Prolonged cutaneous herpes zoster in acquired immunodeficiency syndrome

Hoppenjans, W. B.

doi:10.1001/archderm.126.8.1048

Cited by 32 publications

(29 citation statements)

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“…However, for the treatment of VZV infections and for the suppression of HCMV infections, multiple, high doses of oral or intravenous drug are necessary (Huff et al, 1988;Meyers et al, 1988;Peterslund, 1988;Wood et al, 198'8;Balfour Jr. et sl., 1989;Morton and Thomson, 1989). Suppressive therapy in immunocompromised patients with sub-optimal oral drug doses can lead to less sensitive strains of HSV and VZV (Barry et al, 1985;Engel et al, 1990;Hill et al, 1991;Hoppenjans et al, 1990;Jacobson et al, 1990). Because of the limited oral bioavailability (15-21 %) of acyclovir (de Miranda and Blum, 1983), plasma levels adequate for inhibition of less sensitive viruses can not be achieved easily.…”

Section: Acyclovirmentioning

confidence: 99%

Amino Acid Ester Prodrugs of Acyclovir

Beauchamp

Orr

Miranda

et al. 1992

Antivir Chem Chemother

202

138

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SummaryEighteen amino acid esters of the antiherpetic drug, acyclovir, were synthesized as potential prodrugs for oral administration. The esters were examined for in vitro antiviral activity against herpes simplex virus Type 1 (HSV-1). They were found to have less potency than the parent compound. Their efficiencies as prodrugs were evaluated in rats by measuring the urinary recovery of acyclovir. Ten prodrugs produced greater amounts of the parent drug in the urine. The L-amino acid esters were better prodrugs than the corresponding D-or D,L-isomers, suggesting the involvement of a stereoselective transporter. The L-valyl ester, 256U87, was the best prodrug. Sixty three per cent of its administered dose was excreted as acyclovir in the urine, a considerable improvement over acyclovir itself, for which this value was 19%. Since 256U87 was stable in aqueous solutions, its conversion to acyclovir in vivo was probably enzyme catalyzed. This L-valyl ester prodrug of acyclovir is now undergoing clinical evaluation.

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Section: Acyclovirmentioning

confidence: 99%

Amino Acid Ester Prodrugs of Acyclovir

Beauchamp

Orr

Miranda

et al. 1992

Antivir Chem Chemother

202

138

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“…Indeed, the isolation of ACV-resistant VZV in the non-HIV immunocompromised patient is a rare event (3). The gradual progression of susceptible virus to resistance was carefully documented in one patient (65,82 (117,127). The five patients in the Safrin study harbored 95 to 100% TK-(four patients) or TK-altered (one patient) VZV.…”

Section: Antiviral Drugsmentioning

confidence: 99%

"The end of innocence" revisited: resistance of herpesviruses to antiviral drugs

Field¹,

Biron²

1994

Clin Microbiol Rev

171

109

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In the past 4 years, interest in drug-resistant herpesviruses has evolved from the realm of academic laboratory studies to that of great clinical importance. Recurrent and persistent infections due to the herpes simplex viruses, varicella-zoster virus, and human cytomegalovirus have been an unwelcome consequence of immunosuppression in graft recipients, cancer patients, and those suffering from AIDS. Treatment of these infections with the available antiviral drugs, such as acyclovir, ganciclovir, and foscarnet, has resulted in both clinical benefit and the emergence of drug-resistant variants. In addition, the role of Epstein-Barr virus is being clarified for an array of disease syndromes, and therapeutic approaches are beginning to emerge. In the present review, the emergence and clinical importance of drug resistance among the herpesviruses have been explored. Furthermore, particular attention has been focused on our understanding of the mechanisms of drug resistance and how that understanding will guide us in the development of more effective antiviral drugs and drug usage.

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“…In HIV patients it may present in diverse manner such as multidermatomal involvement, crusted, nodular, vesiculopustular, ulcerative or ecthymatous [5][6][7] lesions that may be widely disseminated [5,[8][9][10] or localized [10].…”

Section: Introductionmentioning

confidence: 99%