Skip to main content
PMC home page
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1987 Mar;31(3):361–367. doi: 10.1128/aac.31.3.361

Acyclovir prophylaxis for herpes simplex virus infection.

D Gold, L Corey
PMCID: PMC174733  PMID: 3555331

Abstract

ACV is an effective agent for the treatment and prophylaxis of HSV infections in both IC and immunologically normal individuals. The drug is well tolerated in both populations and is not significantly associated with clinical or laboratory toxicities. Because of the great potential benefit and low risk, organ transplant recipients and patients with hematologic malignancies undergoing induction chemotherapy should be screened routinely for HSV antibodies; seropositive individuals should receive prophylactic ACV during the period of most profound immunosuppression. Immunologically normal individuals with frequently recurring genital HSV or serious complications associated with outbreaks are candidates for long-term suppression with ACV.

Full text

PDF
361

Selected References

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

  1. Ambinder R. F., Burns W. H., Lietman P. S., Saral R. Prophylaxis: a strategy to minimise antiviral resistance. Lancet. 1984 May 26;1(8387):1154–1155. doi: 10.1016/s0140-6736(84)91396-5. [DOI] [PubMed] [Google Scholar]
  2. Anderson H., Scarffe J. H., Sutton R. N., Hickmott E., Brigden D., Burke C. Oral acyclovir prophylaxis against herpes simplex virus in non-Hodgkin lymphoma and acute lymphoblastic leukaemia patients receiving remission induction chemotherapy. A randomised double blind, placebo controlled trial. Br J Cancer. 1984 Jul;50(1):45–49. doi: 10.1038/bjc.1984.138. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Armstrong D., Gold J. W., Dryjanski J., Whimbey E., Polsky B., Hawkins C., Brown A. E., Bernard E., Kiehn T. E. Treatment of infections in patients with the acquired immunodeficiency syndrome. Ann Intern Med. 1985 Nov;103(5):738–743. doi: 10.7326/0003-4819-103-5-738. [DOI] [PubMed] [Google Scholar]
  4. Bean S. F., Quezada R. K. Recurrent oral erythema multiforme. Clinical experience with 11 patients. JAMA. 1983 May 27;249(20):2810–2812. [PubMed] [Google Scholar]
  5. Britz M., Sibulkin D. Recurrent erythema multiforme and Herpes genitalis (type 2). JAMA. 1975 Aug 18;233(7):812–813. [PubMed] [Google Scholar]
  6. Brooks R. G., Hofflin J. M., Jamieson S. W., Stinson E. B., Remington J. S. Infectious complications in heart-lung transplant recipients. Am J Med. 1985 Oct;79(4):412–422. doi: 10.1016/0002-9343(85)90027-0. [DOI] [PubMed] [Google Scholar]
  7. Bryson Y. J., Dillon M., Lovett M., Acuna G., Taylor S., Cherry J. D., Johnson B. L., Wiesmeier E., Growdon W., Creagh-Kirk T. Treatment of first episodes of genital herpes simplex virus infection with oral acyclovir. A randomized double-blind controlled trial in normal subjects. N Engl J Med. 1983 Apr 21;308(16):916–921. doi: 10.1056/NEJM198304213081602. [DOI] [PubMed] [Google Scholar]
  8. Burns W. H., Saral R., Santos G. W., Laskin O. L., Lietman P. S., McLaren C., Barry D. W. Isolation and characterisation of resistant Herpes simplex virus after acyclovir therapy. Lancet. 1982 Feb 20;1(8269):421–423. doi: 10.1016/s0140-6736(82)91620-8. [DOI] [PubMed] [Google Scholar]
  9. Chou S., Gallagher J. G., Merigan T. C. Controlled clinical trial of intravenous acyclovir in heart-transplant patients with mucocutaneous herpes simplex infections. Lancet. 1981 Jun 27;1(8235):1392–1394. doi: 10.1016/s0140-6736(81)92570-8. [DOI] [PubMed] [Google Scholar]
  10. Coen D. M., Schaffer P. A. Two distinct loci confer resistance to acycloguanosine in herpes simplex virus type 1. Proc Natl Acad Sci U S A. 1980 Apr;77(4):2265–2269. doi: 10.1073/pnas.77.4.2265. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Corey L., Benedetti J. K., Critchlow C. W., Remington M. R., Winter C. A., Fahnlander A. L., Smith K., Salter D. L., Keeney R. E., Davis L. G. Double-blind controlled trial of topical acyclovir in genital herpes simplex virus infections. Am J Med. 1982 Jul 20;73(1A):326–334. doi: 10.1016/0002-9343(82)90117-6. [DOI] [PubMed] [Google Scholar]
  12. Corey L., Benedetti J., Critchlow C., Mertz G., Douglas J., Fife K., Fahnlander A., Remington M. L., Winter C., Dragavon J. Treatment of primary first-episode genital herpes simplex virus infections with acyclovir: results of topical, intravenous and oral therapy. J Antimicrob Chemother. 1983 Sep;12 (Suppl B):79–88. doi: 10.1093/jac/12.suppl_b.79. [DOI] [PubMed] [Google Scholar]
  13. Corey L., Fife K. H., Benedetti J. K., Winter C. A., Fahnlander A., Connor J. D., Hintz M. A., Holmes K. K. Intravenous acyclovir for the treatment of primary genital herpes. Ann Intern Med. 1983 Jun;98(6):914–921. doi: 10.7326/0003-4819-98-6-914. [DOI] [PubMed] [Google Scholar]
  14. Crumpacker C. S., Schnipper L. E., Marlowe S. I., Kowalsky P. N., Hershey B. J., Levin M. J. Resistance to antiviral drugs of herpes simplex virus isolated from a patient treated with acyclovir. N Engl J Med. 1982 Feb 11;306(6):343–346. doi: 10.1056/NEJM198202113060606. [DOI] [PubMed] [Google Scholar]
  15. Dekker C., Ellis M. N., McLaren C., Hunter G., Rogers J., Barry D. W. Virus resistance in clinical practice. J Antimicrob Chemother. 1983 Sep;12 (Suppl B):137–152. doi: 10.1093/jac/12.suppl_b.137. [DOI] [PubMed] [Google Scholar]
  16. 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]
  17. Fiddian A. P., Kinghorn G. R., Goldmeier D., Rees E., Rodin P., Thin R. N., de Konig G. A. Topical acyclovir in the treatment of genital herpes: a comparison with systemic therapy. J Antimicrob Chemother. 1983 Sep;12 (Suppl B):67–77. doi: 10.1093/jac/12.suppl_b.67. [DOI] [PubMed] [Google Scholar]
  18. Field H. J., Darby G. Pathogenicity in mice of strains of herpes simplex virus which are resistant to acyclovir in vitro and in vivo. Antimicrob Agents Chemother. 1980 Feb;17(2):209–216. doi: 10.1128/aac.17.2.209. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Foley F. D., Greenawald K. A., Nash G., Pruitt B. A., Jr Herpesvirus infection in burned patients. N Engl J Med. 1970 Mar 19;282(12):652–656. doi: 10.1056/NEJM197003192821205. [DOI] [PubMed] [Google Scholar]
  20. Gluckman E., Lotsberg J., Devergie A., Zhao X. M., Melo R., Gomez-Morales M., Mazeron M. C., Perol Y. Oral acyclovir prophylactic treatment of herpes simplex infection after bone marrow transplantation. J Antimicrob Chemother. 1983 Sep;12 (Suppl B):161–167. doi: 10.1093/jac/12.suppl_b.161. [DOI] [PubMed] [Google Scholar]
  21. Green J. A., Spruance S. L., Wenerstrom G., Piepkorn M. W. Post-herpetic erythema multiforme prevented with prophylactic oral acyclovir. Ann Intern Med. 1985 May;102(5):632–633. doi: 10.7326/0003-4819-102-5-632. [DOI] [PubMed] [Google Scholar]
  22. 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]
  23. Haverkos H. W., Pazin G. J., Ho M., Nelson P. B. Reactivation of type 2 herpes simplex virus by thoracolumbar neurosurgery. Ann Intern Med. 1984 Oct;101(4):503–504. doi: 10.7326/0003-4819-101-4-503. [DOI] [PubMed] [Google Scholar]
  24. Knox S. R., Corey L., Blough H. A., Lerner A. M. Historical findings in subjects from a high socioeconomic group who have genital infections with herpes simplex virus. Sex Transm Dis. 1982 Jan-Mar;9(1):15–20. doi: 10.1097/00007435-198201000-00003. [DOI] [PubMed] [Google Scholar]
  25. Laskin O. L. Acyclovir and suppression of frequently recurring herpetic whitlow. Ann Intern Med. 1985 Apr;102(4):494–495. doi: 10.7326/0003-4819-102-4-494. [DOI] [PubMed] [Google Scholar]
  26. Lehrman S. N., Douglas J. M., Corey L., Barry D. W. Recurrent genital herpes and suppressive oral acyclovir therapy. Relation between clinical outcome and in-vitro drug sensitivity. Ann Intern Med. 1986 Jun;104(6):786–790. doi: 10.7326/0003-4819-104-6-786. [DOI] [PubMed] [Google Scholar]
  27. Levin M. J., Leary P. L., Arbeit R. D. Effect of acyclovir on the proliferation of human fibroblasts and peripheral blood mononuclear cells. Antimicrob Agents Chemother. 1980 Jun;17(6):947–953. doi: 10.1128/aac.17.6.947. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. MAILMAN C. J., MIRANDA J. L., SPOCK A. RECURRENT ECZEMA HERPETICUM. WIDESPREAD CUTANEOUS HERPES SIMPLEX IN ATOPIC PATIENT WITHOUT ACTIVE ATOPIC DERMATITIS. Arch Dermatol. 1964 Jun;89:815–818. doi: 10.1001/archderm.1964.01590300043013. [DOI] [PubMed] [Google Scholar]
  29. McGuffin R. W., Shiota F. M., Meyers J. D. Lack of toxicity of acyclovir to granulocyte progenitor cells in vitro. Antimicrob Agents Chemother. 1980 Sep;18(3):471–473. doi: 10.1128/aac.18.3.471. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. 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]
  31. 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. Double-blind placebo-controlled trial of oral acyclovir in first-episode genital herpes simplex virus infection. JAMA. 1984 Sep 7;252(9):1147–1151. [PubMed] [Google Scholar]
  32. Mertz G. J., Schmidt O., Jourden J. L., Guinan M. E., Remington M. L., Fahnlander A., Winter C., Holmes K. K., Corey L. Frequency of acquisition of first-episode genital infection with herpes simplex virus from symptomatic and asymptomatic source contacts. Sex Transm Dis. 1985 Jan-Mar;12(1):33–39. doi: 10.1097/00007435-198501000-00007. [DOI] [PubMed] [Google Scholar]
  33. Meyers J. D., Wade J. C., Mitchell C. D., Saral R., Lietman P. S., Durack D. T., Levin M. J., Segreti A. C., Balfour H. H., Jr Multicenter collaborative trial of intravenous acyclovir for treatment of mucocutaneous herpes simplex virus infection in the immunocompromised host. Am J Med. 1982 Jul 20;73(1A):229–235. doi: 10.1016/0002-9343(82)90097-3. [DOI] [PubMed] [Google Scholar]
  34. Mindel A., Adler M. W., Sutherland S., Fiddian A. P. Intravenous acyclovir treatment for primary genital herpes. Lancet. 1982 Mar 27;1(8274):697–700. doi: 10.1016/s0140-6736(82)92618-6. [DOI] [PubMed] [Google Scholar]
  35. Mindel A., Weller I. V., Faherty A., Sutherland S., Fiddian A. P., Adler M. W. Acyclovir in first attacks of genital herpes and prevention of recurrences. Genitourin Med. 1986 Feb;62(1):28–32. doi: 10.1136/sti.62.1.28. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. 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]
  37. Mitchell C. D., Bean B., Gentry S. R., Groth K. E., Boen J. R., Balfour H. H., Jr Acyclovir therapy for mucocutaneous herpes simplex infections in immunocompromised patients. Lancet. 1981 Jun 27;1(8235):1389–1392. doi: 10.1016/s0140-6736(81)92569-1. [DOI] [PubMed] [Google Scholar]
  38. 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]
  39. Parris D. S., Harrington J. E. Herpes simplex virus variants restraint to high concentrations of acyclovir exist in clinical isolates. Antimicrob Agents Chemother. 1982 Jul;22(1):71–77. doi: 10.1128/aac.22.1.71. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Pazin G. J., Ho M., Jannetta P. J. Reactivation of herpes simplex virus after decompression of the trigeminal nerve root. J Infect Dis. 1978 Sep;138(3):405–409. doi: 10.1093/infdis/138.3.405. [DOI] [PubMed] [Google Scholar]
  41. Prentice H. G. Use of acyclovir for prophylaxis of herpes infections in severely immunocompromised patients. J Antimicrob Chemother. 1983 Sep;12 (Suppl B):153–159. doi: 10.1093/jac/12.suppl_b.153. [DOI] [PubMed] [Google Scholar]
  42. 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. Treatment of recurrent genital herpes simplex infections with oral acyclovir. A controlled trial. JAMA. 1984 Apr 27;251(16):2103–2107. [PubMed] [Google Scholar]
  43. Rooney J. F., Felser J. M., Ostrove J. M., Straus S. E. Acquisition of genital herpes from an asymptomatic sexual partner. N Engl J Med. 1986 Jun 12;314(24):1561–1564. doi: 10.1056/NEJM198606123142407. [DOI] [PubMed] [Google Scholar]
  44. Saral R., Ambinder R. F., Burns W. H., Angelopulos C. M., Griffin D. E., Burke P. J., Lietman P. S. Acyclovir prophylaxis against herpes simplex virus infection in patients with leukemia. A randomized, double-blind, placebo-controlled study. Ann Intern Med. 1983 Dec;99(6):773–776. doi: 10.7326/0003-4819-99-6-773. [DOI] [PubMed] [Google Scholar]
  45. Saral R., Burns W. H., Laskin O. L., Santos G. W., Lietman P. S. Acyclovir prophylaxis of herpes-simplex-virus infections. N Engl J Med. 1981 Jul 9;305(2):63–67. doi: 10.1056/NEJM198107093050202. [DOI] [PubMed] [Google Scholar]
  46. 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]
  47. Seale L., Jones C. J., Kathpalia S., Jackson G. G., Mozes M., Maddux M. S., Packham D. Prevention of herpesvirus infections in renal allograft recipients by low-dose oral acyclovir. JAMA. 1985 Dec 27;254(24):3435–3438. [PubMed] [Google Scholar]
  48. Shepp D. H., Dandliker P. S., Flournoy N., Meyers J. D. Once-daily intravenous acyclovir for prophylaxis of herpes simplex virus reactivation after marrow transplantation. J Antimicrob Chemother. 1985 Sep;16(3):389–395. doi: 10.1093/jac/16.3.389. [DOI] [PubMed] [Google Scholar]
  49. Shepp D. H., Newton B. A., Dandliker P. S., Flournoy N., Meyers J. D. Oral acyclovir therapy for mucocutaneous herpes simplex virus infections in immunocompromised marrow transplant recipients. Ann Intern Med. 1985 Jun;102(6):783–785. doi: 10.7326/0003-4819-102-6-783. [DOI] [PubMed] [Google Scholar]
  50. Sibrack C. D., Gutman L. T., Wilfert C. M., McLaren C., St Clair M. H., Keller P. M., Barry D. W. Pathogenicity of acyclovir-resistant herpes simplex virus type 1 from an immunodeficient child. J Infect Dis. 1982 Nov;146(5):673–682. doi: 10.1093/infdis/146.5.673. [DOI] [PubMed] [Google Scholar]
  51. Siegal F. P., Lopez C., Hammer G. S., Brown A. E., Kornfeld S. J., Gold J., Hassett J., Hirschman S. Z., Cunningham-Rundles C., Adelsberg B. R. Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions. N Engl J Med. 1981 Dec 10;305(24):1439–1444. doi: 10.1056/NEJM198112103052403. [DOI] [PubMed] [Google Scholar]
  52. Steel J. G., Dix R. D., Baringer J. R. Isolation of herpes simplex virus type I in recurrent (Mollaret) meningitis. Ann Neurol. 1982 Jan;11(1):17–21. doi: 10.1002/ana.410110104. [DOI] [PubMed] [Google Scholar]
  53. Steele R. W., Marmer D. J., Keeney R. E. Comparative in vitro imunotoxicology of acyclovir and other antiviral agents. Infect Immun. 1980 Jun;28(3):957–962. doi: 10.1128/iai.28.3.957-962.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  54. Straus S. E., Seidlin M., Takiff H. E., Rooney J. F., Lehrman S. N., Bachrach S., Felser J. M., Di Giovanna J. J., Grimes G. J., Jr, Krakauer H. Double-blind comparison of weekend and daily regimens of oral acyclovir for suppression of recurrent genital herpes. Antiviral Res. 1986 May;6(3):151–159. doi: 10.1016/0166-3542(86)90009-4. [DOI] [PubMed] [Google Scholar]
  55. Straus S. E., Seidlin M., Takiff H., Jacobs D., Bowen D., Smith H. A. Oral acyclovir to suppress recurring herpes simplex virus infections in immunodeficient patients. Ann Intern Med. 1984 Apr;100(4):522–524. doi: 10.7326/0003-4819-100-4-522. [DOI] [PubMed] [Google Scholar]
  56. 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]
  57. Thin R. N., Nabarro J. M., Parker J. D., Fiddian A. P. Topical acyclovir in the treatment of initial genital herpes. Br J Vener Dis. 1983 Apr;59(2):116–119. doi: 10.1136/sti.59.2.116. [DOI] [PMC free article] [PubMed] [Google Scholar]
  58. Tucker W. E., Jr Preclinical toxicology profile of acyclovir: an overview. Am J Med. 1982 Jul 20;73(1A):27–30. doi: 10.1016/0002-9343(82)90058-4. [DOI] [PubMed] [Google Scholar]
  59. Vane J. Pathways to new drugs. Scand J Infect Dis Suppl. 1985;47:5–8. [PubMed] [Google Scholar]
  60. Wade J. C., McLaren C., Meyers J. D. Frequency and significance of acyclovir-resistant herpes simplex virus isolated from marrow transplant patients receiving multiple courses of treatment with acyclovir. J Infect Dis. 1983 Dec;148(6):1077–1082. doi: 10.1093/infdis/148.6.1077. [DOI] [PubMed] [Google Scholar]
  61. Wade J. C., Newton B., Flournoy N., Meyers J. D. Oral acyclovir for prevention of herpes simplex virus reactivation after marrow transplantation. Ann Intern Med. 1984 Jun;100(6):823–828. doi: 10.7326/0003-4819-100-6-823. [DOI] [PubMed] [Google Scholar]
  62. Wade J. C., Newton B., McLaren C., Flournoy N., Keeney R. E., Meyers J. D. Intravenous acyclovir to treat mucocutaneous herpes simplex virus infection after marrow transplantation: a double-blind trial. Ann Intern Med. 1982 Mar;96(3):265–269. doi: 10.7326/0003-4819-96-3-265. [DOI] [PubMed] [Google Scholar]
  63. Whitley R. J., Levin M., Barton N., Hershey B. J., Davis G., Keeney R. E., Whelchel J., Diethelm A. G., Kartus P., Soong S. J. Infections caused by herpes simplex virus in the immunocompromised host: natural history and topical acyclovir therapy. J Infect Dis. 1984 Sep;150(3):323–329. doi: 10.1093/infdis/150.3.323. [DOI] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES