title: A non-randomized comparative study using different doses of acyclovir to prevent herpes simplex reactivation in patients submitted to autologous stem cell transplantation.
abstract: The reactivation of Herpes Simplex virus (HSV) occurs in 70% to 80% of patients submitted to autologous stem cell transplantation (ASCT); it increases the severity of chemotherapy-induced mucositis. Therefore, the use of acyclovir in ASCT patients is considered standard practice. However, the minimum dose needed to prevent reactivation is a matter of debate. We compared two doses of acyclovir in a non-randomized fashion in 59 patients submitted to ASCT: 32 patients received a dose of 125 mg/m(2) IV every six hours and the subsequent 27 patients received a dose of 60 mg/m(2) IV every six hours. Viral excretion was evaluated through weekly viral culture of oral swabs. Grade 4 mucositis was more frequent in Group 1 (p= 0.03). The reactivation rates in Groups 1 and 2 were 9% and 4%, respectively (p= 0.62, 95% confidence interval -7 - 18). Prophylaxis with reduced doses of intravenous acyclovir seems to be as effective as a higher dose in inhibiting HSV reactivation, with a significant reduction in cost. Prospective randomized studies are needed to confirm our conclusions.
authors.affiliation: University Hospital, Federal University of Juiz de Fora, MG, Brazil.
authors.forename: Angelo
authors.initials: A
authors.lastname: Atalla
authors.forename: Angelo
authors.initials: A
authors.lastname: Maiolino
authors.forename: Maria Angélica
authors.initials: MA
authors.lastname: Guimarães
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: Guimarães
authors.forename: Marcio
authors.initials: M
authors.lastname: Nucci
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage*; D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage*; D002648:Child; D004334:Drug Administration Schedule; D005260:Female; D006561:Herpes Simplex / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000517:prevention & control*; D018139:Simplexvirus / Q000187:drug effects / Q000502:physiology; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous; D014775:Virus Activation / Q000187:drug effects
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir