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Valacyclovir versus acyclovir for HSV prophylaxisin neutropenic patients
Dawn I Warkentin1, Joel B Epstein, Lara M Campbell
1Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
The Annals of Pharmacotherapy
|September 24, 2002
Summary
Valacyclovir offers an effective and safe alternative to acyclovir for preventing herpes simplex virus (HSV) reactivation in patients with hematologic malignancies, requiring less frequent dosing.
Area of Science:
- Hematology
- Infectious Disease
- Pharmacology
Background:
- Acyclovir prophylaxis for herpes simplex virus (HSV) in neutropenic patients with hematologic malignancies requires frequent dosing, posing challenges.
- Valacyclovir presents an alternative with improved oral bioavailability and less frequent dosing requirements.
Purpose of the Study:
- To compare the efficacy and safety of valacyclovir versus acyclovir for HSV prophylaxis in neutropenic patients undergoing chemotherapy or stem-cell transplantation.
Main Methods:
- Randomized trial involving patients with hematologic malignancies during neutropenia.
- Three treatment arms: acyclovir 400 mg TID, valacyclovir 500 mg BID, and valacyclovir 250 mg BID.
- Clinical success defined as absence of active HSV lesions or asymptomatic viral shedding.
Main Results:
- Similar clinical success rates across all groups: acyclovir (96%), valacyclovir 500 mg (95%), and valacyclovir 250 mg (100%).
- Overall rates of adverse events were comparable among the three treatment groups.
Conclusions:
- Valacyclovir is an effective and safe prophylactic option for preventing HSV reactivation in this patient population.
- The reduced dosing frequency of valacyclovir makes it a more convenient alternative to acyclovir.