By Gregory J. Mertz (auth.), John Mills, Paul A. Volberding, Lawrence Corey (eds.)
The 3 years in view that our final convention in San Francisco have back visible a dramatic enlargement of the variety of antivirals both authorized or within the overdue phases of scientific trials. d4T is now authorized for HIV an infection, famciclovir and the oral pro-drug of acyclovir, valacyclovir, are actually authorized for VZV infections in a few nations. additionally. oral ganciclovir, cidofovir, and sorivudine will not be a long way at the back of. scientific trials with the second-site opposite transcriptase inhibitors and the protease inhibitors for HlV an infection are continuing quickly and on a wide scale, and the initial effects could recommend that a number of of those periods of substances could be approved to boot. regardless of this optimism, notwithstanding, there's expanding proof that antiviral-resistant lines of pathogenic viruses might be an important challenge, might be in particular with remedy of HIV an infection, and there is still a determined want for more suitable medicinal drugs (with both enhanced efficacy or diminished toxicity, or either) for CMV and HIV infections. This ebook is the edited complaints of the Fourth Triennial convention on Antiviral Chemotherapy, held in San Francisco, in November 1994. The convention was once backed through the collage of California, San Francisco, and co-sponsored by way of the foreign Society for Antiviral examine (ISAR), the Macfarlane Burnet Centre for scientific examine in Melbourne, Australia, and the Australian nationwide Centre for HIV Virology study. The convention were prepared to give an outline of the sphere of antiviral chemotherapy.
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Extra resources for Antiviral Chemotherapy 4: New Directions for Clinical Application and Research
Acyclovir therapy for acute herpes zoster. Lancet 1982;2: 118-121. Peterslund NA, Seyer-Hansen K, [spen J et al. Acyclovir in herpes zoster. Lancet 1981;2:827-830. Whitley RI. Therapeutic approaches to varicella-zoster virus infections. Journal of Infections Diseases 1992; 166S51-S57. Balfonr HH Jr, Bean B, Laskin OR et aL Acyclovir halts progression of herpes zoster in immunocompromised patients. New England Journal of Medicine 1983;308: 1448-1453 Shepp DH, Danliker PS, Meyers ID. Treatment of varicella-zoster virus infection in severely immunocompromised patients A randomised comparison of acyclovir and vidarabine.
Table 1. Spectrum of antiviral activity of penciclovir and acyclovir. 1 EBV' CMV' HBY" a Plaque reduction test in MRC-5 cells c Capsid antigen test in P3 HR-l cells Data on file, SmithKline Beecham. 15 cells Numerous of clinical isolates of HSV, and a number of isolates of VZV have been identified which are resistant to acyclovir (see chapters by Coen and Safrin). The majority of these are also cross resistant to penciclovir but a few acyclovir-resistant strains have shown sensitivity to penciclovir.
OtS patients at Day 2' 20 o Famelelovl, 500mg 40 80 60 % Patients 0 Famck:lovl, 750mg • Placebo Figure 3. Cutaneous healing in patients with zoster receiving famciclovir or placebo. From reference 20 , with permission. Enrollment Heal! ng Full Crusting Placebo n: 115 7 days 15 days Healing Full Crusting Famclclovlr 500mgUd n = 117 5 days 22 days 15 days 20 days Figure 4. Rclalivc rates of cutaneous healing in patients with zoster treated With famciclovlf or placebo. Median times to full crusting and healing of skin leSIOns.