Comment: The quality of evidence is downgraded by study limitations (unclear risk of bias).
A Cochrane review included 26 studies with a total of 2084 men and women experiencing their first episode of genital herpes. Oral acyclovir, when compared to placebo, reduced the duration of symptoms (mean difference (MD) -3.22, 95% CI -5.91 to -0.54; 2 trials, I²=52%). Oral valacyclovir showed a similar length of symptom duration when compared to acyclovir in two studies. Two studies reported no evidence of a reduction in the number of median days to recurrence following treatment with oral acyclovir versus placebo. summarizes the results of three RCTs. The largest RCT (n=180) found that aciclovir 200 mg 5 times daily accelerated the healing of lesions, reduced the formation of new lesions (18% vs 62%) and the duration of pain (5 days vs 7 days) and viral shedding (2 days vs 9 days) compared with placebo. Two smaller RCTs had similar results."?>