Valacyclovir to expedite the clearance of recurrent herpes gladiatorum

To determine if valacyclovir usage expedites the clearance of recurrent herpes gladiatorum (HG) in wrestlers.

Double-blind, placebo-controlled, prospective study using valacyclovir from September 2001 through March 2003.

Twenty-nine wrestlers were recruited from the Minneapolis-St. Paul, Minnesota area. They ranged in ages from 18 to 36, of whom 7 were coaches and 22 active wrestlers. All participants had greater than 2-year history of recurrent HG.

Upon an outbreak, all participants would swab the area on a daily basis for 14 days. Swabs were analyzed for herpes simplex virus 1/2 via PCR. End point was determined as the last sample with measurable PCR detected. Individuals were randomly selected, yet equally distributed, to be in 1 of 3 groups: placebo x 7 days, valacyclovir 500 mg BID x 7 days, or valacyclovir 1,000 mg QD x 7 days.

Twenty participants (3 coaches and 17 active wrestlers) experienced outbreaks. All participants were compliant and started medication within 24 hours of developing symptoms. Valacyclovir usage showed significant reduction in mean time until PCR clearance, 8.14 days with placebo versus 6.43 days with valacyclovir 500 mg BID.

A 7-day regimen of valacyclovir 500 mg BID will reduce the length of time until clinical clearance of an outbreak of recurrent HG. Its usage reduced duration of viral presence by 21%.