A Risk-Benefit Evaluation of Aciclovir for the Treatment and Prophylaxis of Herpes Simplex Virus Infections
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The objective of this article is to review and evaluate risks and benefits associated with the use of aciclovir in the treatment and prophylaxis of common manifestations of herpes simplex virus (HSV) infections in immunocompetent and immunocompromised patients. Information was found through a MEDLINE search using keywords: herpes simplex virus, genital herpes, herpes labialis, aciclovir and acyclovir. Selected articles were randomised, double-blind, placebo-controlled, clinical trials. 30 such trials involving 3364 persons were evaluated. All articles were reviewed by the authors and the data were extracted and summarised. In both immunocompetent and immunocompromised hosts, aciclovir therapy demonstrated a high degree of clinical efficacy. None of the studies reported statistically significant differences between aciclovir and placebo for mild or major adverse events. This evaluation found that aciclovir is both effective and well tolerated for treatment and prophylaxis of genital, oral and mucocutaneous HSV infections in immunocompetent and immunocompromised patients. Inmost clinical scenarios, the benefit of aciclovir exceeded any risks by a comfortable margin. The availability of aciclovir as a generic preparation further improves the benefit to cost ratio.