Comparison of Acyclovir and Multistrain Lactobacillus brevis in Women with Recurrent Genital Herpes Infections: a Double-Blind, Randomized, Controlled Study

Abstract

We performed a randomized double-blind controlled trial to compare the efficacy and safety of multistrain probiotic and acyclovir in women patients with recurrent genital herpes simplex virus type 2 (HSV-2) infections. Eighty-one patients enrolled in the study were being treated with multistrain Lactobacillus brevis one vaginal capsule every 12 h and oral acyclovir 400 mg twice daily for 6 months. Of 53 patients who completed both treatment courses, no important differences were identified between acyclovir and probiotic for the primary and secondary efficacy endpoint, resolution of episode (hazard ratio, 0.60; 95% CI, 0.3429 to 1.0663; P = 0.08), lesion healing time (hazard ratio, 0.57; 95% CI, 0.3034 to 1.0717, P = 0.08), viral shedding (hazard ratio, 0.54; 95% CI, 0.3027 to 0.9750, P = 0.04), and percentage of pain (hazard ratio, 0.48; 95% CI, 0.2708 to 0.8545, P = 0.01). The median time to first and second recurrence after treatment were 43 and 121 days in patients receiving acyclovir and 33 and 118 days in patients receiving probiotic (HR 2.61; 95% CI, 1.4427 to 4.7546, P = 0.001, and HR 0.62; 95% CI, 0.3500 to 1.1133, P = 0.1, respectively). No clinically important effects happened during the probiotic treatment but some of adverse events reported in patients taking acyclovir. Easy availability, low cost, and no side effect of L. brevis are valuable properties of probiotic therapy compared with acyclovir. Therefore, we concluded that multistrain L. brevis could play an important role in suppression of recurrent genital herpes simplex virus infection.

Phase 1 Safety and Immunogenicity Trial of Recombinant Lactococcus lactis Expressing Human Papillomavirus Type 16 E6 Oncoprotein Vaccine

“…A sample size of 46 healthy female volunteers in all treatment cohorts were selected (vaccine cohorts, n = 32; placebo cohorts, n = 14) who finished the study. The data was analyzed in MedCalc software (version 17.6; MedCalc, Belgium) 30 . Specific antibodies of a participant who received NZ8123-HPV-16-optiE6 vaccine was deemed positive if the OD 450 was greater than the mean OD 450 plus three standard deviations from the mean for a panel of participants who received the placebo and vaccine was at least 0.100.…”

An Updated Overview of Herpes Simplex Virus-1 Infection: Insights from Origin to Mitigation Measures

“…Amenamevir. Pritelivir) [111][112][113]. The guanosine analog ACV is phosphorylated when the β gene of HSV synthesizes thymidine kinase and the activation of the topical drug leads to viral replication suppression [114].…”

“…Although reduction of the lesion was successfully done by ACV, its limitations are eradicated by prodrugs like valacyclovir and penciclovir. The latter has longer intracellular half-life post phosphorylation by thymidine kinase [113,115]. In contrast, valacyclovir can be used as a short term remedy for the genital lesion caused by HSV-1 [112,116].…”

Twenty years of research on HPV vaccines based on genetically modified lactic acid bacteria: an overview on the gut-vagina axis

“…Extensive literature has attempted to correlate the gut microbiota and immune system such as its effect on local health homeostasis. Also, the long-reaching immune effect of gut microbiota on vaginal diseases is now being well documented [10]. Despite this, the gut-vagina axis remains less studied than the gut-brain and gut-lung axis.…”