Acyclovir Versus Valacyclovir for Herpes Virus in Children

September 2014

Acyclovir Versus Valacyclovir for the Herpes Virus in Children and

Pregnant Women: A Review

Context article selection according to predetermined selection Varicella (chickenpox) and herpes zoster (shingles) are criteria (population, intervention, comparator, outcomes, caused by the varicella-zoster virus, a type of herpes virus. and study designs). Genital herpes is caused by the herpes simplex virus type 1 or type 2. Most cases of chickenpox occur in children aged 14 years or younger, whereas shingles are most common in Key Messages adults older than 50 years of age. Chickenpox in the general adult population is uncommon; however, chickenpox in For the treatment of chicken pox in children: pregnant women is of concern because they are at a higher  acyclovir was shown to be effective risk of complications such as varicella pneumonia, which has  no evidence on the effectiveness of valacyclovir an estimated mortality rate of 20% to 45% in the absence of was found. antiviral drug treatment. For pregnant women with genital In pregnant women: herpes, there is a risk of transferring the virus to the baby.  both acyclovir and valacyclovir appear to be effective for the treatment of recurrent genital Technology herpes Acyclovir and valacyclovir are antiviral drugs used to treat  both acyclovir and valacyclovir appear to be safe; herpes simplex virus types 1 and 2 and the varicella-zoster however, there is substantially more experience virus. There is no evidence that either drug causes major with acyclovir birth defects if they are taken by pregnant women; however,  no evidence was found on the effectiveness of the product monographs for both acyclovir and valacyclovir acyclovir compared with valacyclovir for the list pregnancy as a warning or precaution. Although acyclovir treatment of herpes zoster infection has traditionally been the drug of choice in both pregnancy  no evidence was found on the effectiveness of and pediatrics, valacyclovir may be an appealing alternative acyclovir compared with valacyclovir for the because its lower dosing frequency may lead to increased treatment of chickenpox compliance.  guidelines on the treatment of chickenpox and genital herpes recommend acyclovir in certain Issue situations, and several suggest valacyclovir as A review of the clinical effectiveness of acyclovir compared another option. with valacyclovir for the treatment of chicken pox in children; chicken pox, herpes zoster infection, and herpes simplex virus in pregnant women; and of the related guidelines will Results help inform treatment decisions for these patients. The literature search identified 371 citations, with Methods 12 additional studies identified from other sources. Of these, 20 were deemed potentially relevant and 11 met A limited literature search was conducted of key resources, the criteria for inclusion in this review: 2 systematic reviews, and titles and abstracts of the retrieved publications were 1 cohort study, and 8 guidelines. reviewed. Full-text publications were evaluated for final

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