Efficacy of oral antiviral prophylaxis in preventing ocular herpes simplex virus recurrences in patients with and without self-reported atopy.
OBJECTIVE
To compare the efficacy of oral antiviral prophylactic treatment for herpes simplex virus (HSV) recurrences in patients with and without self-reported atopy.


METHODS
Retrospective cohort comparative study.


METHODS
setting: Cornea Service, Wills Eye Hospital. study population: Patients who presented with previously diagnosed ocular HSV between March 2003 and March 2004. From 244 patients invited, 54 patients (58 eyes) were included. One hundred and ninety patients were excluded according to exclusion criteria: no active episode during follow-up, immunosuppression, less than one year of follow-up, or previous history of penetrating keratoplasty. The Questionnaire regarding history of atopic disease, considers: presence of allergic rhinitis, asthma or atopic dermatitis, and chart review of ocular history. main outcome measures: Incidence of all types of HSV recurrences with and without antiviral prophylaxis within each group and between groups. HSV episodes were classified into infectious, inflammatory, and mixed for analysis.


RESULTS
Atopic/nonatopic (P value): mean follow-up without prophylaxis 8.1 (+/- 8.2)/7.3 years (+/- 8.6) (P = .71); mean follow-up with prophylaxis 2.9 (+/- 2.3)/2.6 years (+/- 2.2) (P = .51); the effect of prophylaxis significantly reduced the all recurrences in both groups except in the inflammatory recurrences in the atopic group and in the mixed recurrences in both groups. Prophylaxis decreased infectious episodes by 44% in nonatopic and 76% in atopics and decreased inflammatory manifestations by 69% in the nonatopic group and 8% in the atopic group.


CONCLUSIONS
Antiviral prophylaxis for HSV recurrences was more effective in reducing infections in atopics and less effective in reducing inflammatory episodes in atopics versus nonatopics.
Rezende
Renata A
RA
Cornea Service, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
Bisol
Tiago
T
Hammersmith
Kristin
K
Rapuano
Christopher J
CJ
Lima
Ana Luisa H
AL
Webster
Guy F
GF
Freitas
Juliana F
JF
Laibson
Peter R
PR
Cohen
Elisabeth J
EJ
D015075:2-Aminopurine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000212:Acyclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D000284:Administration, Oral; D000998:Antiviral Agents / Q000627:therapeutic use*; D000077595:Famciclovir; D005260:Female; D005500:Follow-Up Studies; D018259:Herpesvirus 1, Human / Q000187:drug effects; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications*; D016849:Keratitis, Herpetic / Q000150:complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011355:Prodrugs / Q000627:therapeutic use*; D012189:Retrospective Studies; D055502:Secondary Prevention; D011795:Surveys and Questionnaires; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives / Q000627:therapeutic use
D000998:Antiviral Agents; D011355:Prodrugs; D015075:2-Aminopurine; D014633:Valine; D000077483:Valacyclovir; D000077595:Famciclovir; D000212:Acyclovir