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Acyclovir and Epstein-Barr virus infection.

J S Pagano, J W Sixbey, J C Lin

    The Journal of Antimicrobial Chemotherapy
    |September 1, 1983
    PubMed
    Summary
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    Acyclovir (ACV) showed transient effects on Epstein-Barr virus (EBV) shedding in severe infectious mononucleosis patients but did not improve most symptoms. However, ACV did lead to faster weight regain in treated individuals.

    Area of Science:

    • Virology
    • Pharmacology
    • Infectious Diseases

    Background:

    • Epstein-Barr virus (EBV) causes infectious mononucleosis.
    • Acyclovir (ACV) demonstrates in vitro activity against EBV replication.
    • Limited data exists on ACV efficacy for treating infectious mononucleosis.

    Purpose of the Study:

    • To evaluate the efficacy of intravenous acyclovir (ACV) in hospitalized patients with severe infectious mononucleosis.
    • To assess ACV's impact on viral shedding, immune response, and clinical symptoms.

    Main Methods:

    • Pilot, double-blind, placebo-controlled trial.
    • Ten severe infectious mononucleosis patients received placebo, ten received ACV (1500 mg/m2 daily IV for 5 days).
    • Evaluated viral excretion, lymphocyte generation, and clinical signs/symptoms.

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    Main Results:

    • ACV transiently interrupted oropharyngeal EBV shedding.
    • No significant effect on lymphocyte generation, splenomegaly, lymphadenopathy, lethargy, fever, or pharyngitis.
    • ACV-treated group showed significantly faster weight regain.
    • BW759, another drug, showed potent in vitro activity (ED50 of 0.05 microM).

    Conclusions:

    • Intravenous ACV has limited clinical benefit for severe infectious mononucleosis, despite transiently reducing viral shedding.
    • Further investigation into oral ACV for milder, earlier-stage illness is warranted.
    • Exploration of alternative antivirals like BW759 for EBV infections is ongoing.