Management of recurrent oral herpes simplex infections.

Abstract

The literature has been reviewed for evidence of the efficacy of antiviral agents in both the prophylaxis and treatment of recurrent oral herpes simplex virus (HSV) infections and discussed by a panel of experts. Emphasis was given to randomized controlled trials. Management of herpes-associated erythema multiforme and Bell palsy were also considered. The evidence suggests that 5% acyclovir (ACV) in the cream base may reduce the duration of lesions if applied early. Recurrent herpes labialis (RHL) and recurrent intraoral HSV infections can be effectively treated with systemic ACV 400 mg 3 times a day or systemic valacyclovir 500 to 1000 mg twice a day for 3 to 5 days (longer in the immunocompromised). RHL in the immunocompetent can be effectively prevented with (1) sunscreen alone (SPF 15 or above), (2) systemic ACV 400 mg 2 to 3 times a day, or (3) systemic valacyclovir 500 to 2000 mg twice a day. Valacyclovir 500 mg twice a day is also effective in suppressing erythema multiforme triggered by HSV. Further studies are needed to compare treatment efficacy between topical penciclovir, docosanol, and ACV cream for RHL.

• Authors: Sook-Bin Woo, Stephen J Challacombe
• Journal: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics (Oral Surg Oral Med Oral Pathol Oral Radiol Endod) Vol. 103 Suppl Pg. S12.e1-18 (Mar 2007) ISSN: 1528-395X [Electronic] United States
• PMID: 17379150 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Antiviral Agents
• Organophosphonates
• Sunscreening Agents
• Cytosine
• Valine
• Cidofovir
• Valacyclovir
• Acyclovir

Topics

• Acyclovir (analogs & derivatives, therapeutic use)
• Antiviral Agents (therapeutic use)
• Bell Palsy (drug therapy, virology)
• Cidofovir
• Cytosine (analogs & derivatives, therapeutic use)
• Erythema Multiforme (drug therapy, virology)
• Herpes Labialis (complications, drug therapy, prevention & control)
• Humans
• Immunocompromised Host (immunology)
• Organophosphonates (therapeutic use)
• Secondary Prevention
• Sunscreening Agents (therapeutic use)
• Time Factors
• Valacyclovir
• Valine (analogs & derivatives, therapeutic use)