Tratamento de herpes simples labial com terapia fotodinâmica: ensaio clínico randomizado controlado, duplo-cego com acompanhamento de 12 meses

Abstract

Herpes simplex lesions are treated with acyclovir. Despite reducing symptoms, studies show that it does not prevent recurrence of lesions. Photodynamic therapy (aPDT) has advantages such as decreased remission time and absence of recurrence in the same place. Therefore, the objective of this study was to evaluate if photodynamic therapy can decrease the healing time of these lesions and decrease their recurrence. Patients who present with herpes in the vesicle or ulcer phase and are included in the study were randomly divided into two groups: G1- Aciclovir group - aciclovir + aPDT simulation was used for blinding of the study, G2- aPDT group: 0.005% methylene blue laser group irradiated with 660nm, 100mW (Laser Duo, MMOptics), 120J / cm2, 3J per point. Applied to the central part of the lesion, and 30 seconds of irradiation + aciclovir placebo. The main study variable was the lesion resolution time in days. Secondary variables were assessment of recurrence assessed in months, pain assessed by visual analog scale (VAS), local temperature by digital thermometer. The viruses were quantified by PCRq. All evaluations were be performed at baseline and after 3 and 7 days after the application of aPDT or its placebo. The questionnaire to evaluate the impact of laser treatment on quality of life was be applied at baseline and after 7 days for secondary variables. Long-term follow up was be performed at 1 month, 6 months and one year for quality of life and recurrence assessment. Results: There was no difference resolution of the lesions in both studied groups (p=0.308), pain (p=0862 in the first and p=0339 in the third day) and temperature (p=0.488 first day, p=0.528 second day and p=0.071 on the third day). Conclusion: there was no difference regarding the time for lesion resolution in the analyzed groups, also for all the clinical outcomes analyzed.