![]() Over the last 20 years, prevalence has increased globally and the prevention of RHL poses a big challenge for the 21 st century. Detectable serum antibodies against herpes simplex virus are more prevalent in lower socioeconomic groups. (RHL) Between 20 to 40% of adults become infected with herpes simplex infection at some point during their lifetime. In developed countries, one third of the population suffer from recurrent herpes labialis. Infection rates are high among HIV positive patients about 95% of patients are seropositive to herpes simplex type I antigen. Herpes labialis infection is a global public health problem, with 15 to 40% of the population who experience symptomatic outbreak. Treatment with combined therapy is safe and more effective than placebo or antiviral alone for preventing the recurrence of ulcerative lesions in RHL infection. The adverse reactions in combined therapy were not significantly different than the placebo group (OR, 1.09 95% C, 0.75-1.59 P = .85). However, there were no significant differences in healing time between combined therapy and antiviral alone. The healing time was also significantly shorter in combined therapy in comparison to placebo (P < .001). ![]() Pooled results showed that patients receiving combined therapy had a significantly lower recurrence rate of ulcerative lesions compared to those in both the placebo group (OR, 0.50 95% CI, 0.39-0.66 P < .001) and the antiviral treatment alone group (OR, 0.73, 95% CI, 0.58–0.92 P = .007). Corticosteroids used were 1% hydrocortisone and 0.05% fluocinonide. The antiviral drugs used were acyclovir, famciclovir, and valacyclovir. The total number of participants across included studies was 1,891 (range, 29 to 1,443). Resultsįour studies that fulfilled the selection criteria were included in this review. Heterogeneity among trials was established using I 2 and chi-square test for heterogeneity. A fixed-effects model was used for mild to moderate heterogeneity, whereas a random-effects model was used for significant heterogeneity. We used RevMan software to conduct the meta-analysis. MEDLINE, EMBASE, CINAHL, Web of Science, the Cochrane library, and Google Scholar databases were searched. MethodsĪ systematic review of randomized clinical trials comparing the efficacy of combined therapy (topical corticosteroids with antiviral) with placebo or antiviral alone in the management of RHL was conducted. The objective of this review was to identify the effectiveness of topical corticosteroids in addition to antiviral therapy in the treatment of RHL infection. The available treatments have limited efficacy in preventing the recurrence of ulcerative lesions and reducing the duration of illness. Recurrent herpes labialis (RHL) is one of the most common viral infections worldwide. ![]()
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