Treatment of herpes virus infections in immunocompromised patients with acyclovir by continuous intravenous infusion
Abstract:
Sixteen immunocompromised patients with herpes virus infections were treated for three to five days with continuously administered intravenous acyclovir. Patients received initial acyclovir infusions over 5 minutes in dosages ranging from 1.5 to 5.0 mg/kg followed by continuously infused acyclovir at 7.2, 14.4, 21.6, 28.8, 36.0, or 43.2 mg/kg per day. The mean serum plateau levels of acyclovir determined by radioimmunoassay ranged from 4.1 microM for the 7.2 mg/kg per day dosage to 36.6 microM for the 43.2 mg/kg per day dose. A mean of 75 percent of acyclovir administered was recovered in the urine of patients treated. Eleven of 13 patients with varicella-zoster virus (VZV) infections had no new vesicle formation after three days of acyclovir treatment and all patients ceased to have new vesicles after five days of therapy. For the nine patients from whom complete viral cultures were available, six ceased to shed virus at three days, and viral shedding ceased by five days in all patients treated with acyclovir. No clinical or laboratory adverse reactions were associated with acyclovir therapy. These data suggest that acyclovir given by continuous intravenous infusion may be useful in the treatment of herpes virus infections in immunocompromised patients.
Insights
Continuous intravenous acyclovir effectively treated herpes virus infections in immunocompromised patients. This antiviral therapy, administered over 3-5 days, halted viral shedding and vesicle formation without adverse effects.
Area of Science:
- Virology
- Immunology
- Pharmacology
Background:
- Herpes virus infections pose significant risks to immunocompromised individuals.
- Effective antiviral treatments are crucial for managing these infections.
Purpose of the Study:
- To evaluate the efficacy and safety of continuous intravenous acyclovir in immunocompromised patients with herpes virus infections.
- To determine optimal dosing and therapeutic outcomes.
Main Methods:
- Sixteen immunocompromised patients received continuous intravenous acyclovir for 3-5 days.
- Dosages ranged from 1.5-5.0 mg/kg initially, followed by daily doses of 7.2-43.2 mg/kg.
- Serum acyclovir levels were measured by radioimmunoassay; viral shedding and vesicle formation were monitored.
Main Results:
- Continuous intravenous acyclovir administration led to cessation of new vesicle formation in varicella-zoster virus (VZV) infections within 3-5 days.
- Viral shedding ceased by day five in all treated patients.
- Achieved serum acyclovir levels correlated with dosage, ranging from 4.1 to 36.6 microM.
- No clinical or laboratory adverse reactions were reported.
Conclusions:
- Continuous intravenous acyclovir is a potentially effective treatment for herpes virus infections in immunocompromised patients.
- The treatment demonstrated significant clinical and virological improvements.
- Further investigation into optimal dosing and long-term outcomes is warranted.
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