The role of herpes viruses in the etiology and pathogenesis of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) identifies the need to develop the treatment algorithms.

OBJECTIVE

Effectiveness evaluation of antiviral treatment in patients with herpesvirus-associated CP/CPPS including those complicated by infertility.

MATERIAL AND METHODS

287 patients with CP/CPPS were observed; 103 of them had herpes viruses type IV—VI (subgroups IA and IB) in urogenital samples. Therapy in subgroup IA (n=64): valacyclovir 500 mg 2 times a day for 90 days, α2β-interferon suppositories 1 million U/day for 30 days; in subgroup IB (n=39): α2β-interferon suppositories 1 million U/day 20 days, tamsulosin 0.4 mg orally for 3 months, diclofenac 0.05 suppositories per rectum for 10 days. Group II (comparisons) included 184 men with CP/CPPS without herpes viruses.

RESULTS

By the end of therapy, a statistically significant decrease in the severity of CP/CPPS symptoms was observed in patients of all groups from 19.8±6.3 to 10.0±1.5 points on the Chronic Prostatitis Symptom Index of the US National Institutes of Health. The effectiveness of antiviral treatment in subgroups IA and IB was not inferior to the standard conventional antibiotic, α-blocker and NSAID treatment in group II. The symptom improvement in the first weeks of treatment was the best in subgroup IB and group II, and by the end of the observation period — 6 months’ treatment, the advantages of valacyclovir and α2β-interferon combination were noted (p<0.05). By the end of therapy, a virus-examination showed a decrease in the concentration and number of virus-positive urogenital samples.

CONCLUSIONS

Valacyclovir and α2β-interferon in patients with herpesvirus prostatitis showed a comparable result to standard treatment and can be recommended for this disease.