Effectiveness of antiviral agents for the prevention of recurrent herpes labialis: a systematic review and meta-analysis

Objective. The purpose of this study was to complete a systematic review and, if possible, a meta-analysis on the effectiveness of systemic and topical nucleoside antiviral agents in the prevention of recurrent herpes labialis (RHL) in immunocompetent subjects. Study Design. Multiple comprehensive electronic and manual literature searches without language restrictions identified the studies to be included. Quality assessment and data synthesis methods followed those described in the Cochrane guidelines. Results. Of 2,683 papers reviewed, 10 met the inclusion criteria. Oral acyclovir (800-1,600 mg daily) and valacyclovir (500 mg daily for 4 months) were shown to be effective in the prevention of RHL when taken prior to the appearance of any symptoms or exposure to triggers. Of the 10 papers reviewed, only 1 was determined to have a low risk of bias. Conclusions. This review found support for the use of systemic acyclovir and valacyclovir for the prevention of RHL. (Oral Surg Oral Med Oral Pathol Oral Radiol 2012;113:618-627)