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September 7, 1984

Double-blind Placebo-Controlled Trial of Oral Acyclovir in First-Episode Genital Herpes Simplex Virus Infection

Author Affiliations

From the Departments of Laboratory Medicine (Dr Corey and Ms Critchlow) and Medicine (Drs Mertz and Benedetti), University of Washington and Children's Orthopedic Hospital, Seattle; the Department of Medicine, University of Vermont College of Medicine, Burlington (Drs Reichman and Dolin); the Departments of Medicine (Drs Redfield and Richman), Pediatrics (Dr Connor), and Pathology (Dr Savoia), University of California, San Diego, and San Diego Veterans Administration Medical Center, La Jolla; the Department of Medicine, University of Alberta, Edmonton (Drs Tyrrell and Miedzinski); the Departments of Medicine and Microbiology, Sir Mortimer B Davis-Jewish General Hospital, Montreal (Dr Portnoy); and Burroughs-Wellcome, Research Triangle Park, NC (Dr Keeney).

JAMA. 1984;252(9):1147-1151. doi:10.1001/jama.1984.03350090023017

One hundred nineteen patients with primary and 31 patients with nonprimary first-episode genital herpes were treated for ten days with 200 mg of acyclovir capsules or placebo capsules orally five times daily. Among acyclovir recipients with primary genital herpes, the median duration of viral shedding (two days), time to crusting of all lesions (seven days), time to healing of all lesions (12 days), and duration of local pain (five days) and constitutional symptoms (three days) were shorter than among placebo recipients (9, 10, 16, 7, and 6 days, respectively). Among patients with nonprimary first-episode genital herpes, oral acyclovir shortened the median duration of viral shedding but had no significant effect on the duration of lesions or symptoms. The time to first recurrence and frequency of recurrences were similar in acyclovir- and placebo-treated patients. Oral acyclovir treatment of primary first-episode genital herpes shortens the duration of viral shedding and symptoms and accelerates healing, but it does not appear to influence subsequent genital recurrences.

(JAMA 1984;252:1147-1151)