Study of the Efficacy and Safety of Combined Treatment of Patients With Severe Herpes Simplex (HSV) Infection by Valacyclovir and Interferon Inducer Kagocel
Condition: Herpes; Herpes Simplex; Herpes Oral; Herpes Simplex 2; Herpes Genitalis
MeSH terms: Herpes Simplex; Herpes Genitalis
Study type: Observational

Summary: 
      This study examined the efficacy, safety and benefits of modern treatment and changes in the
      dynamics of the life of adult patients quality with severe herpes simplex in the current
      medical practice when combined therapy by acyclic nucleoside Valacyclovir and antiviral agent
      Kagocel versus monotherapy by Valacyclovir. This study also evaluated the structure of
      herpesvirus infections and the rate of mixed variants of the course, the rate of
      exacerbations of herpes simplex, the time of disappearance of human herpesvirus isolation and
      the features of the immune phenotype of patients taking different types of therapy.
    

Detailed description: 
      This study was a comparative post-registration prospective non-interventional (observational)
      scientific study.

      This research did not include any procedures or medical interventions except those
      recommended in the local clinical guidelines and international standards of care. All
      procedures and evaluations were performed in accordance with routine clinical practice
      adopted in the Russian Federation and the instructions for the medical use of drugs that
      patients received.

      The following data was collected and analyzed after the end of treatment:

        -  demography

        -  disease severity (mild, moderate, severe, continuous relapses)

        -  data of anamnesis (hereditary and family anamnesis, duration of herpes simplex disease,
           previous illnesses, duration of treatment, previous treatment of herpes simplex and its
           efficacy, allergic anamnesis, epidemiological anamnesis, rate and duration of herpes
           relapses over the past year (with indication of the location of herpes simplex rashes),
           main diagnosis and complications, ICD-10 code, date and time of the last exacerbation,
           causes of exacerbation)

        -  verification of inclusion criteria

        -  verification of non-inclusion criteria

        -  prescribed therapy (trade name and prescription scheme, rate, method of administration)

        -  laboratory tests (4 timelines: 1 - first 6-48 hours; 2 - 6 days after starting of
           therapy; 3 - 30 days; 4 - 4 months): clinical and biochemical blood tests; serological
           diagnostics with determination of herpes virus infections's markers: IgM, IgG-HSV1,
           HSV2; hospital screening of venous blood: anti - HIV-1,2; anti-HCV-total, HBsAg, CSR;
           microbiological seeding from the tonsils, posterior pharyngeal wall with determination
           of drug sensitivity; PCR of blood, saliva and/or rash elements; immune status by laser
           flow cytometry: CD3+, CD4+, CD8+, CD4+/CD8+, CD16+, CD19+; serum immunoglobulins: IgA,
           IgM, IgG, IgE total.

        -  medical anamnesis (4 timelines: 1 - first 6-48 hours; 2 - 6 days after starting of
           therapy; 3 - 30 days; 4 - 4 months) or clinical efficacy: the presence and rate of
           exacerbations of the disease orolabial, genital and other sites; local complaints; the
           rate of occurrence of and general symptoms; the rate of epithelialization of the rash's
           morphological elements; duration of recurrence of the herpes simplex virus and speed of
           onset of epithelialization; the rate of relapses and exacerbations of herpes simplex on
           the background of suppressive therapy

        -  taking other drugs during the study (trade name, prescription scheme)

        -  compliance with the drugs regimen

        -  timelines: data of signing the informed consent, start date of the study, date of each
           patient visit, end date of the study, start date and end date of the taking medicines,
           duration of patient follow-up)

        -  quality of life assessment at the end of the study (excellent / good / satisfactory /
           has not changed)

        -  adverse events (yes/no, data description)
    

Intervention name(s): Kagocel+Valacyclovir; Valacyclovir
Intervention type(s): Drug; Drug
Intervention description(s): Group 1-patients with simple severe herpes (HSV-infection orolabial and / or genital localization) treatment [Valacyclovir + Kagocel ° ] (n= 25).
Treatment: Valacyclovir, 1000 mg orally (2 tablets of 500 mg): 1 time per day for at least 4 months continuously (the rate of suppressive therapy). * Kagocel®, 24 mg orally (2 tablets of 12 mg): 3 times per day, 5 days continuously.
* - During the study the minimum duration of Valacyclovir suppressive therapy in instruction for medical use that drag was changed from 4 (what was using in our reserch) to 6 months, and the optimal duration of continuous antiviral therapy with PG was changed from 6 to 12 months; Group 2 -patients with simple severe herpes (HSV-infection orolabial and/or genital localization) receiving treatment [Valacyclovir] (n= 20).
Scheme of treatment: Valacyclovir, 1000 mg orally (2 tablets of 500 mg): 1 time per day for at least 4 months continuously (a course of suppressive therapy)*.
* - During the study the minimum duration of Valacyclovir suppressive therapy in instruction for medical use that drag was changed from 4 (what was using in our reserch) to 6 months, and the optimal duration of continuous antiviral therapy with PG was changed from 6 to 12 months.
Intervention MeSH terms: Valacyclovir
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Adult men and women with signs of severe herpes simplex.
      
Keywords: herpes simplex; HSV1; HSV2; Herpes Genitalis; Herpes Oral; herpes simplex viruses; Valaciclovir