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Long-term acyclovir use to prevent recurrent ocular herpes simplex virus infection
Uchoandro B C Uchoa1, Renata A Rezende, Maria A Carrasco
1Cornea Service, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|December 10, 2003
Summary
Long-term oral acyclovir therapy effectively reduces ocular herpes simplex virus (HSV) recurrences beyond 12 months. Continued use of acyclovir significantly lowers recurrence rates compared to discontinuation.
Area of Science:
- Ophthalmology
- Virology
- Pharmacology
Background:
- Ocular herpes simplex virus (HSV) infections can lead to recurrent episodes, potentially causing vision impairment.
- The efficacy of long-term oral acyclovir for preventing recurrent ocular HSV beyond 12 months requires further evaluation.
Purpose of the Study:
- To assess the effectiveness of oral acyclovir in preventing ocular HSV recurrences when used for over 12 months.
- To compare recurrence rates in patients continuing versus discontinuing long-term acyclovir therapy.
Main Methods:
- Retrospective comparison of two patient groups receiving oral acyclovir.
- Group 1: Acyclovir for ≥12 months, then discontinued. Group 2: Acyclovir for ≥18 months.
- Statistical analysis included t-tests, chi-squared tests, and Kaplan-Meier survival analysis.
Main Results:
- In the period after discontinuation for Group 1, recurrence rates were significantly higher (78%) compared to Group 2 (36%) (P=.01).
- Recurrence-free survival in period 2 was substantially longer in Group 2 (37.3 months) versus Group 1 (15.3 months) (P=.001).
- No significant difference in recurrence was observed during the initial treatment period (Period 1).
Conclusions:
- Sustained oral acyclovir therapy beyond 12 months demonstrates continued effectiveness in reducing ocular HSV recurrences.
- Discontinuing oral acyclovir after prolonged use is associated with a higher risk of recurrent ocular HSV episodes.