Antiviral agents for infectious mononucleosis (glandular fever)

Paor, Muireann de; O’Brien, Kirsty; Fahey, Tom; Smith, Susan M

doi:10.1002/14651858.cd011487

Cited by 7 publications

(6 citation statements)

References 20 publications

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“…The meta‐analysis revealed a trend suggestive of clinical effectiveness, but no statistically significant results were observed; thus far, clinical data do not support the use of ACV for the treatment of acute IM. In 2016, De Paor et al 13 published a meta‐analysis that studied antiviral therapy in patients with IM. Among the seven RCTs included in that meta‐analysis, the antiviral agents used were ACV, valomaciclovir, and valacyclovir.…”

Section: Discussionmentioning

confidence: 99%

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Clinical characteristics and effectiveness of antiviral agents in hospitalized children with infectious mononucleosis in China: A multicenter retrospective study

Deng

et al. 2021

Pediatric Investigation

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Importance The clinical characteristics of infectious mononucleosis (IM) in Chinese children have not been evaluated in multicenter studies, and the effectiveness of antiviral treatment are controversial. Objective To investigate the clinical characteristics of Chinese children with IM and current status of antiviral therapy for affected patients. Methods Hospitalized patients with IM were enrolled between 2018 and 2020 in five children’s hospitals in China. The clinical characteristics were compared among four age groups: <3 years, 3–<6 years, 6–<10 years, and ≥10 years. The clinical characteristics of IM and effectiveness of antiviral therapy were compared among patients receiving acyclovir (ACV), ganciclovir (GCV), and no antiviral therapy (i.e., non‐antiviral group). Results In total, 499 patients were analyzed; most patients were 3–<6 years of age. The most common symptoms and signs included fever (100%), lymphadenopathy (98.6%), pharyngitis (86.4%), eyelid edema (76.8%), and snoring (72.9%). There were significant differences in rash, hepatomegaly, and liver dysfunction among the four age groups. Patients aged < 3 years had a lower incidence of liver dysfunction and a higher incidence of rash. Among the 499 patients, 50.1% were treated with GCV, 26.3% were treated with ACV, and 23.6% received no antiviral therapy. Compared with the non‐antiviral group, patients in the ACV and GCV groups had longer durations of fever (P < 0.001). There were no significant differences in the incidences of complications among the three treatment groups. Interpretation The incidence of IM in Chinese children peaked at 3–<6 years of age. Clinical features of IM varied according to age. Patients receiving antiviral therapy exhibited more serious clinical manifestations than did patients without antiviral therapy. The effectiveness of antiviral therapy for IM requires further analysis.

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Section: Discussionmentioning

confidence: 99%

“…Thus far, antiviral medications such as ganciclovir (GCV) and acyclovir (ACV) have been shown to inhibit EBV replication, 10‐12 but the clinical effectiveness of antiviral therapy for IM is controversial 10,13,14 . The results of studies in Western countries have not conclusively demonstrated the effectiveness of ACV treatment.…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and effectiveness of antiviral agents in hospitalized children with infectious mononucleosis in China: A multicenter retrospective study

Deng

et al. 2021

Pediatric Investigation

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“…Mononucleosis-like syndrome in immunocompetent patients is generally benign and self-limited. Although no high-quality studies exist regarding antiviral treatment of CMV mononucleosis-like syndrome, antiviral treatment for EBV mononucleosis, with or without steroids, has not demonstrated efficacy in clinically important outcomes [ 17 , 18 ]. Effective treatment with ganciclovir for severe CMV mononucleosis-like syndrome has been reported.…”

Section: CMV In the General Population: Presentation Diagnosis Amentioning

confidence: 99%

A Practical Review of Cytomegalovirus in Gastroenterology and Hepatology

Fakhreddine

Frenette

Konijeti

2019

Gastroenterology Research and Practice

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Human cytomegalovirus (CMV) is a ubiquitous Herpesviridae virus with a wide spectrum of pathology in humans. Host immunity is a major determinant of the clinical manifestation of CMV and can vary widely in the gastroenterology and hepatology practice setting. Immunocompetent patients generally develop a benign, self-limited mononucleosis-like syndrome whereas gastrointestinal tissue-invasive disease is more frequently seen in immunocompromised and inflammatory bowel disease patients. Additionally, liver allograft dysfunction is a significant consequence of CMV infection in liver transplant patients. While polymerase chain reaction and immunohistochemistry techniques allow for the reliable and accurate detection of CMV in the human host, the diagnostic value of different serologic, endoscopic, and histologic tests depends on a variety of factors. Similarly, latent CMV, CMV infection, and CMV disease carry different significance depending on the patient population, and the decision to initiate antiviral therapy can be complex and patient-specific. This review will focus on the pathophysiology, diagnosis, and management of CMV in patient populations relevant to the practice of gastroenterology and hepatology—liver transplant recipients, inflammatory bowel disease patients, and otherwise immunocompetent patients.

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“…Bei Verdacht auf Peritonsillarabszess ist eine Tonsillektomie indiziert 38 . Zur Wirksamkeit von Virostatika wie Aciclovir oder Ganciclovir gibt es keine ausreichende Evidenz 39 . Bei EBV-getriggerter HLH kommen Steroide und eine Depletion EBV-infizierter B-Zellen mittels des anti-CD20-Antikörpers Rituximab zum Einsatz 25 .…”

Section: Die Infektiöse Mononukleoseunclassified

Epstein-Barr-Virus-assoziierte Erkrankungen bei Kindern und Jugendlichen

Geisperger¹,

Behrends²

2022

Kinder- und Jugendmedizin

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ZUSAMMENFASSUNGÜber 95 % der Erwachsenen weltweit sind mit dem Epstein-Barr-Virus (EBV) infiziert. Während die Primärinfektion meist oligo- oder asymptomatisch verläuft, erkranken ca. 500 pro 100 000 Menschen pro Jahr an einer Infektiösen Mononukleose (IM), mit einem Häufigkeitsgipfel zwischen 15 und 24 Jahren. In den meisten Fällen heilt die Erkrankung folgenlos aus. Jedoch werden Fälle von protrahierter Abgeschlagenheit (Fatigue) oder postinfektiösem Chronischem Fatigue-Syndrom (syn. Myalgische Enzephalomyelitis) als Folge der IM beobachtet. Weitere schwere akute Komplikationen wie Milzriss, Atemnot aufgrund von „kissing tonsils“ oder Hämophagozytische Lymphohistiozytose sind beschrieben und können prinzipiell alle Organsysteme betreffen. EBV ist zudem mit verschiedenen malignen Erkrankungen wie Nasopharynxkarzinom, Hodgkin- und Burkitt-Lymphom sowie Autoimmunerkrankungen wie Multiple Sklerose assoziiert. Einige angeborene und erworbene Immundefekte gehen mit einem hohen Risiko für EBV-assoziierte Komplikationen einher. In den meisten Fällen sind die Ursachen und Risikofaktoren noch unbekannt. Ein lizensierter Impfstoff ist noch nicht verfügbar. Die Diagnostik der EBV-Primärinfektion kann durch unklare serologische Befunde erschwert sein, ist aber von großer Bedeutung, um akute Komplikationen und Spätfolgen eindeutig zuordnen und rechtzeitig korrekt behandeln zu können.

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Antiviral agents for infectious mononucleosis (glandular fever)

Cited by 7 publications

References 20 publications

Clinical characteristics and effectiveness of antiviral agents in hospitalized children with infectious mononucleosis in China: A multicenter retrospective study

Clinical characteristics and effectiveness of antiviral agents in hospitalized children with infectious mononucleosis in China: A multicenter retrospective study

A Practical Review of Cytomegalovirus in Gastroenterology and Hepatology

Epstein-Barr-Virus-assoziierte Erkrankungen bei Kindern und Jugendlichen

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