Effectiveness of antiviral agents for the prevention of recurrent herpes labialis: a systematic review and meta-analysis.
OBJECTIVE
The purpose of this study was to complete a systematic review and, if possible, a meta-analysis on the effectiveness of systemic and topical nucleoside antiviral agents in the prevention of recurrent herpes labialis (RHL) in immunocompetent subjects.


METHODS
Multiple comprehensive electronic and manual literature searches without language restrictions identified the studies to be included. Quality assessment and data synthesis methods followed those described in the Cochrane guidelines.


RESULTS
Of 2,683 papers reviewed, 10 met the inclusion criteria. Oral acyclovir (800-1,600 mg daily) and valacyclovir (500 mg daily for 4 months) were shown to be effective in the prevention of RHL when taken prior to the appearance of any symptoms or exposure to triggers. Of the 10 papers reviewed, only 1 was determined to have a low risk of bias.


CONCLUSIONS
This review found support for the use of systemic acyclovir and valacyclovir for the prevention of RHL.
Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada.
Hanieh
H
Rahimi
Tom
T
Mara
John
J
Costella
Mark
M
Speechley
Richard
R
Bohay
D015075:2-Aminopurine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000212:Acyclovir / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D000077595:Famciclovir; D006560:Herpes Labialis / Q000517:prevention & control*; D006801:Humans; D016013:Likelihood Functions; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000998:Antiviral Agents; D015075:2-Aminopurine; D014633:Valine; D000077483:Valacyclovir; D000077595:Famciclovir; D000212:Acyclovir