LETTER
Aspirin in the Management of Recurrent Herpes Simplex Virus Infection
Istvan Karadi, MD, PhD;
Sarolta Karpati, DSc; and
Laszlo Romics, DSc
15 April 1998 | Volume 128 Issue 8 | Pages 696-697
TO THE EDITOR:
Recurrent facial-oral or genital herpes simplex virus (HSV-1 and HSV-2) infections affect 28% and 1.1% of the population of college students in the United States, respectively [1]. The painful symptoms can disturb usual activities, and complete recovery often takes 8 to 9 days.
A 45-year-old man with severe recurrent herpes labialis had a myocardial infarction and began receiving aspirin, 125 mg/d. After 3 months, the patient reported complete disappearance of the herpetic episodes. Aspirin was his only new medication.
To explore the effect of aspirin, we recruited 21 volunteers with recurrent HSV infection (mean age ±SD, 29 ± 10 years; 14 were women and 7 were men); 19 had herpes labialis, and 2 had herpes genitalis. Patients immediately began receiving 125 mg of aspirin daily at the first evidence of symptomatic HSV recurrence. Nine of these volunteers continued to take aspirin for several months. We also observed 21 sex- and age-matched persons with recurrent HSV infection who had not taken any anti-inflammatory or antiviral drugs. The aspirin-treated patients had significantly fewer days of active HSV infections than did the controls (4.71 ± 0.95 days compared with 8.09 ± 0.99 days; P < 0.001). All aspirin recipients reported milder skin involvement than they had experienced previously. Patients receiving long-term aspirin therapy had longer symptom-free periods.
Aspirin inhibits viral protein synthesis in cell cultures infected by influenza virus [2], interferes with the nuclear translocation of NF-
B/c-Rel proteins, and inhibits the transcriptional induction of cytokines [3, 4]. Aspirin also decreases the production of proinflammatory prostaglandins while blocking cyclooxygenase-2 [5].
Aspirin, 125 mg/d, may be beneficial in patients with recurrent HSV infections and warrants further placebo-controlled study.
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Author and Article Information
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Semmelweis Medical University; Budapest, Hungary
1. Gibson JJ, Hornug CA, Alexander GR, Lee FK, Potts WA, Nahmias AJ. A cross-sectional study of herpes virus types 1 and 2 in college students: occurrence and determination of infection. J Infect Dis. 1990; 162:306-12.
2. Huang RT, Dietsch E. Anti-influenza viral activity of aspirin in cell culture [Letter]. N Engl J Med. 1988; 319:797.
3. Bitko V, Velasquez A, Yang L, Yang YC, Barik S. Transcriptional induction of multiple cytokines by human respiratory syncytial virus requires activation of NF- B and is inhibited by sodium salicylate and aspirin. Virology. 1997; 232:369-78.
4. Osnes LT, Foss KB, Joo GB, Okkenhaug C, Westvik AB, Ovstebo R, et al. Acetylsalicylic acid and sodium salicylate inhibit LPS-induced NF- B/c-Rel nuclear translocation, and synthesis of tissue factor (TF) and tumor necrosis factor alfa (TNF-
) in human monocytes. Thromb Haemost. 1996; 76:970-6.
5. Mitchell JA, Akarasereenont P, Thiemermann C, Flower RJ, Vane JR. Selectivity of nonsteroidal anti-inflammatory drugs as inhibitors of constitutive and inducible cyclooxygenase. Proc Natl Acad Sci U S A. 1993; 90:11693-7.
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