A comparison of one year of episodic or suppressive treatment of recurrent genital herpes with valacyclovir

Sex Transm Dis. 2007 May;34(5):297-301. doi: 10.1097/01.olq.0000237853.69443.71.


Objectives: We conducted this study to compare episodic and suppressive therapy for genital herpes about disease characteristics, disease burden, and psychologic impact.

Study design: The authors conducted a randomized, open-label, 1-year treatment trial.

Results: Forty subjects were randomized to episodic therapy with valacyclovir (500 mg twice daily for 5 days) and 40 to suppressive therapy (500 mg daily). Subjects in the episodic arm experienced more outbreaks (7.87 +/- 4.65) than those in the suppressive arm (1.59 +/- 1.93) (P <0.001). Subjects in the episodic arm also had significantly more days with pain and lesions (6.5 +/- 7.3) than those in the suppressive arm (1.1 +/- 3.3) (P < 0.001), and other quantitative measures of disease burden also favored the suppressive arm. Both treatment groups had significant improvements in their recurrent genital herpes quality-of-life scores from baseline that persisted throughout the study; however, there was no significant difference between the treatment arms in these scores.

Conclusions: Suppressive therapy of recurrent genital herpes with valacyclovir has a greater impact on measures of disease frequency and burden than episodic therapy. However, both treatment strategies lead to significant improvements in recurrent genital herpes quality-of-life scores. Both treatment strategies benefit patients with recurrent genital herpes.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acyclovir / administration & dosage
  • Acyclovir / analogs & derivatives*
  • Acyclovir / therapeutic use
  • Adult
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / therapeutic use*
  • Disease-Free Survival
  • Drug Administration Schedule
  • Female
  • Herpes Genitalis / mortality
  • Herpes Genitalis / pathology
  • Herpes Genitalis / prevention & control*
  • Humans
  • Male
  • Middle Aged
  • North Carolina
  • Recurrence
  • Severity of Illness Index
  • Treatment Outcome
  • Valacyclovir
  • Valine / administration & dosage
  • Valine / analogs & derivatives*
  • Valine / therapeutic use


  • Antiviral Agents
  • Valine
  • Valacyclovir
  • Acyclovir