Study finds aciclovir benefit

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Long-term use of suppressive prophylactic aciclovir appears to prevent the emergence of drug-resistant herpes simplex virus disease in haematopoietic stem-cell transplant, a study has concluded.

This study examined the effect of long-term use of suppressive aciclovir (ACV) on overall herpes simplex virus (HSV) disease and ACV-resistant HSV disease.

Data were obtained from three consecutive cohorts of haematopoietic stem-cell transplant (HCT) recipients (n=2,049):

• Cohort 1 received ACV for 30 days after HCT.

• Cohort 2 received ACV for one year after HCT.

• Cohort 3 received ACV for an extended period (>1 year) if immunosuppression continued after one year.

The study reported the following results:

Two-year probability of HSV disease:

• 31.6% (95% CI, 28 to 35%) in cohort 1.

• 3.9% (2.7–5.2%) in cohort 2.

• 0% in cohort 3.

ACV-resistant HSV disease developed in:

• 10 patients in cohort 1 (two-year probability, 1.3%; 0.8–2.7%).

• Two patients in cohort 2 (0.2%; 0–0.8%).

• 0 patients in cohort 3.

J Inf Dis 2007;196:266-70