Valacyclovir and Acyclovir for Suppression of Shedding of Herpes Simplex Virus in the Genital Tract

摘要: 6 GlaxoSmithKline, Research Triangle Park, North Carolina Background. Valacyclovir exhibits better oral absorption and higher, more prolonged serum concentrations than acyclovir. The efficacy of valacyclovir acyclovir on genital herpes simplex virus (HSV) shedding was assessed in a double-blind, 3-period crossover trial. Methods. Sixty-nine immunocompetent participants with HSV-2 received valacyclovir, acyclovir, matching placebo random order for 7-week periods. Participants provided daily mucosal swabs HSV detection by viral culture polymerase chain reaction (PCR). Results. detected at least once 62 (90%) 68 (98%) PCR. During placebo, the total rate 15.4% days (PCR, 40.2%); subclinical 6.6% 27.1%). Both antivirals were associated lower (relative risk (RR), 0.03 (95% confidence interval {CI}, 0.01-0.07) RR, 0.05 CI, 0.03-0.10) acyclovir) PCR (RR, 0.18 0.12-0.26) 0.20 0.15-0.28) acyclovir), compared placebo. No significant differences frequency quantity between arms. Conclusions. Although suppression replication is not complete, are highly effective suppressing shedding.