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Prophylactic oral acyclovir in outbreaks of primary herpes simplex virus type 1 infection in a closed community
K Kuzushima1, T Kudo, H Kimura
1Department of Pediatrics, Nagoya University, School of Medicine, Japan.
Insights
Prophylactic oral acyclovir significantly reduced herpes simplex virus (HSV) seroconversion and symptomatic disease in children during outbreaks. This antiviral treatment shows promise for controlling HSV-1 infections in closed communities.
Area of Science:
- Virology
- Pediatric Infectious Diseases
- Antiviral Therapy
Background:
- Herpes simplex virus type 1 (HSV-1) can cause outbreaks of infection, particularly in closed communities.
- Effective strategies are needed to limit the spread and severity of HSV-1 infections in children.
Purpose of the Study:
- To evaluate the efficacy of prophylactic oral acyclovir in preventing HSV-1 infection and disease in children.
- To assess the impact of acyclovir on seroconversion rates and clinical manifestations during HSV-1 outbreaks.
Main Methods:
- A study involving 37 children receiving prophylactic oral acyclovir during HSV-1 outbreaks.
- Comparison with untreated control groups in separate outbreaks.
- Monitoring of seroconversion rates and symptomatic disease incidence.
- Analysis of HSV-DNA and acyclovir resistance.
Main Results:
- Significantly reduced rates of seroconversion to HSV in the acyclovir group (27%) compared to controls (91%).
- A marked decrease in symptomatic disease incidence in treated children (0%) versus controls (82%).
- No acyclovir resistance or adverse effects were observed.
Conclusions:
- Short-term prophylactic acyclovir can effectively limit the spread and reduce clinical symptoms of HSV-1 infections in closed communities.
- This prophylactic use may be considered for communities experiencing severe HSV symptoms.
- Further research may explore optimal duration and indications for prophylactic acyclovir in pediatric populations.
Abstract:
Oral acyclovir was given prophylactically to 37 children in the early stages of three outbreaks of herpes simplex virus type 1 (HSV-1) infection and the results were compared with those in untreated control subjects in two other outbreaks. The rates of seroconversion to HSV were significantly reduced in children treated with acyclovir compared with control subjects (91% vs 27%, P less than .001). The incidence of symptomatic disease was also significantly reduced (82% vs 0%, P less than .001). In some children receiving prophylactic acyclovir, anti-HSV antibody titers did not rise despite the presence of replicative HSV on throat swabs just before the start of treatment. Restriction endonuclease analysis of isolated HSV-DNA confirmed that one strain was responsible for the five outbreaks. No resistance to acyclovir was detected during the study, and no adverse effects of treatment were noted. In conclusion, short-term prophylactic acyclovir may limit the spread and reduce clinical manifestations of HSV infections in closed communities, although this use should be restricted to communities where severe symptoms are observed.