in persons with first episode genital herpes, and typing should be performed to predict the risk and frequency of subsequent recurrences. 6.0 days) and cessation of HSV shedding (HR=1.88, p=0.008; mean 3.0 vs. I have never had any of these problems while taking Acyclovir and I feel it is the best anti-viral for me. Therefore, the only choice you are left with is painkillers together with oral antiviral medication.

Fifty million Americans are infected with genital herpes, and the disease is common in areas of the world of high HIV prevalence. Young people under 25 experience the highest rates of sexually transmitted infections. HSV-1 can also spread from the mouth to the genitals during oral sex (fellatio, cunnilingus, analingus). Objective: To compare the efficacy and safety of oral acyclovir (400 mg twice daily) with oral isoprinosine (500 mg twice daily) in the suppression of recurrent genital herpes. During the first year patients were randomized to receive either 400 mg acyclovir twice daily or placebo. Most people have no or few symptoms from herpes infection. Objective: To determine if suppressive acyclovir near term decreased the frequency of clinical recurrences at delivery in women with recurrent genital herpes simplex virus (HSV) infection.

A randomised, double-blind, placebo-controlled cross-over study was conducted in 24 patients, nine females and 15 males, with a history of more than eight recurrences of genital herpes in the past year.

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