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R. Rezende, U.C. Uchoa, M. Carrasco, C.J. Rapuano, E.J. Cohen, P.R. Laibson; Effect of Long-term Oral Acyclovir Therapy on Recurrent Infectious Herpes Simplex Keratitis in Patients without Grafts – How Long is Long Enough? . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4277.
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Background and Purpose: Long term treatment with oral acyclovir has been shown to prevent recurrences of Herpes Simplex viral (HSV) keratitis when taken for 1 year, but there is little data regarding prophylactic treatment with oral acyclovir for more than one year. Our purpose is to evaluate the efficacy of more than one year oral acyclovir therapy in reducing recurrences of epithelial and stromal herpes simplex keratitis. Methods: Retrospective comparison of the incidence of ocular HSV recurrences after treatment with acyclovir between group 1 who had acyclovir for one year period and group 2 who had the drug for more than one year. Patients with corneal transplants were excluded from the study. Statistical analysis were made using Chi-Square tests and Kaplan-Meyer’s Survival Function Results: 40 patients were included in the study and divided into 2 groups. Group 1: patients who had acyclovir for approximately one year period include: Eighteen patients (9 male, 9 female), mean age 45.5 years old follow up time from the date they started on acyclovir : 45.2 months (± 22.2) Fourteen patients had recurrence (77.8%) time for recurrence after discontinuation of acyclovir : 5.2 months (±6.0) Group 2: patients had acyclovir for more than one year included: Twenty-two patients (12 male, 10 female), mean age 57.1 years old follow up time from the date they started on acyclovir : 42.4 months (± 30.2) Eight patients (36.4%) had recurrence time to recurrence after one year taking acyclovir 22.5 months (±19.1) Recurrence of HSV keratitis was lower and later in the group that had acyclovir for more than 1 year compared to the group that had the drug only for 1 year period. These differences were statistically significant (p= 0.005) Conclusions: Prophylactic treatment with oral acyclovir for more than one year prevents epithelial and stromal recurrences of herpes simplex keratitis.
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