title: A comparison of one year of episodic or suppressive treatment of recurrent genital herpes with valacyclovir.
abstract: OBJECTIVE
  We conducted this study to compare episodic and suppressive therapy for genital herpes about disease characteristics, disease burden, and psychologic impact.
  
  
  METHODS
  The authors conducted a randomized, open-label, 1-year treatment trial.
  
  
  RESULTS
  Forty subjects were randomized to episodic therapy with valacyclovir (500 mg twice daily for 5 days) and 40 to suppressive therapy (500 mg daily). Subjects in the episodic arm experienced more outbreaks (7.87 +/- 4.65) than those in the suppressive arm (1.59 +/- 1.93) (P <0.001). Subjects in the episodic arm also had significantly more days with pain and lesions (6.5 +/- 7.3) than those in the suppressive arm (1.1 +/- 3.3) (P < 0.001), and other quantitative measures of disease burden also favored the suppressive arm. Both treatment groups had significant improvements in their recurrent genital herpes quality-of-life scores from baseline that persisted throughout the study; however, there was no significant difference between the treatment arms in these scores.
  
  
  CONCLUSIONS
  Suppressive therapy of recurrent genital herpes with valacyclovir has a greater impact on measures of disease frequency and burden than episodic therapy. However, both treatment strategies lead to significant improvements in recurrent genital herpes quality-of-life scores. Both treatment strategies benefit patients with recurrent genital herpes.
authors.affiliation: Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA. kfife@iupui.edu
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Fife
authors.forename: Jennifer
authors.initials: J
authors.lastname: Almekinder
authors.forename: Susan
authors.initials: S
authors.lastname: Ofner
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D006558:Herpes Genitalis / Q000401:mortality / Q000473:pathology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D012008:Recurrence; D012720:Severity of Illness Index; D016896:Treatment Outcome; D000077483:Valacyclovir; D014633:Valine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir