Valacyclovir to treat Recurrent Herpes Gladiatorum

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Valacyclovir to treat Recurrent Herpes Gladiatorum

• by
• Jesse Donnenwerth

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Viral Infections

• Herpes Simplex Virus
• -Type I extragenital
• -Type II genital
• -Zoster recurring chicken pox
• Verruca Virus
• Molluscum Contagiosum
• Human Immunodeficiency Virus
• Viral Hepatitis
• Influenza
• Mononucleosis

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Herpes Gladiatorum

• Diagnosed and termed by Selling and Kibrick in
  1964
• HSV Type-I
• Commonly cause lesions on face, neck, or
  shoulders of wrestlers

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The Disease Process of Herpes Virus

• Latency Stage
• -No symptoms
• -Not transmittable
• -Duration 2-7 days
• Shedding Stage
• -Virus multiplies and is transmittable
• -Fever, headache, muscle ache, and vesicles
• -Duration 2-13 days
• Reactivation Stage
• -Spreading of virus to other regions of the body
• -No symptoms

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Previous Research

• Primarily involved (HSV) Type-II
• 5 topical acyclovir
• -Shedding phase 1.8 days to .8 days
• -Total healing 9.7 days to 5.0 days
• Valacyclovir vs acyclovir
• -Total healing 5.9 days to 4.8 days
• Valacyclovir
• -Total healing 4.1 days

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Valtrex Study

• Objective- Determine the length of time the
  herpes simplex virus is contagious while
  comparing Valtrex and placebo.
• Hypothesis- With a recurrent outbreak of herpes
  gladiatorum, the use of Valtrex will decrease the
  duration of viral shedding and healing time.

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Subjects and Design

• Subjects- 90 male wrestlers between 13-40 years
  of age and have previous history of herpes
  gladiatorum
• Design- Double-blind and open study using Valtrex
  and placebo

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Methods

• Three groups of 30 participants are randomly
  selected and placed in one of three treatment
  groups
• Group I placebo twice a day
• Group II Valtrex 500mg twice a day
• GroupIII Valtrex 1000mg in AM and placebo in PM

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Expected Results

• Duration of viral shedding and total healing time
  of the lesion was decreased in both Valtrex
  groups

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Discussion

• Future research should focus on viral shedding
• NCAA rules regarding herpes outbreaks
• -Old rule 72 hours
• -New rule 120 hours
• -Collect data from pre-participation physicals
• High school and club wrestling programs