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Efficacy and Diminishing Need During Successive Years of Treatment

Stephen E. Straus, MD; Kenneth D. Croen, MD; Mark H. Sawyer, MD; Alison G. Freifeld, MD; James M. Felser, MD; Janet K. Dale, RN; Holly A. Smith; Claire Hallahan, MS; Sandra Nusinoff Lehrman, MD

JAMA. 1988;260(15):2227-2230.

Abstract
Forty-seven patients with frequently recurring genital herpes participated in one or more of five sequential trials of oral suppressive therapy with 200 mg of acyclovir three times daily from four to 12 months' duration. The prolonged use of acyclovir was extremely well tolerated, and treatment efficacy was sustained through successive studies. Recurrences in eight patients with repeated treatment "failures" were more effectively suppressed with higher doses of acyclovir. All patients experienced recurrent infections after the treatments were completed; however, the mean time to recurrence following each treatment period became progressively longer, and resumption of suppressive therapy was no longer warranted for ten patients. These data indicate the efficacy and safety of chronic suppressive therapy with acyclovir and the value of interrupting prolonged treatment to assess its further need.

(JAMA 1988;260:2227-2230)

Author Affiliations
From the Medical Virology Section, Laboratory of Clinical Investigation, and the Office of the Director, Intramural Research Program, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Md (Drs Straus, Croen, Sawyer, Freifeld, and Felser and Mss Dale, Smith, and Hallahan); and the Virology Division, Burroughs Wellcome Co, Research Triangle Park, NC (Dr Lehrman).

Footnotes
Reprint requests to the Medical Virology Section, Bldg 10, Room 11N113, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD 20892 (Dr Straus).

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