J R Soc Med. 1994 Jan;87(1):7-8.
The use of acyclovir in suspected encephalitis.

Gleadle J, Dixon C, Brown MM, Schon F.

Atkinson Morley's Hospital, Wimbledon, UK.

The early use of intravenous acyclovir in herpes simplex encephalitis (HSE) is essential. However, rapid diagnostic tests are not freely available. Hence, all patients with suspected encephalitis may need to be commenced on acyclovir. In our study, of 34 patients with suspected encephalitis, only two eventually had HSE confirmed, 19 had encephalitis not due to herpes simplex and in 13 a non-encephalitis illness was finally diagnosed. Guidelines for the use of acyclovir in suspected encephalitis are given aimed at minimizing the drug cost whilst still protecting all cases of presumed HSE.

Online pharmacy ref source - acyclovir: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8308840&dopt=Abstract acyclovir Zovirax




Ann Neurol. 1997 Mar;41(3):353-7.
Treatment of Ramsay Hunt syndrome with acyclovir-prednisone: significance of early diagnosis and treatment.

Murakami S, Hato N, Horiuchi J, Honda N, Gyo K, Yanagihara N.

Department of Otolaryngology, Ehime University School of Medicine, Japan.

Although the antiviral agent acyclovir is currently used for the treatment of Ramsay Hunt syndrome, its effects on facial nerve and hearing recovery remain controversial. We retrospectively analyzed the effects of acyclovir-prednisone treatment in 80 Ramsay Hunt patients. Of 28 patients for whom treatment was begun within 3 days of the onset of facial paralysis, the recovery from paralysis was complete in 21 (75%). By comparison, of 23 patients for whom treatment was begun more than 7 days after onset, recovery from facial paralysis was complete in only 7 (30%). A significant difference in facial nerve recovery was found between these groups. Early administration of acyclovir-prednisone was proved to reduce nerve degeneration by nerve excitability testing. Hearing recovery also tended to be better in patients with early treatment. There was no significant difference in facial nerve outcome between intravenous and oral acyclovir treatment.

Online pharmacy ref source - acyclovir: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9066356&dopt=Abstract acyclovir Zovirax




Rom J Virol. 1996 Jan-Dec;47(1-4):13-24.
Testing of the in vivo therapeutic efficacy on the cutaneous herpes simplex infections of the autochthonous product 5% Acyclovir ointment.

Crisan I, Rojanschi D, Petica M, Fodor C, Morar S, Mutiu A.

The Stefan S. Nicolau Institute of Virology, Bucharest.

The experimental results of the in vivo testing of an autochthonous pharmaceutical Acyclovir form prepared for the topical treatment of herpetic infections with a mucocutaneous location are shown in this paper. This testing on laboratory animals continues the in vivo performed investigations regarding the antiviral activity of this compound, which have proved that the efficacy of the inhibitory action exerted by the product on the Herpes simplex virus multiplication is comparable with the characteristics of the standard substance (Acyclovir-Zovirax Wellcome). By testing the therapeutic efficacy of the autochthonous Acyclovir preparation on an experimental model of cutaneous herpes infection in the newborn rat, it is demonstrated in a statistically significant manner that the product exerts a strong inhibitory action on the virus multiplication at the level of epidermis (proved by the lowering of virus production in the cutaneous tissue); the result is a drastic reduction of local herpes vesicles and of virus propagation in the neuraxis attended by the appearance of herpes meningo-encephalitis with a lethal course. The preparation is well tolerated (phenomena of local intolerance or remote toxicity were not observed). These in vivo positive results corroborated by those obtained in vitro complete the experimental argumentation necessary to support the proposal regarding the clinical trial of the product.

Online pharmacy ref source - acyclovir: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9495780&dopt=Abstract acyclovir Zovirax




Ophthalmology. 1996 Sep;103(9):1399-404; discussion 1404-5.
Long-term oral acyclovir therapy. Effect on recurrent infectious herpes simplex keratitis in patients with and without grafts.

Simon AL, Pavan-Langston D.

Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston 02114, USA.

PURPOSE: To evaluate the efficacy of long-term oral acyclovir therapy in reducing recurrences of dendritic or geographic herpes simplex keratitis (HSK). METHODS: Thirteen patients with a history of frequently recurring HSK were followed before (mean, 27 months) and during long-term systemic acyclovir, and eight were followed after the acyclovir was discontinued. RESULTS: Treatment ranged from 8.5 to 62 months (mean, 34 months). During treatment, the number of recurrences per month decreased from 0.15 to 0.03, and the average duration of relapses decreased from 12.6 to 7.8 days. Recurrences correlated with daily doses of oral acyclovir of 800 mg or less, intraocular surgery within 6 weeks of initiating treatment, and discontinuation of therapy against medical advice. CONCLUSION: The results of this small study appear to demonstrate the efficacy of long-term oral acyclovir in prophylaxis of recurrent epithelial herpes simplex infection: therapeutic doses of oral acyclovir reduce both the rate and duration of recurrences of infectious herpetic keratitis. A multicenter, double-masked, placebo-controlled study is indicated.

Online pharmacy ref source - acyclovir: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8841297&dopt=Abstract acyclovir Zovirax




Dermatology. 1997;194(2):93-7.
Current clinical issues in the management of herpes simplex virus infections in patients with HIV.

Conant M.

University of California Medical Center, San Francisco 94117, USA.

BACKGROUND: A recent study done in Baltimore showed HSV-2 seroprevalence of 81% among 64 HIV-positive homosexual or bisexual men. OBJECTIVE: Our purpose was to examine HSV-2 as a risk factor for acquiring HIV infection, as well as to explore the possibility that acyclovir, an agent that inhibits the replication or infectivity in herpesviruses, might have a survival benefit to patients with HIV infection. METHODS: Studies were undertaken among HIV-positive patients to see if concomitant treatments including acyclovir offered a survival benefit. RESULTS: A Multicenter AIDS Cohort Study held at four university-affiliated clinics and two landmark analyses demonstrated that acyclovir offered a significant survival advantage for HIV-positive patients. Another study had less conclusive results. CONCLUSION: Enough evidence of a survival benefit in HIV-positive patients on long-term acyclovir therapy warrants consideration of long-term prophylactic therapy with suppressive doses of acyclovir as routine intervention for HIV-positive patients.

Online pharmacy ref source - acyclovir: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9094453&dopt=Abstract acyclovir Zovirax