Episodic Acyclovir Therapy as Part of Syndromic Management Among Men Presenting With Genital Ulcer Disease: Is There Benefit?

Abstract

Herpes simplex virus type 2 (HSV-2) is the most common cause of genital ulcer disease (GUD) throughout the world [1]. This often asymptomatic infection is present in about 1 in 5 Americans (17.0%; 95% CI, 15.8%–18.3% in 1999–2004) [2] and prevalence may exceed 80% in individuals residing in developing countries [1]. Despite the often asymptomatic nature of genital herpes, several studies document the role of HSV-2 infection in increasing genital and plasma HIV-1 viral load, which may, in turn, increase HIV transmission [3]. Episodic acyclovir therapy may result in decreased genital HIV-1 shedding and enhance ulcer healing in individuals receiving syndromic therapy for GUD but no study has specifically addressed this issue in men.