Herpes simplex virus infection acyclovir

Oral acyclovir is effective in primary herpetic gingivostomatitis (600 mg/m four times daily for 10 days in children) but has only modest benefit in recurrent orolabial herpes. High-dose valacyclovir (2 g twice over one day) shortens the duration of recurrent orolabial herpes by 1 day. Topical acyclovir is modestly effective in recurrent labial and genital herpes simplex virus infections. Acyclovir prophylaxis (400 mg twice daily for one week) reduces the risk of recurrence by 73% in those with sun-induced recurrences of HSV infections. Acyclovir during the last month of pregnancy reduces the likelihood of viral shedding and frequency of cesarean section in women with primary or recurrent genital herpes. 

YT Bryson, M Dillon, G Acuna, S Taylor, JD Cherry, BL Johnson, E Wiesmeier, W Growden, T Greagh-Kirk, R Keeney. Treatment of first episodes of genital herpes simplex virus infection with oral acyclovir. A randomized double-blind controlled trial in normal subjects. N Engl J Med 308 916-921, 1983. 

Topical acyclovir (Zovirax) is available as a 5% ointment topical penciclovir (Denavir), as a 1% cream for the treatment of recurrent orolabial herpes simplex virus infection in immunocompetent adults. Adverse local reactions to acyclovir and penciclovir may include pruritus and mild pain with transient stinging or burning. 

Topical acyclovir (Zovirax) is available as a 5% ointment for application to primary cutaneous herpes simplex infections and to limited mucocutaneous herpes simplex virus infections in immunocompromised patients. In primary infections, the use of topical acyclovir shortens the duration of viral shedding and may decrease healing time. In localized, limited mucocutaneous infections in immunocompromised patients, its use may be associated with a decrease in the duration of viral shedding. 

Uchoa UBC, Rezende RH, Carrasco MA, et al. Long-term acyclovir use to prevent recurrent ocular herpes simplex virus infection.Arch Ophthalmol 2003 121 1702-1704. 

Erlich KS, Mills J, Chatis P, Mertz GJ, Busch DF, Follansbee SE, Grant RM, Crumpacker CS. Acyclovir-resistant Herpes simplex virus infections in patients with the acquired immunodeficiency syndrome. N Engl J Med 1989 320(5) 293-6. 

Straus SE, Smith HA, Brickman C, de Miranda P, McLaren C, Keeney RE. Acyclovir for chronic mucocutaneous Herpes simplex virus infection in immunosuppressed patients. Ann Intern Med 1982 96(3) 270-7. 

Darville JM, Ley BE, Roome AP, et al. Acyclovir-resistant herpes simplex virus infections in a bone marrow transplant transplant population. Bone Marrow Tranplant 1998 22 587-589. 

McGuirt PV, Furman PA. Acyclovir inhibition of viral DNA chain elongation in herpes simplex virus infected cells. Am J Med 1982 73(suppl) 67-71. 

Thymidine kinase (TK) is an essential enzyme for phosphorylation of deoxy-thymidine and DNA synthesis. In addition, it is the enzyme responsible for activation and-or metabolism of a variety of nucleoside analog drugs (for example DNA chain terminators such as AZT). This enzyme has received significant interest for treatment of herpes simplex virus infections (cf. acyclovir) or mycobacterium infections. In both cases, therapies have been developed that seek to exploit the differences between viral or bacterial TK and human TK. Two forms of thymidine kinase are found in human cells TK1 (cytosolic, active in replicating cells) and TK2 (mitochondrial, constitutively active). Some antiviral-anticancer drugs are metabolized by either one of the isozymes. In some cases, this may be associated with either lack of efficacy or... 

Parenteral acyclovir (e.g., 5 mg/kg infused at a constant rate over 1 hour every 8 hours for 7 days) may be used in mucosal and cutaneous herpes simplex virus infections, and in varicella zoster infections (shingles) in immunocompromised patients and in herpes simplex encephalitis. 

Development of effective antiviral agents has been slow, as the drugs must be highly selective because viral replication depends largely on the metabolic processes ongoing in the invaded cell. Zidovudine is the most important agent available for the treatment of AIDS, and Acyclovir is effective for the treatment of herpes simplex virus infections. 

Acyclovir (Zovirax) and penciclovir (Denavir) are the only topical antiviral dragp currently available These dragp inhibit viral replication. Acyclovir is used in the treatment of initial episodes of genital herpes, as well as heqies simplex virus infections in immunocompromised patients (patients with an immune system incapable of fighting infection). Penciclovir is used for the treatment of recurrent herpes labialis (cold sores) in adults. 

Catechins and proanthocyanidins have a documented antiviral activity. Catechins from an extract of Cocos nucifera husk fibre exhibited a strong inhibitory activity against acyclovir-resistant herpes simplex virus type 1 (HSV-l-ACVr) [62]. The use of 10 to 20ngml of ECG and EGCG has been reported to cause 50% inhibition of human immunodeficiency virus reverse transcriptase [89], while Kara and Nakayama [90] reported that a patented chewing gum containing tea catechins is claimed to prevent viral infections against influenza and to inhibit dissemination of this virus. 

Herpes simplex virus (HSV) /nfecf/ons Treatment of acyclovir-resistant mucocutaneous HSV infections in immunocompromised patients. 

Note Herpes simplex virus encodes a virus-specific thymidine. kinase, which phosphorylates the nucleoside analog acyclovir (acycloguanosine) to form acycloguanosine monophosphate. After further phosphorylation, the resulting acycloguanosine triphosphate is incorporated by the viral DNA polymerase into viral DNA, causing chain termination in virus-infected cells.]... 

Acyclovir is useful in the treatment of herpes. Oral herpes is caused by the herpes simplex virus 1 (HSV-1), and genital herpes is caused by the herpes simplex virus 2 (HSV-2). More than 90 percent of the world s population is infected with the oral herpes virus, though there are many infected people who do not exhibit symptoms. Genital herpes is the most prevalent nondurable sexually transmitted disease. In the United States, there are about 30 million people infected with HSV-2 and an estimated 200,000 to 500,000 new cases each year. 

Soyasaponin I and II were studied in vitro against herpes simplex virus type I (HSV-1). Soyasaponin II was more potent than soyasaponin I in the reduction of HSV-1 production. Soyasaponin II was also found to inhibit the replication of human cytomegalovirus, influenza virus, and human immunodeficiency virus type 1. This activity was not due to the inhibition of virus penetration and protein synthesis, but might involve a virucidal effect. When acyclovir and soyasaponin II were evaluated in combination for anti-HSV-1 activity, additive antiviral effects were observed for this virus [160]. Astragaloside II afforded almost 100% protection of T-lymphocytes in vitro against the cytophatic effects of HIV infection. However, the EC50 of ca. 2.5 x 105 molar was difficult to achieve in vivo [98],... 

In a recent investigation of phenolic compounds tested, using herpes simplex virus type 1 (HSV-1) infected Vero cells, caffeic acid has been reported to inhibit virus replication [91], In a related study [92], chlorogenic acid significantly inhibited acyclovir-resistant HSV-1 replication without any cytotoxicity. However, flavonoids have exhibited cytotoxicity at the same concentration [92],... 

Vidarabine [vye DARE a been] arabinofuranosyl adenine, ara-A, adenine arabinoside) is one of the most effective of the nucleoside analogs and is also the least toxic. However, it has been supplanted clinically by acyclovir, which is more efficacious and safe. Although vidarabine is active against herpes simplex virus type 1 (HSV-1), HSV-2, and varicella-zoster virus (VZV), its use is limited to treatment of immunocompromised patients with herpes simplex keratitis or encephalitis, or VZV infections. Vidarabine, an adenosine analog, is converted in the cell to its 5 -triphosphate analog (ara-ATP), which is postulated to inhibit viral DNA synthesis. Some resistant herpes virus... 

Fife KH, et al. Valaciclovir versus acyclovir in the treatment of first-episode genital herpes infection. Results of an international, multicenter, double-blind, randomized clinical trial. The Valaciclovir International Herpes Simplex Virus Smdy Group. SexTransm Dis 1997 24(8) 481-486. 

Malvy D, TreRhaud M, Boues S, et al. A retrospective, case-control smdy of acyclovir resistance in herpes simplex virus. Clin Infect Dis 2005 41(3) 320-326. 

Foscamet is used for the treatment of cytomegalovirus (CMV) retinitis and mucocutaneous acyclovir-resistant herpes simplex virus (HSV) infections. It may also be beneficial in other types of CMV or HSV infections (Wagstaff and Bryson, 1994). 

Antiviral activity has been demonstrated mainly for A. membranaceus, that represents the most studied species, expecially against Coxsackie viruses [234] but also against different kinds of viral infections. "Astragali radix" extracts show protective effects against Japanese Encephalitis Vitus (JEV) infection in mice both by oral and infraperitoneal injection this effect is based on a non-specific mechanism during the early stage of injection, before it shifts to antibody production. A. membranaceus (AM) shows curative effects on the mice infected with Herpes Simplex Virus type-1 (HSV-1) when somministated with acyclovir (ACV) [329]. The anti-HSV activity of suppository and ointment forms of AM combined... 

Mucsi et al. [197] studied the combined antiviral effects of some benzol a] phenothiazines and 9-[2-hydroxy(ethoxy)methyl]guanine (acyclovir, ACV, and acycloguanisine) on the multiplication of herpes simplex virus type 2 (HSV-2). Vero cells were infected with HSV-2 and treated with a combination of ACV and selected benzo[a]phenohiazines, including 5-oxo-5H-benzo[a]phenothiazine and 6-methyl-5-oxo-5H-benzo[a]phenothiazine. The authors found that such a treatment decreased the infective virus population, probably by reduction of the mutagenic rate in the virus populations. 

Inununosuppressed radiation victims with positive serology for herpes simplex viruses are at risk for reactivation of HSV infection, with resulting clinical picture that mimics radiation stomatitis. These patients should receive prophylaxis with acyclovir or one of its congeners. If serology results are not available, patients with a history of oral or genital herpes infection should receive acyclovir prophylaxis. Patients who develop severe mucositis require assessment for HSV reactivation (2). 

---