Current management and recommendations for access to antiviral therapy of herpes labialis

Abstract

Herpes labialis is a common skin infective condition, worldwide, which is primarily caused by HSV-1. Recurrent episodes of herpes labialis, also known as cold sores, can be frequent, painful, long-lasting and disfiguring for infected patients. At present, there are two types of antivirals for the treatment of herpes labialis, topical and oral, which are available over the counter or as prescription-only. The aim of antiviral therapy is to block viral replication to enable shortening the duration of symptoms and to accelerate healing of the lesions associated with herpes labialis. This review examines the evidence for the effectiveness of current topical and oral antivirals in the management of recurrent episodes of herpes labialis. In most countries, oral antivirals for herpes labialis are available as prescription-only. However, in early 2010, the oral antiviral famciclovir was reclassified from prescription-only medicine to pharmacist-controlled status in New Zealand. The benefits and risks associated with moving an antiviral therapy for herpes labialis from prescription-only to pharmacist-controlled status are reviewed here, and the implications for patients, general physicians and pharmacists are considered.

Recurrent Herpes Labialis during Pregnancy: A Case Report

“…The recommended regimen is acyclovir 5 mg/kg to 10 mg/kg IV every 8 hours for 2-7 days or until clinical improvement is observed, followed by oral antiviral therapy to complete at least 10 days of total therapy [11]. In the present case, complete remission takes place with topical application of antiviral drugs while the authors of previous studies have mentioned about the use of systemic acyclovir for treatment of oral herpes simplex infection in Pregnancy [6,9].…”

“…After the first contact, the virus establishes a life-long latency in sensory nerve ganglia, more frequently the trigeminal ganglion [8]. A variety of factors like exposure to intense sunlight, fatigue, psychological stress, menses, skin trauma or immunosuppression can precipitate a recurrence by activation of the virus, which migrates to the epithelial cells through the affected nerve, causing recurrent herpes [1,9]. Similarly, the immunosuppression during pregnancy could be a possible reason for repeated oral herpes labialis in the present patient.…”

Herpes virus infection in dermatology: problems and modern approach to treatment

“…Современные рекомендации по лечению РПГ с фациальной и лабиальной локализацией указывают на рациональность эпизодической терапии корот-кими курсами системными противовирусными пре-паратами и назначения пролонгированных курсов терапии (супрессивная терапия) при частоте реци-дивов более 6 раз в течение 1 года [7,8].…”

Dendritic cell-based vaccines in treating recurrent herpes labialis: Results of pilot clinical study

“…Short-course regimens with oral antivirals decrease the duration of lesion episodes and pain by approximately one day; however, this treatment does not abort further recurrences.Suppressive therapy with long-lasting courses of acyclic nucleosides are more effective than episodictherapy in reducing the frequency of recurrences and prolonging the time to first recurrence. 8,9 Nevertheless, the data of meta-analysis demonstrate that the clinical benefit of long-term use of oral antiviral agents remains small. 10 Given an important role of immune response to HSV-1 latency, an alternative approach to prevent recurrent episodes is an activation of host immunity.…”