Intravenous Acyclovir for the Treatment of Primary Genital Herpes

doi:10.1059/0003-4819-98-6-914

Intravenous Acyclovir for the Treatment of Primary Genital Herpes

LAWRENCE COREY, M.D.;
KENNETH H. FIFE, M.D., Ph.D.;
JACQUELINE K. BENEDETTI, Ph.D.;
CAROL A. WINTER, R.N.;
ANITA FAHNLANDER, R.N.;
JAMES D. CONNOR, M.D.;
MARIE A. HINTZ, M.D.; and
KING K. HOLMES, M.D., Ph.D.

Abstract

Thirty-one patients with first episodes of genital herpes were randomized in a double-blind fashion to intravenous treatment with saline placebo or acyclovir, 5 mg/kg body weight at 8-hour intervals, for 5 days. The median duration of viral shedding from genital lesions after the onset of therapy was significantly shorter for patients given acyclovir (2 days) than for those given placebo (13 days), p < 0.001. Viral shedding from the pharynx, cervix, urethra, and urine were also shorter in acyclovir-treated patients. (p < 0.01 for each comparison). Local and systemic symptoms were shortened by a mean of 5 days and healing of genital lesions by a mean of 12 days in acyclovir-treated patients. (p < 0.01). Complications during treatment, such as extragenital lesions or urinary retention requiring catheterization, developed in four patients given placebo and in none given acyclovir. (p < 0.05). Intravenous acyclovir substantially decreases the symptoms, duration of lesions, and complications of primary genital herpes.

Article and Author Information

▸From the Departments of Laboratory Medicine, Microbiology, Medicine, and Pediatrics, University of Washington, and the Children's Orthopedic Hospital Medical Center, Seattle, Washington; and the Department of Pediatrics, University of California, San Diego, California.
Grant support: in part by grant AI-14495 from the National Institutes of Health, training grant AI-07044 to Dr. Fife from the National Institutes of Health, grant RR-37 to the General Clinical Research Center from the National Institutes of Health, and a grant from the Burroughs Wellcome Co.
▸Requests for reprints should be addressed to Lawrence Corey, M.D.; Virology Laboratory, Children's Orthopedic Hospital Medical Center, P.O. Box C5371, 4800 Sand Point Way NE; Seattle, WA 98105.