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. 1990 Apr;66(2):101–104. doi: 10.1136/sti.66.2.101

Long-term suppression of severe recurrent genital herpes simplex infections with oral acyclovir: a dose-titration study.

S Kroon 1, C S Petersen 1, L P Andersen 1, J R Rasmussen 1, B F Vestergaard 1
PMCID: PMC1194473  PMID: 2160423

Abstract

Twenty immunocompetent patients, four females and 16 males, with severe recurrent genital herpes (median number of recurrences the previous year 16, range (8-24] entered an open continuous long-term suppressive treatment with oral acyclovir (ACV) for 12 months. The study included a dose-titration schedule: (ACV, 200 mg x 4/1-3 months, ACV, 400 mg x 2/4-6 months, ACV, 200 mg x 2/7-9 months, and ACV, 400 mg x 1/10-12 months). Patients with recurrences on steps two and three received an alternative dose of ACV, 200 mg x 3. Otherwise patients entered the previous dose-step. Five (20%) of patients were completely free of symptoms (recurrences and abortive lesions) during the four dose-reduction periods. A further nine patients (50%) could be dose-reduced to 200 mg x 3 without symptoms. Isolates from three patients showed a decrease in virus sensitivity after ceasing treatment. In conclusion, 14/20 of treated patients could be dose reduced to 200 mg x 2-3 without selection of HSV strains showing clinically important decreases in sensitivity towards ACV.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Douglas J. M., Critchlow C., Benedetti J., Mertz G. J., Connor J. D., Hintz M. A., Fahnlander A., Remington M., Winter C., Corey L. A double-blind study of oral acyclovir for suppression of recurrences of genital herpes simplex virus infection. N Engl J Med. 1984 Jun 14;310(24):1551–1556. doi: 10.1056/NEJM198406143102402. [DOI] [PubMed] [Google Scholar]
  2. Erlich K. S., Mills J., Chatis P., Mertz G. J., Busch D. F., Follansbee S. E., Grant R. M., Crumpacker C. S. Acyclovir-resistant herpes simplex virus infections in patients with the acquired immunodeficiency syndrome. N Engl J Med. 1989 Feb 2;320(5):293–296. doi: 10.1056/NEJM198902023200506. [DOI] [PubMed] [Google Scholar]
  3. Halsos A. M., Salo O. P., Lassus A., Tjøtta E. A., Hovi T., Gabrielsen B. O., Fiddian A. P. Oral acyclovir suppression of recurrent genital herpes: a double-blind, placebo-controlled, crossover study. Acta Derm Venereol. 1985;65(1):59–63. [PubMed] [Google Scholar]
  4. Kroon S., Petersen C. S., Andersen L. P., Rasmussen L. P., Vestergaard B. F. Oral acyclovir suppressive therapy in severe recurrent genital herpes. A double-blind, placebo-controlled cross-over study. Dan Med Bull. 1989 Jun;36(3):298–300. [PubMed] [Google Scholar]
  5. Mattison H. R., Reichman R. C., Benedetti J., Bolgiano D., Davis L. G., Bailey-Farchione A., Remington M., Winter C., Corey L. Double-blind, placebo-controlled trial comparing long-term suppressive with short-term oral acyclovir therapy for management of recurrent genital herpes. Am J Med. 1988 Aug 29;85(2A):20–25. [PubMed] [Google Scholar]
  6. McLaren C., Corey L., Dekket C., Barry D. W. In vitro sensitivity to acyclovir in genital herpes simplex viruses from acyclovir-treated patients. J Infect Dis. 1983 Nov;148(5):868–875. doi: 10.1093/infdis/148.5.868. [DOI] [PubMed] [Google Scholar]
  7. Mertz G. J., Eron L., Kaufman R., Goldberg L., Raab B., Conant M., Mills J., Kurtz T., Davis L. G. Prolonged continuous versus intermittent oral acyclovir treatment in normal adults with frequently recurring genital herpes simplex virus infection. Am J Med. 1988 Aug 29;85(2A):14–19. [PubMed] [Google Scholar]
  8. Mindel A., Faherty A., Carney O., Patou G., Freris M., Williams P. Dosage and safety of long-term suppressive acyclovir therapy for recurrent genital herpes. Lancet. 1988 Apr 23;1(8591):926–928. doi: 10.1016/s0140-6736(88)91725-4. [DOI] [PubMed] [Google Scholar]
  9. Mindel A., Weller I. V., Faherty A., Sutherland S., Hindley D., Fiddian A. P., Adler M. W. Prophylactic oral acyclovir in recurrent genital herpes. Lancet. 1984 Jul 14;2(8394):57–59. doi: 10.1016/s0140-6736(84)90237-x. [DOI] [PubMed] [Google Scholar]
  10. Mostow S. R., Mayfield J. L., Marr J. J., Drucker J. L. Suppression of recurrent genital herpes by single daily dosages of acyclovir. Am J Med. 1988 Aug 29;85(2A):30–33. [PubMed] [Google Scholar]
  11. Nilsen A. E., Aasen T., Halsos A. M., Kinge B. R., Tjøtta E. A., Wikström K., Fiddian A. P. Efficacy of oral acyclovir in the treatment of initial and recurrent genital herpes. Lancet. 1982 Sep 11;2(8298):571–573. doi: 10.1016/s0140-6736(82)90658-4. [DOI] [PubMed] [Google Scholar]
  12. Schnipper L. E., Crumpacker C. S. Resistance of herpes simplex virus to acycloguanosine: role of viral thymidine kinase and DNA polymerase loci. Proc Natl Acad Sci U S A. 1980 Apr;77(4):2270–2273. doi: 10.1073/pnas.77.4.2270. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Simonsen J. N., Cameron D. W., Gakinya M. N., Ndinya-Achola J. O., D'Costa L. J., Karasira P., Cheang M., Ronald A. R., Piot P., Plummer F. A. Human immunodeficiency virus infection among men with sexually transmitted diseases. Experience from a center in Africa. N Engl J Med. 1988 Aug 4;319(5):274–278. doi: 10.1056/NEJM198808043190504. [DOI] [PubMed] [Google Scholar]
  14. Straus S. E., Takiff H. E., Seidlin M., Bachrach S., Lininger L., DiGiovanna J. J., Western K. A., Smith H. A., Lehrman S. N., Creagh-Kirk T. Suppression of frequently recurring genital herpes. A placebo-controlled double-blind trial of oral acyclovir. N Engl J Med. 1984 Jun 14;310(24):1545–1550. doi: 10.1056/NEJM198406143102401. [DOI] [PubMed] [Google Scholar]

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