Virucidal effect of mouthwash on acyclovir-resistant herpes simplex virus

Oral Dis. 2024 Oct;30(7):4762-4766. doi: 10.1111/odi.14843. Epub 2023 Dec 27.

Abstract

Objectives: The symptoms of herpes simplex viruses type 1 (HSV-1) infections might be severe and persistent in immunocompromised patients in whom they reactivate at a high frequency. The development of Acyclovir (ACV) resistant strains due to long-term treatment with antiviral agents in those patients is not uncommon. The aim of the present study was to assess the virucidal effect of commercially available mouthwashes against ACV-resistant HSV-1 strains.

Materials and methods: Two acyclovir-resistant HSV-1 strains were exposed for 30 s to essential oil-based (Listerine Fresh Burst® and Listerine Zero®), chlorhexidine gluconate 0.2% (Hexidyl®) and povidone-iodine 7.5% (Betadine Gargle®) mouthwashes. Loss of virus infectivity was determined by means of plaque reduction assays in a cell culture system.

Results: All 4 of the tested solutions significantly reduced virus infectivity, with the essential oil-based and povidone-iodine mouthwashes being slightly more efficacious, compared to chlorhexidine.

Conclusion: The findings of this analysis revealed that the tested oral rinses demonstrated in-vitro antiviral activity against ACV-resistant HSV. Comparative clinical trials are required to establish the clinical effectiveness of daily use of oral rinses in reducing the appearance of oral HSV lesions in immunocompromised patients.

Keywords: acyclovir; chlorhexidine; essential oils‐based mouthwashes; herpes simplex virus; povidone‐iodine; resistant.

MeSH terms

  • Acyclovir* / pharmacology
  • Anti-Infective Agents, Local / pharmacology
  • Antiviral Agents* / pharmacology
  • Chlorhexidine / analogs & derivatives
  • Chlorhexidine / pharmacology
  • Chlorocebus aethiops
  • Drug Combinations
  • Drug Resistance, Viral*
  • Herpesvirus 1, Human* / drug effects
  • Humans
  • Mouthwashes* / pharmacology
  • Oils, Volatile / pharmacology
  • Povidone-Iodine* / pharmacology
  • Salicylates / pharmacology
  • Terpenes / pharmacology
  • Vero Cells

Substances

  • Mouthwashes
  • Acyclovir
  • Antiviral Agents
  • Povidone-Iodine
  • Chlorhexidine
  • Drug Combinations
  • chlorhexidine gluconate
  • Listerine
  • Terpenes
  • Salicylates
  • Anti-Infective Agents, Local
  • Oils, Volatile