Herpes virus, treatment

Acyclovir [9-(2-hydroxyethoxymethyl)guanine] (ACV) is clinically useful in the treatment of infections caused by several members of the herpes virus (e.g., herpes simplex, varicella zoster and Epstein-Barr virus [2,38,39]). An enzyme coded for by the virus phosphorylates ACV to a monophosphate intermediate. This species in turn undergoes further phosphorylation to a triphosphate with the aid of normal cell enzymes. Then, ACV triphosphate inhibits the herpes virus DNA... 

In a study reported in 2001, Curran described research designed to synthesize a library of analogs of a natural product called map-picine. A ketone derivative of mappicine had been shown to be effective in the treatment of the herpes virus and cytomegalovirus. Curran s research team was interested in determining whether there were analogs of mappicine that also display antiviral action. 

Aciclovir (acyclovir) was one of the first effective selective antiviral agents. It is a guanine derivative of value in treating herpes viruses, though it does not eradicate them, and is only useful if drug treatment is started at the onset of infection. 

Antibodies against the virus but also amantadine and derivatives, interfere with host cell penetration. There are nucleoside analogues such as aciclovir and ganciclovir, which interfere with DNA synthesis, especially of herpes viruses. Others like zidovudine and didanosine, inhibit reverse transcriptase of retroviruses. Recently a number of non-nucleoside reverse transcriptase inhibitors was developed for the treatment of HIV infections. Foscarnet, a pyrophosphate analogue, inhibits both reverse transcriptase and DNA synthesis. Protease inhibitors, also developed for the treatment of HIV infections, are active during the fifth step of virus replication. They prevent viral replication by inhibiting the activity of HIV-1 protease, an enzyme used by the viruses to cleave nascent proteins for final assembly of new vi-rons. 

Antiviral activity. Water extract of the dried fruit, in cell culture at a concentration of 10%, was inactive on herpes virus-type 2, influenza, poliovirus, and vaccina . Tincture of the dried fruit, administered orally to adults of both sexes at a dose of 60 mL/person, was active on herpes virus. PCT patent number W096/14064 reported treatment of six subjects with herpes virus infections. The activity was highly dose... 

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. 

The ongoing clinical trials include the use of adenovirus and herpes virus vectors. One example of adenoviral vector is ONYX-015, which lacks E1B protein, required for replication with a normal p53 pathway and RNA export during viral replication. It has been used to treat squamous cell carcinoma of the head and neck and has also been tested as a preventive treatment for oral precancerous tissue. The concept behind using this vector is that ONYX-015 will proliferate in p53 pathway-deficient tumor cells and kill them. 

In addition to the antineoplastic activity, camptothecin was found to be an effective inhibitor of adenovirus replication [268, 269] and herpes virus replication [252, 270]. 10-Methoxycamptothecin is about 8-times more potent than camptothecin as an inhibitor of herpes virus [252]. A combination of camptothecin and dimethyl sulphoxide is very effective for the topical treatment of psoriasis [271]. Since, in the goldfish brain, camptothecin blocks RNA synthesis in eucaryotic cells by blocking the incorporation of uridine into RNA, this alkaloid can block the memory of conditioned avoidance and produces no measurable effect on retention of the learned response [272]. 

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... 

Interferons (IFN) are glycoproteins that, among other products, are released from virus-infected cells. In neighboring cells, interferon stimulates the production of antiviral proteins. These inhibit the synthesis of viral proteins by (preferential) destruction of viral DNA or by suppressing its translation. Interferons are not directed against a specific virus, but have a broad spectrum of antiviral action that is, however, species-specific. Thus, interferon for use in humans must be obtained from cells of human origin, such as leukocytes (IFN-a), fibroblasts (IFN-p), or lymphocytes (IFN-y). Interferons are used in the treatment of certain viral diseases, as well as malignant neoplasias and autoimmune diseases e.g., IFN-a for the treatment of chronic hepatitis C and hairy cell leukemia and IFN-p in severe herpes virus infections and multiple sclerosis. 

Although oral corticosteroids have had an established use in herpes zoster treatment, their value has become controversial.They are clearly contraindicated in HIV and while the virus is still present in immunocompetent patients. Some authors report increased quality of life and decreased acute pain with oral steroid use in the elderly, but this value is offset by potential risk. Significant relief may be obtained with early antiviral therapy so that oral steroids are an unnecessary risk. Oral steroids are of no value in preventing PHN as was previously believed. The duration of PHN, however, is significantly shortened by early and aggressive use of oral antiviral agents in the acute phase of herpes zoster. Tricyclic antidepressants may also be useful when prescribed at the time of acute... 

Phosphorylated aciclovir inhibits DNA polymerase and so prevents viral DNA being formed. It effectively treats susceptible herpes viruses if started early in the course of infection, but it does not eradicate persistent infection. Taken orally about 20% is absorbed from the gut, but this is sufficient for the systemic treatment of some infections. It distributes widely in the body the concentration in CSF is approximately half that of plasma, and the brain concentration may be even less. These differences are taken into account in dosing for viral encephalitis (for which aciclovir must be given i.v.). The drug is excreted in the urine (t, 3 h). For oral and topical use the drug is given x 5/d. 

Cidofovir is an acyclic nucleotide analogue of the monophosphate of cytosine. When phosphoiylated by host cellular enzymes, the active compound cidofovir diphosphate has broad activity against the herpes viruses, including CMV, HSV 1 and 2, VZV, Epstein-Barr virus, and the BK polyomavirus. Cidofovir has primarily been used in the treatment of CMV retinitis in patients who have failed treatment with ganciclovir or foscarnet and in acyclovir-resistant herpes simplex infections. More recently, there is also a growing experience with the use of this medication in kidney transplant patients who have BK virus-associated nephropathy [31], although this interest has been dampened by significant toxicity and only modest clinical activity [32]... 

Keratitis and keratoconjunctivitis in association with equine herpes virus (EHV) respiratory disease has been recorded in foals. In adult horses, putative viral superficial keratitis, unassociated with systemic disease, is commonly seen in practice in the UK and may occur sporadically in the USA and mainland Europe. No specific virus has been isolated consistently from affected eyes and the suspected viral etiology is based largely upon the response to topical antiviral treatment. The disease is characterized by acute ocular pain and focal epitheliopathy. Two specific forms of the disease are encountered. Type 1 is characterized by epithelial fissuring, which occasionally results in dendritic or, rarely, frankly ulcerative lesions. Type 2 is characterized by shallow pimctate ulceration. 

It can be used orally to treat infection by the herpes viruses, famotidine [ban. inn, usan[ (YM 11170 L 643341 MK 208 Pepcid ) is a thiosulfamoylpropionamidine, a histamine Hj-RECEPTOR ANTAGONIST. It is a GASTRIC SECRETION INHIBITOR and ANTIULCEROGENIC. It is also suggested to be beneficial in the treatment of schizophrenia, and as an antiviral. famprofazone [ban. inn] is one of the pyrazolone series of cyclooxygenase inhibitors with nsaid analgesic. 

This chapter is a review of the antimicrobial susceptibilities of the causative organisms and the treatment of the sexually transmitted infections most prevalent in North America and Western Europe, gonorrhea, nongonococcal urethritis, genital herpes virus infections, and trichomoniasis. Because of their relative rarity or because no important advances in therapy have been made in the past decade, syphilis, lymphogranuloma venereum, chancroid, and granuloma inguinale are not considered. 

Verbascum thapsus L. (whole plant) Amentoflavone (1). Used in temperate Himalaya for the treatment of asthma and other lung eomplaints. Antiviral activity against herpes virus type 1. Hussain et al., 2009[327]. 

Adefovir is a nucleotide analog of deoxyadenosine monophosphate that is active against retroviruses (like HIV), herpes viruses, and hepadnaviruses. Adefovir dipivoxil 10 mg by mouth once daily for 48 weeks has been approved for use in adult patients with chronic HBV who are either treatment naive or have lamivudine-resistant... 

Acyclovir is the drug of choice for herpes simplex encephalitis. In patients with normal renal function, acyclovir is usually administered as 10 mg/kg intravenously every 8 hours for 2 to 3 weeks. Herpes virus resistance to acyclovir has been reported with increasing incidence, particularly from immunocompromised patients with prior or chronic exposures to acyclovir. The alternative treatment for acyclovir-resistant herpes simplex virus is foscarnet. The major toxicity of foscarnet is renal impairment, and doses must be individualized for renal function. The dose for patients with normal renal function is 40 mg/kg infused over 1 hour every 8 to 12 hours for 2 to 3 weeks. Ensuring adequate hydration is imperative. In addition, patients receiving foscarnet should be monitored for seizures related to alterations in plasma electrolyte levels. 

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