Herpes simplex virus infection treatment

Neonatal herpes simplex virus infection Treatment of neonatal herpes infections. Parenteral Treatment of initial and recurrent mucosal and cutaneous herpes simplex virus (HSV)-I and -2 and varicella-zoster virus (VZV/shingles) infections in immunocompromised patients. 

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. 

WraZ/nfecf/on. Treatment with tacrolimus ointment may be associated with an increased risk of varicella zoster virus infection (chicken pox or shingles), herpes simplex virus infection, or eczema herpeticum. 

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. 

Trifluoromethyl-2 -deoxyuridine, trifluridine (Viroptic ), is an anti-viral drug acting on TS via another mechanism. It is a mechanism-based inactivator of thy-midylate synthase (Figs. 27 and 28). Trifluridine is marketed for the topical treatment of Herpes simplex virus infection in eyes. 

Trifluridine (5-trifluoromethyl-2 -deoxyuridine) (Viroptic ) is marketed for the topical treatment of herpes simplex virus infection in the eyes. This antiviral drug is a mechanism-based inactivator of thymidylate synthase. The mechanism of inhibition and synthesis of trifluoridine are reported in Chapter 7. 

Treatment of herpes simplex virus infection of the skin and mucous membrane, including initial and recurrent genital herpes. 

IgG receptors on cultured, human lymphocytes.526 Sialidase treatment of lymphocytes from sensitized subjects increased the responsiveness to viral, bacterial, and fungal antigens.527 The same treatment of human, Herpes simplex virus-infected cells was found to enhance the sensitivity of the cells to lysis mediated by antibody and complement.528... 

Inhibition of glycosylation in virus-infected cells usually has dramatic effects on virus multiplication. This discovery prompted promulgation of a new concept in the experimental therapy of virus-induced diseases. Local treatment of the affected regions with 2-deoxy-D-arabtno-hexose led50n s02 to significant improvements in human-genital herpes infections, or Herpes simplex virus infection of the eye. 

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. 

Whitley R J, Roizman B 2001 Herpes simplex virus infections. Lancet 357 1513-1518 Winstanley P1998 Malaria treatment. Journal of the Royal College of Physicians of London 32 ... 

Brady RC, Bernstein D1 (2004) Treatment of herpes simplex virus infections. Antiviral Res 61 73-81. 

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... 

Vidarabine, an antiviral agent (10 to 15 mg/kg/day for 5 to 10 days), is indicated in the treatment of herpes simplex virus encephalitis, neonatal herpes simplex virus infections, and herpes zoster in immunosuppressed patients. In addition, vidarabine (ophthalmic ointment 3% vidarabine monohydrate [equivalent to 2.8% vidarabine]) is indicated in the treatment of acute keratoconjunctivitis and recurrent epithelial keratitis due to herpes simplex virus types 1 and 2, or superficial keratitis caused by herpes simplex virus that has not responded to topical idoxuridine or when toxic or hypersensitivity reactions to idoxuridine have occurred. 

R.H. Kaufman, E. Adam, R.R. Mirkovic, J.L. Melnick, R.L. Young (1978). Treatment of genital herpes simplex virus infection with photodynamic inactivation. Am. J. Obstet. Gynecol, 132(8), 861-869. 

Adenine itself was successfully incorporated into a number of pharmaceuticals, Adefovir dipivoxil, also known as bis-POM PMEA, with trade names Preveon and Hepsera, is used for the treatment of hepatitis B and herpes simplex virus infection. It is an orally administered nucleotide analog as a reverse transcriptase inhibitor (NRTI). Reverse transcriptase is an enzyme crucial to viral production. A second NRXI that contains adenine is Tenofovir disoproxil fumarate (TDF), which has been used in the treatment of HIV/AIDS and hepatitis B. TDF is a prodrug of tenofovir (also known as PMPA) designed to improve absorption and cell permeability of the active moiety under the trade name Viread. Both adefovir dipivoxil and TDF are marketed by Gilead Sciences. 

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. 

Human embryo lung fibroblasts infected with a reference laboratory strain of herpes simplex virus (HS V) type 2 were used to detect antibody to HSV type 2 in serum samples. After treatment of cells with serial dilutions of sera, HRP-labeled immunoglobulins to human IgG (class G immunoglobulins) were added and detected with CL substrate [36], In both cases a sharp detection of the specific antibodies was achieved with chemiluminescent assays, which proved more sensitive than the colorimetric immunoperoxidase assays. 

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

Efficacy In other conditions The clinical efficacy in the treatment of stromal keratitis and uveitis caused by herpes simplex or ophthalmic infections caused by vaccinia virus and adenovirus, or in the prophylaxis of herpes simplex virus keratoconjunctivitis and epithelial keratitis has not been established by well-controlled clinical trials. Not effective against bacterial, fungal, or chlamydial infections of the cornea or trophic lesions. 

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. 

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. 

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