Aciclovir is used for the treatment of herpes simplex virus and varicella zoster virus infections, including: Genital herpes simplex (treatment and prevention) Neonatal herpes simplex Herpes simplex labialis (cold sores) Shingles Acute chickenpox in immunocompromised patients Herpes simplex encephalitis Acute mucocutaneous HSV infections in immunocompromised patients Herpes of the eye and herpes simplex blepharitis (a chronic (long-term) form of herpes eye infection) Prevention of herpes viruses in immunocompromised people (such as people undergoing cancer chemotherapy) Its effectiveness in treating Epstein-Barr virus (EBV) infections is less clear. It has not been found to be useful for infectious mononucleosis due to EBV. Aciclovir taken by mouth does not appear to decrease the risk of pain after shingles. In those with herpes of the eye, aciclovir may be more effective and safer than idoxuridine. It is not clear if aciclovir eye drops are more effective than brivudine eye drops. Intravenous aciclovir is effective to treat severe medical conditions caused by different species of the herpes virus family, including severe localized infections of herpes virus, severe genital herpes, chickenpox and herpetic encephalitis. It is also effective in systemic or traumatic herpes infections, eczema herpeticum and herpes simplex meningitis. Reviews of research dating from the 1980s show there is some effect in reducing the number and duration of lesions if aciclovir is applied at an early stage of an outbreak. Research shows effectiveness of topical aciclovir in both the early and late stages of the outbreak as well as improving methodologically and in terms of statistical certainty from previous studies. Aciclovir trials show that this agent has no role in preventing HIV transmission, but it can help slow HIV disease progression in people not taking anti-retroviral therapy (ART). This finding emphasizes the importance of testing simple, inexpensive non-ART strategies, such as aciclovir and cotrimoxazole, in people with HIV.
