THE EFFECT OF SUPPRESSIVE ORAL ACYCLOVIR ON THE PSYCHOLOGICAL MORBIDITY ASSOCIATED WITH RECURRENT GENITAL HERPES

Objectives-To assess the psychological impact of recurrent genital her pes and to determine if longterm acyclovir has any impact on this morb idity. Setting and subjects-Patients with frequently recurring genital herpes attending a department of genitourinary medicine who were cons idered suitable for longterm acyclovir. Methods-Patients completed an 80 item, self-administered psychological questionnaire before starting acyclovir and every three months for one year. Treatment was then sto pped and three months later a further questionnaire was completed. The questionnaire consisted of the General Health Questionnaire (GHQ); th e Hospital Anxiety and Depression Questionnaire (HADQ); Illness Attitu de Scales and Illness Concern. Data were analysed by McNemar's test fo r changes in proportions and by Wilcoxon's test for changes in scores. Results-102 patients were recruited: 55 men, and 47 women. Eighty two (80%) patients completed three months treatment, 75 (74%) six months, 64 (63%) nine months and 61 (60%) a year. Fifty (49%) of the original 102 patients completed the three months post treatment follow up. At first visit 63% (64/102) were designated as GHQ ''cases''. Within thre e months this decreased to 26% (21/82). McNemar's test showed that 67% (34151) of the patients who were initially classified as GHQ ''cases' ' became ''noncases'' after three months (p < 0.0001). There was a sig nificant decrease in the proportion of HAD anxiety cases from visit on e to visit two (p < 0.0001) and a decrease in illness concern scores f rom visit one to visit two (p < 0.0001). All these decreases were main tained throughout the years treatment with acyclovir. Conclusions-Ther e is a substantial morbidity associated with frequently recurring geni tal herpes. However, acyclovir suppression significantly reduces illne ss concern and anxiety and is a useful addition to the treatment of th is infection.