PMID- 7510619
OWN - NLM
STAT- MEDLINE
DCOM- 19940421
LR  - 20181113
IS  - 0012-6667 (Print)
IS  - 0012-6667 (Linking)
VI  - 47
IP  - 1
DP  - 1994 Jan
TI  - Aciclovir. A reappraisal of its antiviral activity, pharmacokinetic properties 
      and therapeutic efficacy.
PG  - 153-205
AB  - Aciclovir (acyclovir) is a nucleoside analogue with antiviral activity in vitro 
      against the herpes simplex viruses (HSV), varicella zoster virus (VZV), 
      Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human herpesvirus 6 (HHV-6). 
      Topical, oral or intravenous aciclovir is well established in the treatment of 
      ophthalmic, mucocutaneous and other HSV infections, with intravenous aciclovir 
      the accepted treatment of choice in herpes simplex encephalitis. The efficacy of 
      aciclovir is increased with early (preferably during the prodromal period) 
      initiation of treatment but, despite significant clinical benefit, viral latency 
      is not eradicated, and pretreatment frequencies of recurrence usually continue 
      after episodic acute treatment is completed. Intravenous administration has also 
      shown benefit in the treatment of severe complications of HSV infection in 
      pregnancy, and neonatal HSV infections. Recurrence of HSV has been completely 
      prevented or significantly reduced during suppressive therapy with oral aciclovir 
      in immunocompetent patients. Use of oral aciclovir is effective but controversial 
      in the treatment of otherwise healthy individuals with varicella (chickenpox), 
      and in some countries it has been recommended for use only in cases which may be 
      potentially severe. The development of rash and pain associated with herpes 
      zoster (shingles) is attenuated with oral or intravenous aciclovir therapy, 
      ocular involvement is prevented, and post-herpetic neuralgia appears to be 
      decreased. Similarly, in a few patients with zoster ophthalmicus, oral aciclovir 
      has reduced the frequency and severity of long term ocular complications and 
      post-herpetic neuralgia, and herpes zoster oticus is improved with intravenous 
      aciclovir. Oral aciclovir has prevented recurrence of HSV genital or orofacial 
      infections during suppressive therapy in > 70% of immunocompetent patients in 
      most clinical trials. Suppression of latent HSV, VZV and CMV infections has been 
      achieved in many immunocompromised patients receiving the oral or intravenous 
      formulations. Aciclovir also appears to offer partial protection from invasive 
      CMV disease in CMV-seropositive bone marrow transplant recipients. The few 
      comparative trials published have shown aciclovir to be at least as effective as 
      other investigated antivirals in the treatment of HSV infections in 
      immunocompetent patients, and more effective than inosine pranobex in the 
      prophylaxis of genital herpes. Similarly, in isolated clinical trials, oral 
      aciclovir appears as effective as topical idoxuridine and oral brivudine in some 
      parameters in immunocompetent patients with VZV infections, and the intravenous 
      formulation appears at least as effective as oral brivudine and intravenous 
      vidarabine in treating these infections in immunocompromised patients.(ABSTRACT 
      TRUNCATED AT 400 WORDS)
FAU - Wagstaff, A J
AU  - Wagstaff AJ
AD  - Adis International Limited, Auckland, New Zealand.
FAU - Faulds, D
AU  - Faulds D
FAU - Goa, K L
AU  - Goa KL
LA  - eng
PT  - Journal Article
PT  - Review
PL  - New Zealand
TA  - Drugs
JT  - Drugs
JID - 7600076
RN  - 0 (Antiviral Agents)
RN  - X4HES1O11F (Acyclovir)
SB  - IM
MH  - Acyclovir/adverse effects/pharmacokinetics/*pharmacology/*therapeutic use
MH  - Animals
MH  - Antiviral Agents/*pharmacology/*therapeutic use
MH  - Humans
MH  - Immunologic Deficiency Syndromes/complications
MH  - Virus Diseases/complications/*drug therapy/microbiology
RF  - 375
EDAT- 1994/01/01 00:00
MHDA- 1994/01/01 00:01
CRDT- 1994/01/01 00:00
PHST- 1994/01/01 00:00 [pubmed]
PHST- 1994/01/01 00:01 [medline]
PHST- 1994/01/01 00:00 [entrez]
AID - 10.2165/00003495-199447010-00009 [doi]
PST - ppublish
SO  - Drugs. 1994 Jan;47(1):153-205. doi: 10.2165/00003495-199447010-00009.