Abstract | BACKGROUND: METHODS: The authors enrolled 125 otherwise healthy HSV-seropositive adults who reported having recurrent herpes labialis (more than one episode per year and at least one episode in the previous year) in a randomized, double-blind, placebo-controlled study and gave them valacyclovir prophylactically (2 grams taken twice on the day of dental treatment and 1 g taken twice the next day) or a matching placebo. To detect the presence of the virus, the authors used clinical examinations, viral cultures and real-time polymerase chain reaction analysis of saliva. RESULTS: During the one-week observation period after treatment, there were more clinical lesions (20.6 percent versus 11.3 percent), more HSV-1-positive culture specimens (7.9 percent versus 1.6 percent) and more HSV-1-positive saliva specimens (7.9 percent versus 4.0 percent) in placebo than in valacyclovir-treated patients, respectively. The percentage of patients who developed recurrences and shed HSV-1 in saliva 72 hours after dental procedures was significantly smaller in the valacyclovir group than in the placebo group (11.3 percent versus 27 percent; P = .026). The mean time to pain cessation was significantly less in the valacyclovir group (3.2 days) than in the placebo group (6.2 days) (P = .006). CONCLUSION: HSV recrudescence after routine dental treatment is suppressed by valacyclovir prophylaxis. CLINICAL IMPLICATIONS: HSV recrudescence is common after routine dental treatment. Clinicians should consider antiviral therapy for patients at risk of experiencing a recurrence, as well as to minimize transmission of the disease.
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Authors | Craig S Miller, Larry L Cunningham, John E Lindroth, Sergei A Avdiushko |
Journal | Journal of the American Dental Association (1939)
(J Am Dent Assoc)
Vol. 135
Issue 9
Pg. 1311-8
(Sep 2004)
ISSN: 0002-8177 [Print] England |
PMID | 15493396
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antiviral Agents
- Placebos
- Prodrugs
- Valine
- Valacyclovir
- Acyclovir
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Topics |
- Acyclovir
(analogs & derivatives, therapeutic use)
- Adolescent
- Adult
- Aged
- Antiviral Agents
(therapeutic use)
- Child
- Dental Care
- Double-Blind Method
- Female
- Follow-Up Studies
- Herpes Labialis
(prevention & control)
- Humans
- Male
- Middle Aged
- Placebos
- Premedication
- Prodrugs
(therapeutic use)
- Prospective Studies
- Recurrence
- Saliva
(virology)
- Simplexvirus
(isolation & purification)
- Stomatitis, Herpetic
(prevention & control)
- Treatment Outcome
- Valacyclovir
- Valine
(analogs & derivatives, therapeutic use)
- Virus Shedding
(drug effects)
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