Famciclovir for the Suppression of Symptomatic and Asymptomatic Herpes Simplex Virus Reactivation in HIV-Infected Persons: A Double-Blind, Placebo-Controlled Trial

Schacker, Timothy W.; Hu, Hui Lin; Koelle, David M.; Zeh, Judith; Saltzman, Robin; Boon, R. J.; Shaughnessy, Mary; Barnum, Gail; Corey, Lawrence

doi:10.7326/0003-4819-128-1-199801010-00004

Cited by 156 publications

(63 citation statements)

References 26 publications

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“…Clinical trials have shown that FCV is effective in the treatment of acute herpes labialis and genital herpes (39,41) and as a prophylactic treatment of UV-induced herpes labialis, excimer laser skin resurfacing, and genital herpes (2,11,43,44). We report that FCV may be beneficial in reducing corneal morbidity in patients with recurrent herpes keratitis.…”

Section: Discussionmentioning

confidence: 85%

“…FCV is currently approved for the treatment of herpes zoster and the treatment and suppression of genital herpes (7,9). FCV has also been used in clinical trials for herpes labialis (2,8,11,39,41,43,44). A clinical trial by Spruance et al (44) demonstrated that oral FCV decreased the median lesion size in a dose-dependent manner and that, at higher doses, it decreased the time to healing following UV radiation-induced HSV labialis.…”

mentioning

confidence: 99%

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Effect of Famciclovir on Herpes Simplex Virus Type 1 Corneal Disease and Establishment of Latency in Rabbits

Loutsch

Sáinz

Marquart

et al. 2001

Antimicrob Agents Chemother

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Famciclovir (FCV) is efficacious in the treatment of acute herpes zoster and recurrent genital infections but has not been used to treat ocular herpes simplex virus (HSV) infections. We evaluated the efficacy of orally administered FCV in treating HSV-1 epithelial keratitis and determined its effects on the establishment of latency and subsequent reactivation. Rabbits were inoculated with HSV-1 strain 17 syn؉ and treated twice daily with increasing concentrations of FCV (60 to 500 mg/kg of body weight). This resulted in a significant, dose-dependent improvement in keratitis scores, as well as prolonged survival. Regardless of the dose of drug used, all groups exhibited the high rates of spontaneous and induced reactivation characteristic of 17syn؉. The efficacy of 250 mg of FCV per kg was also compared to topical treatment with 1% trifluorothymidine (TFT). Although TFT treatment was more effective at reducing eye disease, FCV-treated rabbits had a better survival rate. Real-time quantitative PCR analysis of rabbit trigeminal ganglia (TG) demonstrated that FCV significantly reduced the HSV-1 copy number compared to that after treatment with TFT or the placebo but not in a dose-dependent manner. In summary, oral FCV treatment significantly reduces the severity of corneal lesions, reduces the number of HSV-1 genomes in the TG, improves survival, and therefore may be beneficial in reducing the morbidity of HSV keratitis in the clinic.

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Section: Discussionmentioning

confidence: 85%

mentioning

confidence: 99%

Effect of Famciclovir on Herpes Simplex Virus Type 1 Corneal Disease and Establishment of Latency in Rabbits

Loutsch

Sáinz

Marquart

et al. 2001

Antimicrob Agents Chemother

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“…There is evidence of more rapid HIV-1 disease progression in dually infected individuals (6,15,29) as well as in vitro data demonstrating that HSV-2 proteins can activate the HIV-1 long terminal repeat, leading to increased HIV-1 replication (10,18,23). Recent trials of acyclovir monotherapy for HSV-2 infection in HSV-2/HIV-1-coinfected individuals showed an approximately 0.33 to 0.5 log 10 decrease in HIV-1 plasma levels, but the overall benefits of this approach remain unclear (24,30,36).…”

mentioning

confidence: 99%

Consistent Inhibition of HIV-1 Replication in CD4 ⁺ T Cells by Acyclovir without Detection of Human Herpesviruses

McMahon

Parsons

Shen

et al. 2011

J Virol

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Acyclovir, a nucleoside analog, is thought to be specific for the human herpesviruses because it requires a virally encoded enzyme to phosphorylate it to acyclovir monophosphate. Recently, acyclovir triphosphate was shown to be a direct inhibitor of human immunodeficiency virus type 1 (HIV-1) reverse transcriptase. Here, we showed that acyclovir is an inhibitor of HIV-1 replication in CD4 ؉ T cells from cord blood that have undetectable levels of the eight human herpesviruses. Additionally, acyclovir phosphates were detected by reverse-phase-high performance liquid chromatography (RP-HPLC) and quantified in a primer extension assay from cord blood. The data support acyclovir as an inhibitor of HIV-1 replication in herpesvirus-negative cells.

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“…재발방지에 효과있는 약제로 경구 acyclovir, valacyclovir, famciclovir가 있다(AI) [246][247]. 이 경우 HIV 감염인 에서는 valacyclovir를 하루 두번 500 mg 투여한다(AI).…”

Section: ) 재발의 방지unclassified

Clinical Guidelines for the Treatment and Prevention of Opportunistic Infections in HIV-infected Koreans

대한에이즈학회¹

2012

Infect Chemother

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Famciclovir for the Suppression of Symptomatic and Asymptomatic Herpes Simplex Virus Reactivation in HIV-Infected Persons: A Double-Blind, Placebo-Controlled Trial

Abstract: Antiviral chemotherapy with famciclovir results in clinically and statistically significant reductions in the symptoms associated with HSV infection and the symptomatic and asymptomatic shedding of HSV among HIV-positive persons.

Cited by 156 publications

References 26 publications

Effect of Famciclovir on Herpes Simplex Virus Type 1 Corneal Disease and Establishment of Latency in Rabbits

Effect of Famciclovir on Herpes Simplex Virus Type 1 Corneal Disease and Establishment of Latency in Rabbits

Consistent Inhibition of HIV-1 Replication in CD4 ⁺ T Cells by Acyclovir without Detection of Human Herpesviruses

Clinical Guidelines for the Treatment and Prevention of Opportunistic Infections in HIV-infected Koreans

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Famciclovir for the Suppression of Symptomatic and Asymptomatic Herpes Simplex Virus Reactivation in HIV-Infected Persons: A Double-Blind, Placebo-Controlled Trial

Abstract: Antiviral chemotherapy with famciclovir results in clinically and statistically significant reductions in the symptoms associated with HSV infection and the symptomatic and asymptomatic shedding of HSV among HIV-positive persons.

Cited by 156 publications

References 26 publications

Effect of Famciclovir on Herpes Simplex Virus Type 1 Corneal Disease and Establishment of Latency in Rabbits

Effect of Famciclovir on Herpes Simplex Virus Type 1 Corneal Disease and Establishment of Latency in Rabbits

Consistent Inhibition of HIV-1 Replication in CD4 + T Cells by Acyclovir without Detection of Human Herpesviruses

Clinical Guidelines for the Treatment and Prevention of Opportunistic Infections in HIV-infected Koreans

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Consistent Inhibition of HIV-1 Replication in CD4 ⁺ T Cells by Acyclovir without Detection of Human Herpesviruses