Forty patients with serum antibody against herpes simplex virus (HSV) were enrolled in a randomized, placebo-controlled, double-blind investigation of acyclovir given orally in a low dosage as prophylaxis against recurrent HSV infection after renal transplantation. The virion of herpes simplex viruses consists of four components: 1) a core containing a single linear, double-stranded DNA molecule approximately 152 kbp in size; 2) an icosahedral capsid made up of 162 capsomeres; 3) an amorphous, though tightly adherent, tegument surrounding the capsid; and 4) a lipid bilayer envelope containing viral glycoprotein spikes surrounding the capsid-tegument complex. The mean recurrence rate per month of treatment was 1.4 in the placebo-treated patients and 0.05 in the acyclovir group. Also searched were conference proceedings available online or in published format, and abstracts of the following forums: Society for Maternal-Fetal Medicine (1966 to 2003), Infectious Diseases Society for Obstetrics and Gynecology (1966 to 2002), and the Society for Gynecological Investigation (1996 to 2003). From 30 to 90 days after transplantation when no antiviral medicine was given, 60% (3/5) of the remaining placebo recipients and 44% (7/16) of the acyclovir patients developed active HSV infections. Restriction endonuclease fingerprinting as well as DNA sequencing can also distinguish between HSV-1 and HSV-2 (6, 61). For studies published in multiple reports, only the report containing the most information was included.
Study selection Study designs of evaluations included in the review Randomised controlled trials (RCTs) were eligible for inclusion. Specific interventions included in the review Studies of prophylactic acyclovir were eligible for inclusion. Seroprevalence studies indicate that HSV-1 and HSV-2 infections are common worldwide, in both developed and undeveloped countries (53).