General Obstetrics and Gynecology: ObstetricsValacyclovir therapy to reduce recurrent genital herpes in pregnant women
Section snippets
Material and methods
This was a randomized double-masked, placebo-controlled clinical trial of gravid women with documented recurrent HSV-2 infection conducted between March 1998 and May 2001. The primary site for the investigation was the Center for Research in Women's Health at the University of Alabama at Birmingham (UAB) and a secondary site was the University of South Alabama (USA) in Mobile, AL. One hundred and two women were enrolled at UAB and 10 at USA. The Institutional Review Boards of both institutions
Results
A summary of screening, enrollment, and randomization of women to valacyclovir and placebo groups is provided in the Figure. A total of 112 women were randomized, including 57 in the valacyclovir group and 55 in the placebo group. Demographic characteristics of the 2 groups are depicted in Table I. No significant differences were observed between the 2 groups for maternal age, ethnicity, marital status, nulliparity, or gestational age at enrollment. There was also no significant difference
Comment
In this study, daily valacyclovir suppression initiated at 36 weeks' gestation and continued through delivery in women with a documented history of recurrent HSV infection significantly reduced the number of women with subsequent clinical HSV recurrences after treatment initiation. However, suppression did not decrease the number of women with viral shedding near delivery, active HSV lesions at delivery, or the number requiring cesarean delivery for active HSV lesions. Although not
Acknowledgment
The authors acknowledge Dr Susan Baker at the University of South Alabama, Mobile, AL, for her contributions to this study.
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Diagnostic and therapeutic recommendations for sexually transmitted diseases: Genital herpes
2019, Annales de Dermatologie et de VenereologieGenital herpes and pregnancy: Epidemiology, clinical manifestations, prevention and screening. Guidelines for clinical practice from the French College of Gynecologists and Obstetrician (CNGOF)
2017, Gynecologie Obstetrique Fertilite et SenologieManagement of pregnant women with recurrent herpes. Guidelines for clinical practice from the French College of Gynecologists, Obstetricians (CNGOF)
2017, Gynecologie Obstetrique Fertilite et SenologieManagement of pregnant women with first episode of genital herpes. Guidelines for clinical practice from the French college of gynecologists and obstetricians (CNGOF)
2017, Gynecologie Obstetrique Fertilite et SenologieNo. 208-Guidelines for the Management of Herpes Simplex Virus in Pregnancy
2017, Journal of Obstetrics and Gynaecology CanadaCitation Excerpt :Valacyclovir is the valine ester of acyclovir and is broken down to acyclovir in the blood stream, so safety data on acyclovir may be extrapolated to valacyclovir. A recent study has demonstrated the cost effectiveness of acyclovir suppression in pregnant women.35 Use of acyclovir in pregnancy has not been associated with any consistent pregnancy complications or fetal/neonatal adverse effects, other than transient neutropenia in data from the Acyclovir Pregnancy Registry.23,36,37
Supported by a research grant from GlaxoSmithKline, Research Triangle Park, North Carolina.
Dr Deeter is currently at Amgen, Inc, Thousand Oaks, CA.
Presented at the 2003 Society of Maternal-Fetal Medicine Annual Meeting, San Francisco, CA, February 2003.
Reprints not available from the authors.