Herpes simplex virus infection mucocutaneous

Ointment Management of initial episodes of herpes genitalis and in limited non-life-threatening mucocutaneous herpes simplex virus infections in immunocompromised patients. 

Aciclovir is phosphorylated preferentially by herpes simplex virus-coded thymidine kinase and following further phosphorylation aciclovir triphosphate interferes with herpes virus DNA polymerase and viral DNA replication. Aciclovir topical cream is indicated in the management of initial genital herpes and in limited non-life threatening mucocutaneous herpes simplex virus infections in immunocompromised patients. 

Foscarnet is an inorganic pyrophosphate analogue which causes selective inhibition of viral DNA polymerase and reverse transcriptase. Topical foscarnet cream has appeared to be a safe and effective treatment for aciclovir-unresponsive mucocutaneous herpes simplex virus infection in AIDS patients. 

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. 

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. 

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

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). 

Chatis PA, Miller CH, Schrager LE, Crumpacker CS. Successful treatment with foscamet of an acyclovir-resistant mucocutaneous infection with Herpes simplex virus in a patient with acquired immunodeficiency syndrome. N Engl J Med 1989 320(5) 297-300. 

Herpes simplex viruses (HSV) types 1 and 2 cause significant morbidity in patients with AIDS. Seropositivity for HSV is widespread among adults with AIDS, and clinical disease usually is the result of reactivation of latent virus. The manifestations of HSV disease observed in persons with AIDS include orolabial, genital, and anorectal mucocutaneous disease esophagitis and less commonly, encephalitis. Ulcerative HSV lesions present for longer than 1 month in an individual with laboratory evidence for HIV infection or no other apparent cause for immunodeficiency are considered an AIDS-defining condition. 

Foscamet is an antiviral agent that inhibits replication of all known herpes viruses, including cytomegalovirus (CMV), herpes simplex virus types 1 and 2 (HSV-1, HSV-2), human herpes virus 6 (HHV-6), Epstein-Barr virus (EBV) and varicella-zoster virus (VZV). It is indicated in the treatment of CMV retinitis in patients with AIDS treatment of acyclovir-resistant mucocutaneous HSV infections in immunocompromised patients and as combination therapy with ganciclovir for patients who have relapsed after monotherapy with either drug. 

Herpesviridae Cytomegalovirus Epstein-Barr virus Herpes simplex, types 1 and 2 Varicella-zoster virus Cytomegalic inclusion disease (i.e., widespread involvement of virtually any organ, especially the brain, liver, lung, kidney, intestine) Infectious mononucleosis Local infections of oral, genital, and other mucocutaneous areas systemic infections Chickenpox herpes zoster (shingles) other systemic infections... 

This drug is reported to stimulate the host immune response to virus infection and has been used for mucocutaneous herpes simplex and genital warts (but aciclovir is superior). It is administered by mouth and metabolised to uric acid, so should be used with caution in patients with h5rperuricaemia or gout. 

Famciclovir is an antiherpes virus agent that converts to penciclovir, which inhibits viral DNA replication by interfering with viral DNA polymerase. It is indicated in the treatment of acute herpes zoster treatment or suppression of recurrent genital herpes in immunocompetent patients and treatment of recurrent mucocutaneous herpes simplex infections in HIV-infected patients. 

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