Herpes Simplex Treated With Antimicrobial Photodynamic Therapy: Randomized Controlled Trial.

Abstract

Objective: To compare the efficacy of antimicrobial photodynamic therapy (aPDT) with topical acyclovir in terms of healing time for herpes simplex lesions, recurrence rates, HSV-1 quantification in secretion and saliva, pain levels, temperature changes, and outcomes measured by the Oral Health Impact Profile Questionnaire (OHIP-14).

Subjects and methods: Patients with vesicle or ulcer phase lesions were randomly divided into two groups: the control group (topical acyclovir four times daily for 7 days + aPDT simulation, n = 12) and the experimental group (placebo acyclovir ointment + aPDT applied once, n = 12). The primary outcome was lesion resolution time, with secondary assessments for recurrence, pain, local temperature, virus quantification via quantitative polymerase chain reaction (qPCR), and impact on quality of life.

Results: After 1 year, the remission and recurrence rates were similar between groups (p = 0.718 and p = 0.317, respectively), as were pain levels and temperature (p = 0.039 and 0.217). There was an increase in HSV-1 viral load in saliva, measured by qPCR, on Day 3 in the ACV group (p = 0.043). The OHIP-14 scores were similar between groups after 1 year.

Conclusion: This study found no differences between aPDT and topical acyclovir regarding lesion resolution time, recurrence rates, pain levels, local temperature changes, and OHIP-14 scores. Both treatments showed similar efficacy in managing herpes simplex lesions over 1 year. While there was an increase in HSV-1 viral load in saliva in the acyclovir group on Day 3, this did not translate into differences in clinical outcomes between the groups.

Trial registration: NCT04037475.