Glenny, A. M., Fernandez Mauleffinch, L. M., Pavitt, S., & Walsh, T. (2009). Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer. Cochrane Database of Systematic Reviews, 1, CD006706.
To examine the effects of interventions for the prevention, treatment, or both, of herpes simplex virus (HSV) in patients receiving treatment for cancer.
Forty studies were initially reviewed.
The evidence suggested that acyclovir may be beneficial for the prevention and treatment of herpes infection in this patient population; however, the risk ratios were relatively small, suggesting limited benefit. Valaciclovir may also be effective; however, few studies have reported this particular agent, so firm conclusions cannot be drawn. Prostaglandin E appears to have no benefit for the prevention of herpes infection in this group of patients. The degree of immunocompromised patients in study samples was not discussed, and sample sizes varied across studies, suggesting limited ability to truly generalize the findings provided here. Acyclovir was more effective than placebo in the prevention of herpes infections whether given orally (RR = 0.11; 95% CI [0.05, 0.24]) or IV (RR = 0.24; 95% CI [0.07, 0.86]). No differences were found in effectiveness between oral or IV use or between adults and children. Valaciclovir appeared to be as effective as aciclovir in two relatively small trials for prophylaxis.
Fifteen trials evaluated the effect for prevention of herpes infection, and two trials evaluated herpes treatment.