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Sample records for acyclovir

  1. Acyclovir-induced thrombotic microangiopathy

    Science.gov (United States)

    Goli, R.; Mukku, K. K.; Devaraju, S. B. R.; Uppin, M. S.

    2017-01-01

    Acyclovir is a commonly used antiviral drug. Acute kidney injury (AKI) due to intratubular crystal precipitation and interstitial nephritis is well known. Here we present a case of acyclovir induced AKI in a 61 year old male with herpes zoster, which presented like thrombotic microangiopathy with acute interstitial nephritis. This is the first case report on acyclovir causing thrombotic microaniopathy with partial improvement in renal function after plasmapharesis. PMID:28356666

  2. Managing recurrent genital herpes with acyclovir

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    Bedi T

    1995-01-01

    Full Text Available Seventy five patients of recurrent genital herpes (RGH treated with oral or topical acyclovir and placebo were compared and followed for periods ranging 4 to 8 years in a prospective study. Oral acyclovir definitely helps RGH patients; it shortens healing time; postpones recurrences and instills confidence in the patients. There is sufficient evidence that RGH dies a natural death with time as seen after 8 years follow up in placebo group patients. Topical use of acyclovir cream is not as useful as believed.

  3. Acyclovir

    Science.gov (United States)

    ... such as amikacin (Amikin), gentamicin (Garamycin), kanamycin (Kantrex), neomycin (Nes-RX, Neo-Fradin), paramomycin (Humatin), streptomycin, and tobramycin (Tobi, Nebcin); aspirin and other nonsteroidal ...

  4. Improving oral bioavailability of acyclovir using nanoparticulates of thiolated xyloglucan.

    Science.gov (United States)

    Madgulkar, Ashwini; Bhalekar, Mangesh R; Dikpati, Amrita A

    2016-08-01

    Acyclovir a BCS class III drug exhibits poor bioavailability due to limited permeability. The intention of this research work was to formulate and characterize thiolated xyloglucan polysaccharide nanoparticles (TH-NPs) of acyclovir with the purpose of increasing its oral bioavailability. Acyclovir-loaded TH-NPs were prepared using a cross-linking agent. Interactions of formulation excipients were reconnoitered using Fourier transform infrared spectroscopy (FT-IR). The formulated nanoparticles were lyophilised by the addition of a cryoprotectant and characterized for its particle size, morphology and stability and optimized using Box Behnken Design.The optimized TH-NP formulation exhibited particle size of 474.4±2.01 and an entrapment efficiency of 81.57%. A marked enhancement in the mucoadhesion was also observed. In-vivo study in a rat model proved that relative bioavailability of acyclovir TH-NPs is ∼2.575 fold greater than that of the marketed acyclovir drug suspension.

  5. Colloidal dispersions for the delivery of acyclovir: A comparative study

    Directory of Open Access Journals (Sweden)

    Rita Cortesi

    2011-01-01

    Full Text Available This paper describes a comparative study on the performances of ethosomes and solid lipid nanoparticle as delivery systems for acyclovir. Ethosomes were spontaneously produced by dissolution of phosphatidylcholine and acyclovir in ethanol followed by addition of an aqueous buffer while solid lipid nanoparticle were produced by homogenization and ultrasonication. Both colloidal systems were morphologically characterized by cryo-transmission electron microscopy. The encapsulation efficiency was 94.2±2.8% for ethosomes and 53.2±0.2% for solid lipid nanoparticle. Concerning Z potential, both formulations are close to neutrality. The diffusion coefficients of the drug from ethosomes and solid lipid nanoparticle, determined by a Franz cell method, were 9.4 and 1.2-fold lower as compared to the free acyclovir in solution, thus evidencing the ability of both colloidal systems in enhancing the diffusion of the drug. The antiviral activity against HSV-1 of both systems was tested by plaque reduction assay in monolayer cultures of Vero cells. Data showed that no significant differences in the antiviral activity were observed by acyclovir in the free or loaded forms. Taken together these results, colloidal systems could be interesting to mediate the penetration of acyclovir within Vero cells.

  6. Colloidal Dispersions for the Delivery of Acyclovir: A Comparative Study

    Science.gov (United States)

    Cortesi, Rita; Ravani, Laura; Menegatti, Enea; Drechsler, M.; Esposito, Elisabetta

    2011-01-01

    This paper describes a comparative study on the performances of ethosomes and solid lipid nanoparticle as delivery systems for acyclovir. Ethosomes were spontaneously produced by dissolution of phosphatidylcholine and acyclovir in ethanol followed by addition of an aqueous buffer while solid lipid nanoparticle were produced by homogenization and ultrasonication. Both colloidal systems were morphologically characterized by cryo-transmission electron microscopy. The encapsulation efficiency was 94.2±2.8% for ethosomes and 53.2±0.2% for solid lipid nanoparticle. Concerning Z potential, both formulations are close to neutrality. The diffusion coefficients of the drug from ethosomes and solid lipid nanoparticle, determined by a Franz cell method, were 9.4 and 1.2-fold lower as compared to the free acyclovir in solution, thus evidencing the ability of both colloidal systems in enhancing the diffusion of the drug. The antiviral activity against HSV-1 of both systems was tested by plaque reduction assay in monolayer cultures of Vero cells. Data showed that no significant differences in the antiviral activity were observed by acyclovir in the free or loaded forms. Taken together these results, colloidal systems could be interesting to mediate the penetration of acyclovir within Vero cells. PMID:23112407

  7. Colloidal dispersions for the delivery of acyclovir: a comparative study.

    Science.gov (United States)

    Cortesi, Rita; Ravani, Laura; Menegatti, Enea; Drechsler, M; Esposito, Elisabetta

    2011-11-01

    This paper describes a comparative study on the performances of ethosomes and solid lipid nanoparticle as delivery systems for acyclovir. Ethosomes were spontaneously produced by dissolution of phosphatidylcholine and acyclovir in ethanol followed by addition of an aqueous buffer while solid lipid nanoparticle were produced by homogenization and ultrasonication. Both colloidal systems were morphologically characterized by cryo-transmission electron microscopy. The encapsulation efficiency was 94.2±2.8% for ethosomes and 53.2±0.2% for solid lipid nanoparticle. Concerning Z potential, both formulations are close to neutrality. The diffusion coefficients of the drug from ethosomes and solid lipid nanoparticle, determined by a Franz cell method, were 9.4 and 1.2-fold lower as compared to the free acyclovir in solution, thus evidencing the ability of both colloidal systems in enhancing the diffusion of the drug. The antiviral activity against HSV-1 of both systems was tested by plaque reduction assay in monolayer cultures of Vero cells. Data showed that no significant differences in the antiviral activity were observed by acyclovir in the free or loaded forms. Taken together these results, colloidal systems could be interesting to mediate the penetration of acyclovir within Vero cells.

  8. Polymeric micelles for acyclovir drug delivery.

    Science.gov (United States)

    Sawdon, Alicia J; Peng, Ching-An

    2014-10-01

    Polymeric prodrug micelles for delivery of acyclovir (ACV) were synthesized. First, ACV was used directly to initiate ring-opening polymerization of ɛ-caprolactone to form ACV-polycaprolactone (ACV-PCL). Through conjugation of hydrophobic ACV-PCL with hydrophilic methoxy poly(ethylene glycol) (MPEG) or chitosan, polymeric micelles for drug delivery were formed. (1)H NMR, FTIR, and gel permeation chromatography were employed to show successful conjugation of MPEG or chitosan to hydrophobic ACV-PCL. Through dynamic light scattering, zeta potential analysis, transmission electron microscopy, and critical micelle concentration (CMC), the synthesized ACV-tagged polymeric micelles were characterized. It was found that the average size of the polymeric micelles was under 200nm and the CMCs of ACV-PCL-MPEG and ACV-PCL-chitosan were 2.0mgL(-1) and 6.6mgL(-1), respectively. The drug release kinetics of ACV was investigated and cytotoxicity assay demonstrates that ACV-tagged polymeric micelles were non-toxic.

  9. Cocrystals of acyclovir with promising physicochemical properties.

    Science.gov (United States)

    Sarkar, Anindita; Rohani, Sohrab

    2015-01-01

    Cocrystal forming ability of antiviral drug acyclovir (ACV) with different coformers was studied. Three cocrystals containing ACV with fumaric acid, malonic acid, and DL-tartaric acid were isolated. Methods of cocrystallization included grinding with dropwise solvent addition and solvent evaporation. The cocrystals were characterized by powder X-ray diffraction, differential scanning calorimetry, and thermogravimetric analysis. The crystal structure of the cocrystal with fumaric acid as conformer was determined by single crystal X-ray diffraction. Formation of supramolecular synthon was observed in the cocrystal. Stability with respect to relative humidity for the three cocrystals was evaluated. The aqueous solubility of the ACV-cocrystal materials was significantly improved with a maximum of malonic acid cocrystal, which was about six times more soluble at 35°C compared with that of parent ACV. The dissolution profile indicates that at any particular dissolution time, the concentration of cocrystals in the solution was higher than that of the parent ACV, and malonic acid cocrystals had a maximum release of about twice than the hydrated ACV.

  10. Formulation and Optimization of Mucoadhesive Nanodrug Delivery System of Acyclovir

    OpenAIRE

    Bhosale, UV; Kusum, Devi V; Jain, N

    2011-01-01

    Acyclovir is an antiviral drug used for the treatment of herpes simplex virus infections, with an oral bioavailability of only 10–20% [limiting absorption in gastrointestinal tract to duodenum and jejunum] and half-life of about 3 h, and is soluble only at acidic pH (pKa 2.27). Mucoadhesive polymeric nanodrug delivery systems of acyclovir have been designed and optimized using 23 full factorial design. Poly (lactic-co-glycolic acid) (PLGA) (50:50) was used as the polymer along with polycarbop...

  11. Topical distribution of acyclovir in normal equine skin and equine sarcoids: An in vitro study.

    Science.gov (United States)

    Haspeslagh, M; Taevernier, L; Maes, A A; Vlaminck, L E M; De Spiegeleer, B; Croubels, S M; Martens, A M

    2016-06-01

    Topical acyclovir application is an owner-friendly treatment for occult equine sarcoids, without the caustic side-effects other topical treatments have. Variable clinical success rates have been described, but it is not known to what rate and extent acyclovir penetrates in and through equine skin from a topical formulation. In the current study, an in vitro Franz diffusion model was used to determine the permeation parameters for a generic 5% acyclovir cetomacrogol cream for both healthy and sarcoid equine skin. The distribution of acyclovir between different layers of both skin types was also evaluated. While acyclovir penetrated through both skin types, significantly less acyclovir permeated to the deep dermis of sarcoid skin (197.62ng/mm(3)) compared to normal skin (459.41ng/mm(3)). Within sarcoid skin samples, significantly higher acyclovir concentrations were found in the epidermis (983.59ng/mm(3)) compared to the superficial dermis (450.02ng/mm(3)) and the deep dermis. At each sample point, significantly more acyclovir permeated to the receptor fluid through normal skin compared to sarcoid skin, which is reflected in the significantly higher permeation parameters of normal skin. Normal skin was found to be more permissive for acyclovir, but even in sarcoid skin, enough acyclovir reached the deep dermis to treat a Herpes simplex virus infection. In the case of equine sarcoids, the treatment is aimed at the Bovine papillomavirus and no information is available on the susceptibility of the DNA polymerase of this virus for acyclovir. Therefore, further research is needed to determine the efficacy of acyclovir to treat equine sarcoids.

  12. Alopecia following oral acyclovir for the treatment of herpes simplex keratitis

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    Ashok Sharma

    2014-01-01

    Full Text Available The authors report acyclovir-induced alopecia in a patient treated for herpetic keratouveitis. A 32-years-old female was diagnosed with herpetic keratouveitis. She was placed on prednisolone acetate (1% suspension four times a day, atropine sulfate (1% thrice a day, and oral acyclovir 400 mg twice-daily. Three weeks following oral acylovir, keratouveitis improved, but she developed alopecia without any drug eruptions. Oral acyclovir was discontinued. Three months later, alopecia completely resolved. Alopecia may be considered a possible complication following oral acyclovir.

  13. Alopecia following oral acyclovir for the treatment of herpes simplex keratitis.

    Science.gov (United States)

    Sharma, Ashok; Mohan, Kanwar; Sharma, Rajan; Nirankari, Verinder S

    2014-01-01

    The authors report acyclovir-induced alopecia in a patient treated for herpetic keratouveitis. A 32-years-old female was diagnosed with herpetic keratouveitis. She was placed on prednisolone acetate (1%) suspension four times a day, atropine sulfate (1%) thrice a day, and oral acyclovir 400 mg twice-daily. Three weeks following oral acylovir, keratouveitis improved, but she developed alopecia without any drug eruptions. Oral acyclovir was discontinued. Three months later, alopecia completely resolved. Alopecia may be considered a possible complication following oral acyclovir.

  14. Acyclovir in the prevention of duodenal ulcer recurrence

    DEFF Research Database (Denmark)

    Rune, S J; Linde, J; Bonnevie, O;

    1990-01-01

    This study tests the hypothesis that reactivation of a latent herpes simplex virus infection may be a cause of recurrent duodenal ulceration. Patients with recently healed duodenal ulcer were entered into a double blind, randomised study of maintenance treatment with the antiviral drug acyclovir...... (400 mg bid) versus placebo, to determine if suppression of herpes virus infection would influence the natural history of the ulcer disease. One hundred and fifteen patients entered the trial and 76 patients completed it according to the protocol. Endoscopy was performed when ulcer symptoms recurred...... and at the end of the 25 week trial period. In the acyclovir group the cumulated relapse rate was 63% compared with 56% in the placebo group (NS). This result suggests that reactivation of herpes simplex virus is not a cause of recurrent duodenal ulcer....

  15. Formulation and evaluation of acyclovir microcapsules using bakers yeast

    Institute of Scientific and Technical Information of China (English)

    Krishnan PN; Saraswathi R; Dilip C; Ramarao N

    2010-01-01

    Objective:To formulate and evaluate acyclovir microcapsules using bakers yeast. Methods:Acyclovir, pretreated yeast and deionised water were taken at a volumetric ratio of 1:2:4 respectively. This suspension was agitated in a magnetic stirrer at 25℃, 30℃, 35℃, and 40℃for 4 hours. The suspension was then centrifuged for 10 minutes at 2 000 rpm. The supernatant solution was decanted and the cells were washed 5 times with deionised water. Then the suspended drug entrapped yeast cells were dried in a lyophillizer for 48 hours. The yield was noted. Results:The first four formulations were done with 200 mg of the drug, followed by 400 mg for the next four formulations and 800 mg the last four formulations. SEM showed that the surface of the microcapsules was intact, with no burst characteristics. FTIR showed no interaction between acyclovir and the cell wall. DSC showed that the peak was within the standard values. The mean particle size for all the samples was 8 μm in diameter. The dissolution studies were done for all the twelve samples and showed a Fickian model of diffusion. Conclusions:From the results it is inferred that the samples prepared at 40℃(FY-4, FY-8, FY-12) show better entrapment and release. So these samples are formulated in the form of a suspension and compared with marketed acyclovir suspension using HPLC technique. The formulated suspensions with FY-4, FY-8 and FY-12 shows drug content in accordance with the standards of the pharmacopoeial limits.

  16. Synthesis and characterization of novel dipeptide ester prodrugs of acyclovir

    Science.gov (United States)

    Nashed, Yasser E.; Mitra, Ashim K.

    2003-07-01

    Four dipeptide (Gly-Gly, Gly-Val, Val-Val, Val-Gly) ester prodrugs of 9-[(2-hydroxyethoxy)methyl]guanine (acyclovir, ACV) were synthesized. LC/MS was used to characterize the new prodrugs. Both 1H NMR and 13C NMR spectra of the four prodrugs of ACV were measured and assigned based on spectral comparison with compounds of similar structures.

  17. Galactose decorated PLGA nanoparticles for hepatic delivery of acyclovir.

    Science.gov (United States)

    Gupta, Swati; Agarwal, Abhinav; Gupta, Nishant Kumar; Saraogi, Gauravkant; Agrawal, Himanshu; Agrawal, G P

    2013-12-01

    The present study explores prospective of surface tailored nanoparticles for targeted delivery of acyclovir along with the interception of minimal side effects. Acyclovir loaded plain and galactosylated poly lectic co glycolic acid (PLGA) nanoparticles were efficiently prepared and characterized by Fourier transform infrared spectroscopy, scanning electron microscopy (SEM), size, polydispersity index, zeta potential, and entrapment efficiency. The formulations were evaluated for in vitro drug release and hemolysis. Further, biodistribution study and fluorescent microscopic studies were carried out to determine the targeting potential of formulations. SEM revealed smooth morphology and spherical shape of the nanoparticles. In vitro, the galactosylated nanoparticles were found to be least hemolytic and exhibited a sustained release pattern. In vivo studies exhibited an augmented bioavailability, increased residence time and enhanced delivery of acyclovir to the liver upon galactosylation. It may therefore be concluded that galactose conjugated PLGA nanoparticles can be used suitably as vehicles for delivery of bioactives specifically to the hepatic tissues and may be thus exploited in the effective management of various liver disorders.

  18. Design of Nanoparticles Loaded Acyclovir for Controlled Delivery System

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    Shadab Shahsavari

    2015-10-01

    Full Text Available Introduction: The aim of this research was to develop a new drug release systems based on Nanoparticles. In this study, the natural polymer chitosan was used for preparation of nanoparticles due to its unique properties, such as biocompatibility and biodegradability. Methods: The polymeric nano-drug controlled release system has been designed with experimental design D-optimal response surface methodology, for varied variables such as the concentration of acyclovir, concentration ratio of chitosan/ TPP and pH using the ionic gelation method. The nanoparticles were characterized morphologically by scanning electron microcopy (SEM, particle size analyser (DLS for determining size, zeta and PdI, Fourier Transform Infra-Red (FTIR Spectroscopy for determination of structure of nanoparticlesand thermo gravimetric analysis (TGAfor studying thermal behavior. The optimized nanoparticles were characterized. Results: The size of the particles was detected to be 132±24.3 nm; zeta potential was 32±2.87 mV; PdI of particles was 0.159±0.05; and calculated EE% was 85±4.38%. An in-vitro release study of the prepared nanoparticles illustrated that the percentage of acyclovir released from the nanoparticles was 80.17±2.45% within 48 hrs. Conclusion: The optimized nanoparticles according to SEM image, exhibited segregated and non-aggregated nanoparticles with sub-spherical smooth morphology and also the high thermal stability of acyclovir nanoparticles at temperature up to 200°C due to TGA analysis, which indicated a well-established structure of nanoparticles.

  19. Controlled delivery of acyclovir from porous silicon micro- and nanoparticles

    Energy Technology Data Exchange (ETDEWEB)

    Maniya, Nalin H.; Patel, Sanjaykumar R.; Murthy, Z.V.P., E-mail: zvpm2000@yahoo.com

    2015-03-01

    Graphical abstract: - Highlights: • Porous silicon (PSi) was fabricated by electrochemical etching process. • Micro- and nanoparticles were prepared by ultrasonic fracture of PSi films. • Acyclovir was loaded into native, oxidized, and hydrosilylated PSi particles. • Micro- and nanoparticles displays controlled release behaviour for several days. • Drug release behaviour and release kinetics from PSi particles were studied. - Abstract: In this work, micro- and nanoparticles of porous silicon (PSi) are demonstrated to act as effective carrier for the controlled delivery of acyclovir (ACV). PSi films prepared by electrochemical etching were fractured by ultrasonication to prepare micro- and nanoparticles. PSi native particles were thermally oxidized (TOPSi) and thermally hydrosilylated using undecylenic acid (UnPSi). PSi particles with three different surface chemistries were then loaded with ACV by physical adsorption and covalent attachment. Such particles were characterized by scanning electron microscopy, dynamic light scattering, and Fourier transform infrared spectroscopy. In vitro ACV release experiments in phosphate buffered saline showed sustained release behaviour from both micro- and nanoparticles and order of release was found to be native PSi > TOPSi > UnPSi. Drug release kinetics study using Korsmeyer-Peppas model suggested a combination of both drug diffusion and Si scaffold erosion based drug release mechanisms.

  20. Early, patient-initiated treatment of herpes labialis with topical 10% acyclovir.

    OpenAIRE

    Spruance, S. L.; Crumpacker, C S; Schnipper, L E; Kern, E. R.; Marlowe, S; Arndt, K A; Overall, J C

    1984-01-01

    To determine whether topical acyclovir in polyethylene glycol could reduce the severity of herpes simplex labialis if applied immediately after onset of a recurrence, 10% acyclovir in polyethylene glycol ointment or polyethylene glycol alone was prospectively dispensed to 352 patients in a double-blind, randomized trial. Sixty-nine subjects initiated treatment in the prodrome (57%) or erythema (43%) stage and were followed by clinical and virological criteria. The healing time (6.0 days), max...

  1. Encapsulation of Acyclovir in new carboxylated cyclodextrin-based nanosponges improves the agent's antiviral efficacy.

    Science.gov (United States)

    Lembo, David; Swaminathan, Shankar; Donalisio, Manuela; Civra, Andrea; Pastero, Linda; Aquilano, Dino; Vavia, Pradeep; Trotta, Francesco; Cavalli, Roberta

    2013-02-25

    Cyclodextrin-based nanosponges (NS) are solid nanoparticles, obtained from the cross-linking of cyclodextrins that have been proposed as delivery systems for many types of drugs. Various NS derivatives are currently under investigation in order that their properties might be tuned for different applications. In this work, new carboxylated cyclodextrin-based nanosponges (Carb-NS) carrying carboxylic groups within their structure were purposely designed as novel Acyclovir carriers. TEM measurements revealed their spherical shape and size of about 400 nm. The behaviour of Carb-NS, with respect to the incorporation and delivery of Acyclovir, was compared to that of NS, previously investigated as a drug carrier. DSC, XRPD and FTIR analyses were used to investigate the two NS formulations. The results confirm the incorporation of the drug into the NS structure and NS-Acyclovir interactions. The Acyclovir loading into Carb-NS was higher than that obtained using NS, reaching about 70% (w/w). In vitro release studies showed the release kinetics of Acyclovir from Carb-NS to be prolonged in comparison with those observed with NS, with no initial burst effect. The NS uptake into cells was evaluated using fluorescent Carb-NS and revealed the nanoparticle internalisation. Enhanced antiviral activity against a clinical isolate of HSV-1 was obtained using Acyclovir loaded in Carb-NS.

  2. The effects of oral Acyclovir in the treatment of necrotizing Herpetic keratouveitis

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    "Hosseini Tehrani M;Poormostadam B;Vallaei N;Raiszadeh F "

    2000-08-01

    Full Text Available This study was conducted to evaluate the effects of administering oral acyclovir in conjunction with topical acyclovir and steroids in the treatment of necrotizing herpetic keratouveitis. All patients with necrotizing herpetic keratouveits who have been consulted during 1996-1997 at the farbi Eye Hospital were studied . the patients were randomly assigned to two groups. In the first group, topical acyclovir ointment and topical steroids were administered, while the second group took oral acyclovir, 1600 mg in four divided does in addition to the above mentioned treatment. The patients undervent follow-up examination every three days in the first three weeks and therafter periodically for one year.After three weeks, 92% and 88% improvement was observed in the first and second groups, respectively. The observed difference was not statistically significant. Making nonpharmacologic interventions such as application of soft contact lenses, corneal grafts, and conjunctival flaps were inevitable in some cases in both groups. Secondary infection was observed in three patients (first grop and two patients (2 and group.The sample size was not large enough to draw a definite statistical conclusion, but it seems that the addition of oral acyclovir has no added effect in the treatment of necrotizing herpetic keratouveitis than topical acyclovir and steroids. In this study , the males were affected more frequently than females.

  3. Preparation and evaluation of gastroretentive floating tablets of acyclovir.

    Science.gov (United States)

    Garg, Rajeev; Gupta, G D

    2009-10-01

    The present study performed by preparation and evaluation of floating tablets of Acyclovir as model drug for prolongation of gastric residence time. Floating effervescent tablets were formulated by various materials like hydroxypropyl methylcellulose K 4M, K 15M, psyllium husk, swelling agent as crospovidone and microcrystalline cellulose and gas generating agent like sodium bicarbonate and citric acid and evaluated for floating properties, swelling characteristics and in vitro drug release studies. Floating noneffervescent tablets were prepared by polypropylene foam powder and different matrix forming polymers like HPMC K 4M, Carbopol 934P, xanthan gum and sodium alginate. In vitro drug release studies were performed and drug release kinetics evaluated using the linear regression method was found to follow both the Higuchi and the Korsmeyer and Peppas equation. The drug release mechanism was found fickian type in most of the formulations.

  4. Controlled delivery of acyclovir from porous silicon micro- and nanoparticles

    Science.gov (United States)

    Maniya, Nalin H.; Patel, Sanjaykumar R.; Murthy, Z. V. P.

    2015-03-01

    In this work, micro- and nanoparticles of porous silicon (PSi) are demonstrated to act as effective carrier for the controlled delivery of acyclovir (ACV). PSi films prepared by electrochemical etching were fractured by ultrasonication to prepare micro- and nanoparticles. PSi native particles were thermally oxidized (TOPSi) and thermally hydrosilylated using undecylenic acid (UnPSi). PSi particles with three different surface chemistries were then loaded with ACV by physical adsorption and covalent attachment. Such particles were characterized by scanning electron microscopy, dynamic light scattering, and Fourier transform infrared spectroscopy. In vitro ACV release experiments in phosphate buffered saline showed sustained release behaviour from both micro- and nanoparticles and order of release was found to be native PSi > TOPSi > UnPSi. Drug release kinetics study using Korsmeyer-Peppas model suggested a combination of both drug diffusion and Si scaffold erosion based drug release mechanisms.

  5. [Delirium during oral therapy of herpes zoster with acyclovir. Case report and brief review of central nervous system side-effects of acyclovir].

    Science.gov (United States)

    Braun, J S; Apel, I; Schäffer, S; Schumacher, M; Berger, M

    1998-11-01

    In differential diagnosis of a delir also adverse effects of medicaments have to be taken into account beside other causes. We report a case of an agitated delir with nocturnal disturbance of consciousness, confusion, restlessness and sleeplessness. This delir existed exclusively during the therapy of a cutaneous herpes zoster with zovirax-pills which can only be explained by a causal connection--after exclusion of other causes. As a so far undescribed predisposition for neurotoxicity of oral therapy with acyclovir signs of vascular encephalopathy were found in the patient's cranial magnetic resonance imaging. The central nervous side effects of acyclovir were summarized shortly.

  6. Acyclovir-resistant herpetic keratitis in a solid-organ transplant recipient on systemic immunosuppression

    Directory of Open Access Journals (Sweden)

    Turner LD

    2013-01-01

    Full Text Available Liam Daniel Turner,1 Peter Beckingsale1,2,31Princess Alexandra Hospital; 2Terrace Eye Centre; 3Laser Sight, Brisbane, Queensland, AustraliaPurpose: To report a case of acyclovir-resistant herpetic keratitis in a solid-organ lung transplant recipient that was effectively treated with topical trifluridine.Methods: A case of a 35-year-old female with herpetic epithelial keratitis resistant to acyclovir is described. The patient presented following treatment for 4 weeks with topical acyclovir ointment five times per day and oral valacyclovir 1 g three times per day for herpetic keratitis with no resolution of the epithelial defect or symptoms. Corneal scrapes and swabs were taken for confirmation of the diagnosis and resistance testing. The results were positive for herpes simplex virus 1 and showed acyclovir resistance (inhibitor concentration 90 = 200 µg/mL and foscarnet sensitivity (inhibitor concentration 90 = 200 µg/mL. The patient was treated with topical trifluridine 2-hourly for 3 weeks and weaned off the drops over the following week.Results: The patient showed resolution of the epithelial defect, but did have significant corneal toxicity associated with the use of the trifluridine. At 8 weeks, the patient had some stromal shadowing associated with the recent active infection, but symptoms had settled.Conclusion: This case documents the effective use of topical trifluridine in proven acyclovir-resistant herpetic keratitis. It highlights three things: (1 the importance of considering topical trifluridine as an alternative to topical acyclovir in unresponsive disease; (2 the need to consider solid-organ transplant recipients in the immunocompromised population with resistant herpetic disease, and (3 the need to look for alternatives to treatment of resistant herpetic disease.Keywords: acyclovir resistance, herpetic keratitis, trifluridine

  7. Photolysis of three antiviral drugs acyclovir, zidovudine and lamivudine in surface freshwater and seawater.

    Science.gov (United States)

    Zhou, Chengzhi; Chen, Jingwen; Xie, Qing; Wei, Xiaoxuan; Zhang, Ya-nan; Fu, Zhiqiang

    2015-11-01

    Photodegradation is an important elimination process for many pharmaceuticals in surface waters. In this study, photodegradation of three antiviral drugs, acyclovir, zidovudine, and lamivudine, was investigated in pure water, freshwater, and seawater under the irradiation of simulated sunlight. Results showed that zidovudine was easily transformed via direct photolysis, while acyclovir and lamivudine were mainly transformed via indirect photolysis. We found that in freshwater, nitrate enhanced the photodegradation of the three antiviral drugs, bicarbonate promoted the photodegradation of acyclovir, and dissolved organic matter (DOM) accelerated the photolysis of acyclovir and lamivudine. In seawater, the photolysis of acyclovir was not susceptible to Cl(-), Br(-) and ionic strength; however, the photolysis of zidovudine was inhibited by Cl(-) and Br(-), and the photolysis of lamivudine was enhanced by Cl(-), Br(-) and ionic strength. Second-order reaction rate constants for the three antiviral drugs with (1)O2 (k1O2) and OH (kOH) were also measured. These results are important for fate and ecological risk assessment of the antiviral drugs in natural waters.

  8. Sustained Release Floating Microspheres Of Acyclovir: Formulation, Optimization, Characterization And In Vitro Evaluation

    Directory of Open Access Journals (Sweden)

    Parmar Kunal Vinodbhai

    2011-03-01

    Full Text Available The aim of the present work was to prepare floating microspheres of acyclovir to prolong residence time in stomach and to sustain the release of acyclovir. Acyclovir loaded floating microspheres were prepared by double emulsion solvent evaporation method. The 32 full factorial design was applied to optimize the formulation. The resultant microspheres were evaluated for average particle size, percentage encapsulation efficiency, in vitro drug release and model fitting kinetics. Scanning electron microscopy, Fourier transform infrared (FTIR spectroscopy and differential scanning calorimetry were used to investigate the physical state of the drug in the microspheres. The particle size of microspheres was in the range of 275-340 µm. Percentage encapsulation efficiency was between 59%-77% w/w. Microspheres remained buoyant for more than about 12 h. The results of FT-IR spectroscopy and differential scanning calorimetry indicated the stable character of acyclovir in microspheres and also revealed absence of drugpolymer interaction. The in vitro drug release study showed that acyclovir release from the microspheres was slow and sustained for more than about 10 h. Drug release followed Korsemeyer-peppas model. The results of factorial batches revealed that the concentration of ethyl cellulose and stirring speed significantly affected drug encapsulation efficiency and particle size of the microspheres. Thus we can conclude that floating microspheres can successfully be developed to sustain the drug release.

  9. [Diagnostic and therapeutic strategy for acyclovir-resistant herpes encephalitis].

    Science.gov (United States)

    Saijo, Masayuki

    2014-01-01

    Acyclovir (ACV), which inhibits the replication of herpes simplex virus, is the standard drug for the treatment of herpes simplex encephalitis. Thanks to the introduction of ACV, the morbidity and mortality of HSE patients have significantly improved. However, the disease is still the severe infection, because it makes some patients with HSE suffer from severe consequences. The sensitivity test of the etiological HSV to ACV is very difficult due to the inability of isolation of the virus from cerebrospinal fluid (CSF). The cases of the ACV treatment-resistant HSE patients have been reported. However, these cases were not virologically confirmed. The first case of encephalitis in newborn baby with HSE caused by an ACV-resistant HSV-1, which was virologically confirmed, was reported by our group. According to the sensitivity profile of the causative viruses to antiviral drugs, the drugs of choice for HSE should be properly considered. Strategy for diagnoses of HSE including antiviral sensitivity assessment and selection of drugs in HSE is reviewed.

  10. Mechanistic insights into acyclovir-polyethylene glycol 20000 binary dispersions

    Science.gov (United States)

    Venkateskumar, Krishnamoorthy; Parasuraman, Subramani; Gunasunderi, Raju; Sureshkumar, Krishnan; Nayak, M. Muralidhar; Shah, Syed Adnan Ali; Kassen, Khoo; Kai, Heng Wei

    2016-01-01

    Objective: The objective of this study is to provide a mechanistic insight into solubility enhancement and dissolution of acyclovir (ACY) by polyethylene glycol20000 (PEG20000). Materials and Methods: Solid dispersions with differing ratios of drug (ACY) and carrier (PEG20000) were prepared and evaluated by phase solubility, in vitro release studies, kinetic analysis, in situ perfusion, and in vitro permeation studies. Solid state characterization was also done by Powder X-Ray Diffraction (PXRD), Differential Scanning Calorimetry (DSC), Fourier Transform Infrared spectroscopy (FT-IR) analysis and surface morphology was assessed by Polarizing Microscopic Image (PMI) analysis, Scanning Electron Microscopy (SEM), Atomic Force Microscopy (AFM), and Nuclear Magnetic Resonance (NMR) analysis. Results: Thermodynamic parameters proved the solubilization effect of carrier. The aqueous solubility and dissolution of ACY were increased in all samples. Formation of solid solution, crystallinity reduction, and absence of interaction between drug and carrier was proved by XRD, DSC, and FTIR analysis. The particle size reduction and change in surface morphology were confirmed by SEM and AFM and analysis. The permeation coefficient and amount of drug diffused was higher in samples as compared to ACY. The stability was high in dispersions, and it was proved by NMR analysis. Conclusion: The mechanical insights into the enhancement of solubility and dissolution could be used as a platform to improve the aqueous solubility for other poor water soluble drugs. PMID:28123988

  11. Design and optimization of floating drug delivery system of acyclovir

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    Kharia A

    2010-01-01

    Full Text Available The purpose of the present work was to design and optimize floating drug delivery systems of acyclovir using psyllium husk and hydroxypropylmethylcellulose K4M as the polymers and sodium bicarbonate as a gas generating agent. The tablets were prepared by wet granulation method. A 32 full factorial design was used for optimization of drug release profile. The amount of psyllium husk (X1 and hydroxypropylmethylcellulose K4M (X2 were selected as independent variables. The times required for 50% (t 50% and 70% (t 70% drug dissolution were selected as dependent variables. All the designed nine batches of formulations were evaluated for hardness, friability, weight variation, drug content uniformity, swelling index, in vitro buoyancy, and in vitro drug release profile. All formulations had floating lag time below 3 min and constantly floated on dissolution medium for more than 24 h. Validity of the developed polynomial equation was verified by designing two check point formulations (C1 and C2. The closeness of predicted and observed values for t 50% and t 70% indicates validity of derived equations for the dependent variables. These studies indicated that the proper balance between psyllium husk and hydroxypropylmethylcellulose K4M can produce a drug dissolution profile similar to the predicted dissolution profile. The optimized formulations followed Higuchi′s kinetics while the drug release mechanism was found to be anomalous type, controlled by diffusion through the swollen matrix.

  12. [A young patient of acute encephalitis complicated with acyclovir encephalopathy without renal dysfunction].

    Science.gov (United States)

    Tomori, Koji; Isozumi, Kazuo; Motohashi, Sachiko; Komatsumoto, Satoru; Fukuuchi, Yasuo

    2003-08-01

    A previously healthy 30-year-old woman was admitted to our hospital because of impaired consciousness after convulsion. A temporary diagnosis of herpes simplex encephalitis was made, and intravenous acyclovir (ACV) therapy (250 mg four times daily in normal saline over 2 hours) was started. Three days later, she became confused, and was having hallucinations, dysarthria and generalized painful seizures occurred without focal neurologic deficit. Whether the neuropsychiatric symptoms were related to herpes simplex encephalitis or acyclovir neurotoxity was initially unclear. The brain MRI and lumbar puncture findings were initially normal, but abnormal FLAIR lesions appeared later. ACV-associated encephalopathy was considered. ACV was discontinued, and she recovered from the neurological disorder within 24 hours. Although blood levels of acyclovir were not determined, it is unlikely that they were in a toxic range, in view of her normal renal function.

  13. Acyclovir prodrug for the intestinal di/tri-peptide transporter PEPT1

    DEFF Research Database (Denmark)

    Thomsen, Anne Engelbrecht; Christensen, Michael Søberg; Bagger, Morten Aavad

    2004-01-01

    as a measure for intracellular accumulation. In addition, bi-directional transport studies of Glu(acyclovir)-Sar across Caco-2 cell monolayers and in vitro metabolism studies of Glu(acyclovir)-Sar in various media of rat origin were performed. For these purposes HPLC-UV analysis was applied. Oral...... extracts. Bi-directional flux across Caco-2 cell monolayers apical to basolateral (FluxA-->B) and basolateral to apical (FluxB-->A) was measured and the FluxB-->A/FluxA-->B ratios of approximately 0.8 indicate that apical efflux mechanisms may not explain this lack of intracellular accumulation. These data...

  14. Necrotizing Keratitis Caused by Acyclovir-Resistant Herpes Simplex Virus

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    Koji Toriyama

    2014-10-01

    Full Text Available Background: We report a case of necrotizing keratitis caused by acyclovir (ACV-resistant herpes simplex virus (HSV with a clinical appearance similar to a previous fungal keratitis infection. Methods: Observational case report. Results: Penetrating keratoplasty was performed in the left eye with a history of herpetic keratitis that resolved with periodic treatment with ACV ointment and a topical steroid. The left eye was painful and red with an abscess and corneal erosion in the peripheral donor cornea. Examination of the scraped corneal epithelium by light microscopy and culturing identified Candida albicans; polymerase chain reaction (PCR was negative for human herpes viruses. After antifungal treatment, the ocular pain gradually decreased and the lesions slowly improved but recurred with a similar clinical appearance. A second light microscopy examination and cultures were negative for pathogens including C. albicans. PCR was positive for HSV-1 DNA; treatment with 3% topical ACV ointment was unsuccessful. A third examination showed only HSV-1 DNA. Despite antiviral ACV ointment, no clinical improvement occurred based on the HSV DNA copy numbers, which were the same before and after treatment, indicating a possible ACV-resistant strain. When topical trifluorothymidine was substituted for ACV, clinical improvement occurred and the HSV DNA copy numbers decreased. Conclusion: Necrotizing keratitis induced by ACV-resistant HSV occurred independently after fungal keratitis, with a similar clinical appearance in this case, making diagnosis and treatment difficult. Monitoring the HSV DNA load by real-time PCR could be useful for refractory cases even with atypical clinical appearances.

  15. Simultaneous delivery of tenofovir and acyclovir via an intravaginal ring.

    Science.gov (United States)

    Moss, John A; Malone, Amanda M; Smith, Thomas J; Kennedy, Sean; Kopin, Etana; Nguyen, Cali; Gilman, Josh; Butkyavichene, Irina; Vincent, Kathleen L; Motamedi, Massoud; Friend, David R; Clark, Meredith R; Baum, Marc M

    2012-02-01

    Vaginal microbicides may play an important role in protecting women from HIV infection. A strong synergy between HSV and HIV has been observed, and epidemiological studies demonstrate that HSV infection increases the risk of HIV acquisition. Incorporation of the antiretroviral tenofovir (TFV) along with the antiherpetic acyclovir (ACV) into combination intravaginal rings (IVRs) for sustained mucosal delivery of both compounds could lead to increased microbicide product adherence and efficacy compared with conventional vaginal formulations. A novel, dual-protection "pod IVR" platform developed in-house and delivering ACV and TFV was evaluated in rabbit and sheep models. The devices were safe and exhibited sustained release of both drugs independently and at controlled rates over the 28-day studies. Daily release rates were estimated based on residual drug content of the used devices: rabbits, 343 ± 335 μg day(-1) (ACV) and 321 ± 207 μg day(-1) (TFV); sheep, 174 ± 14 μg day(-1) (ACV) and 185 ± 34 μg day(-1) (TFV). Mean drug levels in sheep vaginal samples were as follows: secretions, 5.25 ± 7.31 μg ml(-1) (ACV) and 20.6 ± 16.2 μg ml(-1) (TFV); cervicovaginal lavage fluid, 118 ± 113 ng ml(-1) (ACV) and 191 ± 125 ng ml(-1) (TFV); tissue, 173 ng g(-1) (ACV) and 93 ng g(-1) (TFV). An in vitro-in vivo correlation was established for both drugs and will allow the development of future formulations delivering target levels for prophylaxis and therapy. These data suggest that the IVR based on the pod design has potential in the prevention of transmission of HIV-1 and other sexually transmitted pathogens.

  16. Enhanced dermal delivery of acyclovir using solid lipid nanoparticles.

    Science.gov (United States)

    Jain, Sanyog; Mistry, Meghal A; Swarnakar, Nitin K

    2011-10-01

    The present investigation was enthused by the possibility to develop solid lipid nanoparticles (SLNs) of hydrophilic drug acyclovir (ACV) and evaluate their potential as the carrier for dermal delivery. ACV-loaded SLNs (ACV-SLNs) were prepared by the optimized double emulsion process using Compritol 888 ATO as solid lipid. The prepared SLNs were smooth and spherical in shape with average diameter, polydispersity index, and entrapment efficiency of 262 ± 13 nm, 0.280 ± 0.01, and 40.08 ± 4.39% at 10% (w/w) theoretical drug loading with respect to Compritol 888 ATO content. Differential scanning calorimetry and powder X-ray diffraction pattern revealed that ACV was present in the amorphous state inside the SLNs. In vitro skin permeation studies on human cadaver and Sprague-Dawley rat skin revealed 17.65 and 15.17 times higher accumulation of ACV-SLNs in the dermal tissues in comparison to commercially available ACV cream after 24 h. Mechanism of topical permeation and dermal distribution was studied qualitatively using confocal laser scanning microscopy. While free dye (calcein) failed to penetrate skin barrier, the same encapsulated in SLNs penetrated deeply into the dermal tissue suggesting that pilosebaceous route was followed by SLNs for skin penetration. Histological examination and transdermal epidermal water loss measurement suggested that no major morphological changes occurred on rat skin surface due to the application of SLNs. Overall, it was concluded that ACV-loaded SLNs might be beneficial in improving dermal delivery of antiviral agent(s) for the treatment of topical herpes simplex infection.

  17. Pharmacokinetics of Stereoisomeric Dipeptide Prodrugs of Acyclovir Following Intravenous and Oral Administrations in Rats: A Study Involving In vivo Corneal Uptake of Acyclovir Following Oral Dosing

    Directory of Open Access Journals (Sweden)

    Ravi S.Talluri

    2009-10-01

    Full Text Available Objective: To delineate the plasma pharmacokinetics and determine the corneal uptake of valine based stereoisomeric dipeptide prodrugs of acyclovir (ACV in rats. Methods: Male Sprague-Dawley rats were used for the study. Pharmacokinetics of ACV, L-valine-acyclovir (LACV, L-valine- D-valine-acyclovir (LDACV and D-valine-L-valine acyclovir (DLACV prodrugs were delineated. These compounds were administered intravenously as a bolus via jugular vein cannula and orally by gavage. Samples were purified by protein precipitation method and analyzed by LC-MS/MS. Pertinent pharmacokinetic parameters were obtained by using WinNonlin. Corneal uptake studies of LDACV and LACV were studied following oral administration. Results: Following i.v. administration, the area under the curve (AUC in µM*min of generated ACV was in the order of LACV › LDACV › DLACV indicating their rate of metabolism. The AUC values of total drug obtained in the systemic circulation after oral administration LACV and LDACV were 1077.93 ± 236.09 and 1141.76 ± 73.67 µM*min, respectively. DLACV exhibited poor oral absorption. Cmax (µM and AUC of the intact prodrug obtained in the systemic circulation following oral administration of LDACV were almost 4–5 times higher than LACV. Moreover, concentrations achieved in the cornea after oral administration of LDACV were almost two times of LACV. Conclusions: LDACV increased both the oral bioavailability and subsequent in vivo corneal uptake of ACV. Hence, LDACV can be considered as the most promising drug candidate for delivery of ACV, in treatment of both genital herpes and ocular herpes keratitis after oral administration.

  18. Long-term ultra-low-dose acyclovir against varicella-zoster virus reactivation after allogeneic hematopoietic stem cell transplantation.

    Science.gov (United States)

    Asano-Mori, Yuki; Kanda, Yoshinobu; Oshima, Kumi; Kako, Shinichi; Shinohara, Akihito; Nakasone, Hideki; Sato, Hiroyuki; Watanabe, Takuro; Hosoya, Noriko; Izutsu, Koji; Asai, Takashi; Hangaishi, Akira; Motokura, Toru; Chiba, Shigeru; Kurokawa, Mineo

    2008-06-01

    To evaluate the efficacy of long-term prophylaxis with ultra-low-dose acyclovir against varicella-zoster virus (VZV) reactivation, we analyzed the records of 242 Japanese adult patients who underwent allogeneic hematopoietic stem cell transplantation for the first time from 1995 to 2006 at our hospital. We started long-term oral acyclovir at 200 mg/day in July 2001. Acyclovir was continued until the end of immunosuppressive therapy and at least 1 year after transplantation. Sixty-six patients developed VZV reactivation at a median of 248 days after HSCT, with a cumulative incidence of 34.7%. Only one breakthrough reactivation occurred during long-term acyclovir, which responded well to therapeutic dose of valacyclovir. The use of long-term acyclovir was the only independent determinant that significantly decreased the overall incidence of VZV reactivation (20% vs. 50%, P < 0.0001). With this prophylaxis, visceral dissemination and serious complications other than post-herpetic neuralgia was completely eliminated, and thereby need for hospitalization was significantly reduced (21% vs. 71%, P = 0.0034). Fifteen of the 57 patients who discontinued acyclovir developed VZV reactivation, with a cumulative incidence of 32.1%. VZV reactivation following discontinuation tended to occur in patients who were receiving immunosuppressive therapy at the cessation of acyclovir. These findings suggested that long-term prophylaxis of ultra-low-dose acyclovir resulted in a successful prevention of severe VZV-related symptoms and death, with a significantly decreased overall incidence of VZV reactivation. Prolongation of prophylactic acyclovir on profound immunosuppression might be important for thorough suppression of VZV reactivation.

  19. Effect of oral acyclovir after penetrating keratoplasty for herpetic keratitis: a placebo-controlled multicenter trial.

    NARCIS (Netherlands)

    Rooij, J.G.M. van; Rijneveld, W.J.; Remeijer, L.; Volker-Dieben, H.J.; Eggink, C.A.; Geerards, A.J.; Mulder, P.G.H.; Doornenbal, P.; Beekhuis, W.H.

    2003-01-01

    OBJECTIVE: To determine the prophylactic effect of oral acyclovir on the recurrence rate of herpetic eye disease after penetrating keratoplasty. DESIGN: A randomized, double-masked, placebo-controlled multicenter trial. PARTICIPANTS: Sixty-eight consecutive patients (68 eyes) with corneal opacities

  20. A Randomized Double-Blind Placebo Controlled Trial of Oral Acyclovir in Renal Allograft Recipients

    Directory of Open Access Journals (Sweden)

    Walter F Schlech

    1993-01-01

    Full Text Available Fifty renal transplant patients were randomized to receive either 800 mg acyclovir by mouth four times daily or identical placebo tablets for prophylaxis of herpes simplex infection. Patients were followed weekly to assess reactivation of herpes simplex, varicella zoster virus, Epstein-Barr virus or cytomegalovirus (CMV infections. The patients received standard immunosuppressive regimens including cyclosporine A. Acyclovir suppressed secretion of herpes simplex virus in treated patients (P=0.001. Three episodes of mucocutaneous herpes simplex virus occurred in placebo recipients and one in a noncompliant acyclovir recipient. A clinically important difference in graft survival was demonstrated, but because of sample size failed to reach statistical significance (P=0.11. No reactivation of varicella zoster virus, Epstein-Barr virus or CMV infection was detected in either group. Toxicity was limited to central nervous irritability. The authors conclude that high dose oral acyclovir provides effective prophylaxis for prevention of herpes simplex virus infections in renal transplantation and may be associated with increased graft survival, perhaps from suppression of CMV infection.

  1. Acyclovir-resistant corneal HSV-1 isolates from patients with herpetic keratitis

    NARCIS (Netherlands)

    R. Duan (Rui); R.D. de Vries (Rory); A.D.M.E. Osterhaus (Ab); L. Remeijer (Lies); G.M.G.M. Verjans (George)

    2008-01-01

    textabstractThe prevalence and molecular characteristics of isolates from 173 immunocompetent patients with herpetic keratitis (HK) whowere infected with acyclovir (ACV)-resistant(ACVR) corneal herpes simplex virus (HSV)-1 was determined. Isolates from 11 (6.4%) of the patients were ACVR, and 9 of t

  2. Prevalence of intrathecal acyclovir resistant virus in herpes simplex encephalitis patients

    NARCIS (Netherlands)

    J.G. Mitterreiter (Johanna G.); M.J. Titulaer (Maarten); G.P. van Nierop (Gijsbert); J.J.A. van Kampen (Jeroen); G.I. Aron; A.D.M.E. Osterhaus (Albert); G.M.G.M. Verjans (George); W.J.D. Ouwendijk (Werner )

    2016-01-01

    textabstractHerpes simplex encephalitis (HSE) is a life-threatening complication of herpes simplex virus (HSV) infection. Acyclovir (ACV) is the antiviral treatment of choice, but may lead to emergence of ACV-resistant (ACVR) HSV due to mutations in the viral UL23 gene encoding for the ACV-targeted

  3. Influence of Low Cetyltrimethylammonium Bromide Concentration on the Interactions and Properties of Hemoglobin with Acyclovir

    Institute of Scientific and Technical Information of China (English)

    LIU Tian-Qing; GUO Rong

    2006-01-01

    The effects of cetyltrimethylammonium bromide (CTAB) on the properties of hemoglobin (Hb) at low CTAB concentration were studied in Hb/acyclovir/CTAB system by the methods of UV-Vis spectrum, fluorescence, zeta potential, conductivity and negative-staining transmission electron microscope (TEM). With the increase of CTAB concentration, the UV peak intensity at 276 nm, the intrinsic fluorescence, the zeta potential of Hb and the system conductivity were all enhanced. Hb was easily oxidized to oxyHb and hemichrome. In Hb/acyclovir/CTAB system,CTAB made the UV-Vis spectrum, fluorescence, conductivity and conformation of Hb tend to be returned to those of the original Hb but the zeta potential not to do so. The UV absorption peak of Hb-acyclovir complex disappeared,and the tight structure of Hb aroused by acyclovir was refolded. When CTAB concentration was higher than 5 ×10-5 mol/L, the two absorption peaks at 536 and 576 nm appeared again, and the Hb structure became looser again.

  4. Determination of Acyclovir in Human Plasma Samples by HPLC Method with UV Detection: Application to Single-Dose Pharmacokinetic Study

    Directory of Open Access Journals (Sweden)

    Dragica Zendelovska

    2015-03-01

    CONCLUSION: Good precision, accuracy, simplicity, sensitivity and shorter time of analysis of the method makes it particularly useful for processing of multiple samples in a limited period of time for pharmacokinetic study of acyclovir.

  5. Enzyme-catalyzed Transesterification of Unusual Substrate: Synthesis of Acyclovir and L-ascorbic Acid (Vitamin C) Vinyl Esters

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    The synthesis of acyclovir and L-ascorbic acid with divinyladipate was performed with alkaline protease from Bacillus subtilis and lipase from Lipozyme (immobilized from Mucor miehei) in different anhydrous organic solvents. Two corresponding derivatives were obtained.

  6. Multicenter randomized study of inosine pranobex versus acyclovir in the treatment of recurrent herpes labialis and recurrent herpes genitalis in Chinese patients.

    Science.gov (United States)

    You, Yi; Wang, Li; Li, Yafei; Wang, Qianqiu; Cao, Shuanglin; Tu, Yating; Li, Shenqiu; Bai, Li; Lu, Jianyun; Wei, Zhiping; Chen, Wenchieh; Hao, Fei

    2015-06-01

    The objective of the study is to evaluate the efficacy and safety of oral inosine pranobex as compared with acyclovir in the treatment of recurrent herpes labialis (RHL) and recurrent herpes genitalis (RHG). A multicenter double-blind, double-dummy, randomized, controlled, parallel group trial was conducted in 144 patients with RHL and 144 RHG. Patients were assigned to treatment in one of two groups: (i) inosine pranobex group (active inosine pranobex, 1 g four times daily, and acyclovir placebo); or (ii) acyclovir group (active acyclovir, 200 mg five times daily, and inosine pranobex placebo). The total symptom score (TSS) of patients with RHL did not differ in the inosine pranobex and acyclovir group on the 3rd or 7th day of treatment. There was also no difference in the efficacy rates between the two groups. No difference of TSS was observed between patients with RHG taking inosine pranobex and acyclovir on days 3 or 5 of the treatment, respectively. The short-term clinical recurrence rate of RHG at 3-month follow-up was much lower in the inosine pranobex group than acyclovir group. The incidence of hyperuricemia was higher in the inosine pranobex group than acyclovir group. In conclusion, inosine pranobex was as effective as acyclovir in treating RHL and RHG with significantly greater reduction of the short-term recurrence rate of herpes genitalis at 3-month follow up. Long-term recurrence rates at 6 months or longer remain to be determined. Hyperuricemia should be monitored during the treatment.

  7. Acyclovir and hydrocortisone cream for the early treatment of recurrent cold sores

    Directory of Open Access Journals (Sweden)

    Carrie A Sailer

    2011-01-01

    Full Text Available Carrie A Sailer1, Spotswood L Spruance2, Christopher M Hull11Department of Dermatology, 2Department of Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, USAAbstract: Current antiviral therapies for herpes simplex labialis primarily reduce healing time. Since the host immune response also plays a role in both controlling recurrent infection as well as producing clinical symptoms, new studies are showing efficacy using topical corticosteroids. This review will evaluate the safety and efficacy of 5% acyclovir–1% hydrocortisone cream (Xerese™[US], Xerclear®[Europe] for treatment of patients with herpes simplex labialis. A large, randomized, double-blind, placebo-controlled study recently demonstrated that treatment with 5% acyclovir–1% hydrocortisone cream significantly decreased the percentage of ulcerative lesions, reduced lesion healing time, and decreased mean lesion area compared with both topical acyclovir alone and vehicle.Keywords: herpes labialis, herpes simplex virus, HSV, acyclovir, hydrocortisone, ME-609, Xerese, Xerclear

  8. Differential scanning calorimetry as a screening technique in compatibility studies of acyclovir extended release formulations

    Energy Technology Data Exchange (ETDEWEB)

    Barboza, Fernanda M.; Vecchia, Debora D. [Universidade Estadual de Ponta Grossa (UEPG), PR (Brazil). Dept. de Ciencias Farmaceuticas. Lab. de Controle de Qualidade; Tagliari, Monika P.; Ferreira, Andrea Granada; Silva, Marcos A.S.; Stulzer, Hellen K., E-mail: hellen.stulzer@gmail.co [Universidade Federal de Santa Catarina (UFSC), Florianopolis, SC (Brazil). Dept. de Ciencias Farmaceuticas. Lab. de Controle de Qualidade

    2009-07-01

    Acyclovir (ACV) has been investigated during the past years, mainly due to its antiviral activity. Assessment of possible incompatibility between an active component and different excipients along with the evaluation of thermal stability are crucial parts of a normal study prior to the final formulation setting of a medicine. Thermal analysis studies were used as important and complementary tools during pre-formulation to determine the compatibility of drug excipients with the purpose of developing an acyclovir extended release formulation. Fourier transform infrared spectroscopy and X-ray powder diffraction analyses were also realized. The results showed that ACV only exhibited interaction which could influence the stability of the product in the binary mixtures of ACV/magnesium stearate. (author)

  9. Structural and Theoretical Evidence of the Depleted Proton Affinity of the N3-Atom in Acyclovir

    Directory of Open Access Journals (Sweden)

    Esther Vílchez-Rodríguez

    2016-10-01

    Full Text Available The hydronium salt (H3O2[Cu(N7–acv2(H2O2(SO42]·2H2O (1, acv = acyclovir has been synthesized and characterized by single-crystal X-ray diffraction and spectral methods. Solvated Cu(OH2 is a by-product of the synthesis. In the all-trans centrosymmetric complex anion, (a the Cu(II atom exhibits an elongated octahedral coordination; (b the metal-binding pattern of acyclovir (acv consists of a Cu–N7(acv bond plus an (aquaO–H···O6(acv interligand interaction; and (c trans-apical/distal sites are occupied by monodentate O-sulfate donor anions. Neutral acyclovir and aqua-proximal ligands occupy the basal positions, stabilizing the metal binding pattern of acv. Each hydronium(1+ ion builds three H-bonds with O–sulfate, O6(acv, and O–alcohol(acv from three neighboring complex anions. No O atoms of solvent water molecules are involved as acceptors. Theoretical calculations of molecular electrostatic potential surfaces and atomic charges also support that the O-alcohol of the N9(acv side chain is a better H-acceptor than the N3 or the O-ether atoms of acv.

  10. Oxidation of the antiviral drug acyclovir and its biodegradation product carboxy-acyclovir with ozone: kinetics and identification of oxidation products.

    Science.gov (United States)

    Prasse, Carsten; Wagner, Manfred; Schulz, Ralf; Ternes, Thomas A

    2012-02-21

    The oxidation of the antiviral drug acyclovir (ACV) and its main biotransformation product carboxy-acyclovir (carboxy-ACV) by ozone was investigated. Both compounds have recently been detected in surface water, and carboxy-ACV has also been detected in drinking water. The experiments revealed a strong pH dependence of the oxidation of ACV and carboxy-ACV with reaction rate constants increasing by 4 orders of magnitude between the protonated, positively charged form (k(ox,PH(+)), ∼2.5 × 10(2) M(-1) s(-1)) and the deprotonated, negatively charged form (k(ox,P(-)), 3.4 × 10(6) M(-1) s(-1)). At pH 8 a single oxidation product was formed which was identified via LC-LTQ-Orbitrap MS and NMR as N-(4-carbamoyl-2-imino-5-oxoimidazolidin)formamido-N-methoxyacetic acid (COFA). Using Vibrio fischeri , an acute bacterial toxicity was found for COFA while carboxy-ACV revealed no toxic effects. Ozonation experiments with guanine and guanosine at pH 8 led to the formation of the respective 2-imino-5-oxoimidazolidines, confirming that guanine derivatives such as carboxy-ACV are undergoing the same reactions during ozonation. Furthermore, COFA was detected in finished drinking water of a German waterworks after ozonation and subsequent activated carbon treatment.

  11. Evaluation of the effects of acyclovir and/or human amniotic membrane on herpes virus culture and quantitative virus inactivity by real-time polymerase chain reaction

    Institute of Scientific and Technical Information of China (English)

    Feride; Aylin; Kantarci; Ali; Reza; Faraji; Aykut; Ozkul; Fikret; Akata

    2014-01-01

    ·AIM: To investigate the permeability of amniotic membrane in herpes virus cell culture to acyclovir with real time polymerase chain reaction(RT-PCR).·METHODS: Madin-Darby Bovine Kidney(MDBK) cell culture and Bovine Herpes Virus(BHV1) type 1 were used in the study. Cell cultures were grouped into two on the basis of herpes virus inoculation. Each group was sub-grouped into three. Amniotic membrane(V-HAM),acyclovir(V-A), and amniotic membrane and acyclovir(V-HAM-A) were applied to these subgroup cultures,respectively. After the application of the membrane and the drug, the cultures were evaluated at 24 and 48 h for cytopathic effect positive(CPE +) with a tissue culture microscope. In the CPE(+) samples, the DNA was extracted for viral DNA analysis by RT-PCR.·RESULTS: In control cultures without herpes virus CPE was not detected. Besides, amniotic membrane and acyclovir did not have cytotoxic effect on cell cultures.CPE were detected in Bovine Herpesvirus type-1inoculated cell cultures after amniotic membrane and/or acyclovir application. DNA analysis with RT-PCR indicated that Cycle threshold(Ct) values were lower in the BHV1 and membrane applied group(amniotic membrane group < acyclovir group < membrane and acyclovir group). This showed that membrane did not have antiviral effect. The membrane and acyclovir cell culture groups with high Ct values indicated thatmembrane was permeable and had a low barrier effect to drug.·CONCLUSION: In our in-vitro study, we found that amniotic membrane, which can be used in the treatment of corneal diseases, did not have antiviral effect. Besides,we detected that amniotic membrane was permeable to acyclovir in BHV-1 inoculated MDBK cell culture.However, more studies are necessary to investigate the quantitative effects of amniotic membrane and acyclovir.

  12. Amino acid substitutions in the thymidine kinase gene of induced acyclovir-resistant herpes simplex virus type 1

    Science.gov (United States)

    Hussin, Ainulkhir; Nor, Norefrina Shafinaz Md; Ibrahim, Nazlina

    2013-11-01

    Acyclovir (ACV) is an antiviral drug of choice in healthcare setting to treat infections caused by herpes viruses, including, but not limited to genital herpes, cold sores, shingles and chicken pox. Acyclovir resistance has emerged significantly due to extensive use and misuse of this antiviral in human, especially in immunocompromised patients. However, it remains unclear about the amino acid substitutions in thymidine (TK) gene, which specifically confer the resistance-associated mutation in herpes simplex virus. Hence, acyclovir-resistant HSV-1 was selected at high concentration (2.0 - 4.5 μg/mL), and the TK-gene was subjected to sequencing and genotypic characterization. Genotypic sequences comparison was done using HSV-1 17 (GenBank Accesion no. X14112) for resistance-associated mutation determination whereas HSV-1 KOS, HSV-1 473/08 and HSV clinical isolates sequences were used for polymorphism-associated mutation. The result showed that amino acid substitutions at the non-conserved region (UKM-1: Gln34Lys, UKM-2: Arg32Ser & UKM-5: Arg32Cys) and ATP-binding site (UKM-3: Tyr53End & UKM-4: Ile54Leu) of the TK-gene. These discoveries play an important role to extend another dimension to the evolution of acyclovir-resistant HSV-1 and suggest that selection at high ACV concentration induced ACV-resistant HSV-1 evolution. These findings also expand the knowledge on the type of mutations among acyclovir-resistant HSV-1. In conclusion, HSV-1 showed multiple strategies to exhibit acyclovir resistance, including amino acid substitutions in the TK gene.

  13. Acyclovir-loaded sorbitan esters-based organogel: development and rheological characterization.

    Science.gov (United States)

    Rajpoot, Kuldeep

    2017-05-01

    Herein, a nanoemulsion-based organogel (NEOG) system loaded with acyclovir has been developed for the effective treatment of herpes simplex virus infection via topical delivery. Pseudo-ternary phase diagram exhibited increase in non-birefrigent, optically isotropic region of organogel with Smix (Kw) ratio. The NEOG C showed good storage (G') and loss moduli (G″), and more compact network structures. Gel-sol transition temperature (Tg) and fractal dimension (Df) of NEOG system revealed increased density of the tubular network with Kw. Hence, high gelling ability of the developed NEOG system may attribute to the combination of sustained and site-specific delivery of drugs.

  14. Evaluation of cross-linked chitosan microparticles containing acyclovir obtained by spray-drying

    Energy Technology Data Exchange (ETDEWEB)

    Stulzer, Hellen Karine [Laboratorio Quitech, Departamento de Quimica, Universidade Federal de Santa Catarina (Brazil); Laboratorio de Controle de Qualidade, Departamento de Ciencias Farmaceuticas, Universidade Federal de Santa Catarina (Brazil); Laboratorio de Controle de Qualidade, Departamento de Ciencias Farmaceuticas, Universidade Estadual de Ponta Grossa (Brazil)], E-mail: hellen.stulzer@gmail.com; Tagliari, Monika Piazzon [Laboratorio de Controle de Qualidade, Departamento de Ciencias Farmaceuticas, Universidade Federal de Santa Catarina (Brazil); Parize, Alexandre Luis [Laboratorio Quitech, Departamento de Quimica, Universidade Federal de Santa Catarina (Brazil); Silva, Marcos Antonio Segatto [Laboratorio de Controle de Qualidade, Departamento de Ciencias Farmaceuticas, Universidade Federal de Santa Catarina (Brazil); Laranjeira, Mauro Cesar Marghetti [Laboratorio Quitech, Departamento de Quimica, Universidade Federal de Santa Catarina (Brazil)

    2009-03-01

    The aim of this study was to obtain microparticles containing acyclovir (ACV) and chitosan cross-linked with tripolyphosphate using the spray-drying technique. The resultant system was evaluated through loading efficiency, differential scanning calorimetry (DSC), thermogravimetric analysis (TG), X-ray powder diffraction (XRPD), scanning electron microscopy (SEM), in vitro release and stability studies. The results obtained indicated that the polymer/ACV ratio influenced the final properties of the microparticles, with higher ratios giving the best encapsulation efficiency, dissolution profiles and stability. The DSC and XRPD analyses indicated that the ACV was transformed into amorphous form during the spray-drying process.

  15. Formulation and evaluation of acyclovir nanosuspension for enhancement of oral bioavailability

    Directory of Open Access Journals (Sweden)

    Mangesh Ramesh Bhalekar

    2014-01-01

    Full Text Available Acyclovir, an antiviral drug used against herpes simplex virus and varicella zoster virus. The dose ranges between 200 and 800 mg and the oral bioavailability is 10-20%, which decreases as the dose is increased. The aim of this research work was to formulate and characterize nanosuspensions of acyclovir with an intention to increase the oral bioavailability. Nanosuspensions were prepared by the precipitation-ultra sonication method and the effects of important process parameters i.e., precipitation temperature, stirring speed, end point temperature of probe sonicator, energy input and sonication time were investigated systematically, the optimal nanosuspension (particle size 274 nm was obtained at values of 4°C, 10,000 rpm, 30°C, 600 Watt and 20 min, respectively. The nanosuspension was lyophilized using different matrix formers and sucrose (100% w/w to drug was found to prevent agglomeration and particle size upon reconstitution was found to be 353 nm. The lyophilized nanocrystals appeared flaky in scanning electron microscopy images, the X-ray powder diffraction and differential scanning calorimetry analysis showed the nanoparticles to be in the crystalline state. Ex vivo permeation study for calculating absorption rate and in vivo bioavailability area under the curve both showed three-fold increase over marketed suspension.

  16. Development and Validation of Acyclovir HPLC External Standard Method in Human Plasma: Application to Pharmacokinetic Studies

    Directory of Open Access Journals (Sweden)

    Selvadurai Muralidharan

    2014-01-01

    Full Text Available A simple, rapid, and selective RP-HPLC method was developed for the estimation of acyclovir in human plasma. The method involves a simple protein precipitation technique. Chromatographic separation was carried out on a reverse phase C18 column using mixture of 5 mM ammonium acetate (pH 4.0 and acetonitrile (40 : 60, v/v at a flow rate of 1.0 mL/min with UV detection at 290 nm. The retention time of acyclovir was 4.12 minutes. The method was validated and found to be linear in the range of 25.0–150.0 ng/mL. Validation studies were achieved by using the fundamental parameters, including accuracy, precision, selectivity, sensitivity, linearity and range, stability studies, limit of detection (LOD, and limit of quantitation (LOQ. It shows recovery at 91.0% which is more precise and accurate compared to the other method. These results indicated that the bioanalytical method was linear, precise, and accurate. The new bioanalytical method was successfully applied to a pharmacokinetic linearity study in human plasma.

  17. Synergistic penetration of ethosomes and lipophilic prodrug on the transdermal delivery of acyclovir.

    Science.gov (United States)

    Zhou, Yan; Wei, Yu-Hui; Zhang, Guo-Qiang; Wu, Xin-An

    2010-04-01

    The aim of this study was to investigate the lipophilic prodrug as a means of promoting acyclovir (ACV) that exhibited biphasic insolubility into the ethosomes for optimum skin delivery. Acyclovir Palmitate (ACV-C(16)) was synthesized as the lipophilic prodrug of ACV. The ethosomal system and the liposomal system bearing ACV or ACV-C(16) were prepared, respectively. The systems were characterized for shape, zeta potential value, particle size, and entrapment efficiency. Franz diffusion cells and confocal laser scanning microscopy were used for the percutaneous absorption studies. The results showed that the entrapment efficiency of ACV-C(16) ethosomes (87.75%) were much higher than that of ACV ethosomes (39.13%). The quantity of drug in the skin from ACV-C(16) ethosomes at the end of the 24 h transdermal experiment (622.89 microg/cm(2)) was 5.30 and 3.43 times higher than that from ACV-C(16) hydroalcoholic solution and ACV ethosomes, respectively. This study indicated that the binary combination of the lipophilic prodrug ACV-C(16) and the ethosomes synergistically enhanced ACV absorption into the skin.

  18. Pemphigus vulgaris in a patient with arthritis and uveitis: successful treatment with immunosuppressive therapy and acyclovir.

    Science.gov (United States)

    Pranteda, G; Carlesimo, M; Bottoni, U; Di Napoli, A; Muscianese, M; Pimpinelli, F; Cordiali, P; Laganà, B; Pranteda, G; Di Carlo, A

    2014-01-01

    A case of pemphigus vulgaris in a 41-year-old man with undifferentiated arthritis and uveitis is described. Histology of labial mucosa showed acantholytic, necrotic, and multinucleated giant keratinocytes having some nuclear inclusions suggestive of a virus infection. Specific serological tests revealed IgG positivity for HSV-1, CMV, and EBV, while real-time polymerase chain reaction assay from a biopsy of the mucosal lesion showed the presence of HSV-1/2 DNA. Treatment with prednisone, methotrexate, and acyclovir induced the complete remission of mucosal and joint symptoms, which then relapsed after interruption of antiviral therapy or immunosuppressive therapy. Therefore, a combined treatment with low doses of prednisone, methotrexate, and acyclovir was restarted and during 18 months of follow-up no recurrence was registered. Correlations between pemphigus and the herpes virus infection and also between autoimmune arthritis and herpetic agents have been well documented, but the exact role of the herpes virus in these disorders still needs further discussion. Our case strongly suggests that when autoimmune disorders do not respond to immunosuppressive agents, a viral infection should be suspected, researched, and treated.

  19. Randomized clinical study comparing Compeed (R) cold sore patch to acyclovir cream 5% in the treatment of herpes simplex labialis

    DEFF Research Database (Denmark)

    Karlsmark, T.; Goodman, J.J.; Drouault, Y.

    2008-01-01

    . Methods An assessment of CSP efficacy and safety was conducted in an international, multicentre, assessor-blinded study, which enrolled 728 subjects with a history of recurrent HSL. Of these, 351 experienced an HSL outbreak and were randomized to use CSP (n = 179) or acyclovir cream 5% (n = 172...

  20. Disposition kinetics of a dipeptide ester prodrug of acyclovir and its metabolites following intravenous and oral administrations in rat.

    Science.gov (United States)

    Talluri, Ravi S; Gaudana, Ripal; Hariharan, Sudharshan; Jain, Ritesh; Mitra, Ashim K

    2009-01-01

    The objective of this work was to study the disposition kinetics of valine-valine-acyclovir (VVACV), a dipeptide ester prodrug of acyclovir following intravenous and oral administrations in rat. A validated LC-MS/MS analytical method was developed for the analysis VVACV, Valine-Acyclovir (VACV), and Acyclovir (ACV) using a linear Ion Trap Quadrupole. ACV was administered orally for comparison purpose. In the VVACV group, both blood and urine samples and in the ACV group only blood samples were collected. All the samples were analyzed using LC-MS/MS. The LLOQ for ACV, VACV, and VVACV were 10, 10, and 50 ng/ml, respectively. Relevant pharmacokinetic parameters were obtained by non-compartmental analyses of data with WinNonlin. Following i.v. administration of VVACV, AUC(0-inf) (min*µM) values for VVACV, VACV, and ACV were 55.06, 106, and 466.96, respectively. The AUC obtained after oral administration of ACV was 178.8. However, following oral administration of VVACV, AUC(0-inf) values for VACV and ACV were 89.28 and 810.77, respectively. Thus the exposure of ACV obtained following oral administration of VVACV was almost 6-fold higher than ACV. This preclinical pharmacokinetic data revealed that VVACV has certainly improved the oral bioavailability of ACV and is an effective prodrug for oral delivery of ACV.

  1. The Influence of Chitosan on the Oral Bioavailability of Acyclovir-a Comparative Bioavailability Study in Humans

    NARCIS (Netherlands)

    Kubbinga, M.; Nguyen, M.A.; Staubach, P.; Teerenstra, S.; Langguth, P.

    2015-01-01

    PURPOSE: The effects of chitosan hydrochloride on the oral absorption of acyclovir in humans were studied to confirm the absorption enhancing effects reported for in vitro and rat studies, respectively. METHODS: A controlled, open-label, randomized, 3-phase study was conducted in 12 healthy human vo

  2. Influences of Triton X-100 on Hemoglobin Behaviors in Hemoglobin/Acyclovir/Triton X-100/H2O System

    Institute of Scientific and Technical Information of China (English)

    LIU,Tian-Qing; GUO,Rong

    2007-01-01

    The influences of Triton X-100 on hemoglobin(Hb)behaviors were studied by the methods of UV-Vis spectrum,fluorescence spectrum,HPLC,conductivity,zeta potential and negative-staining transmission electron microscope in Hb/acyclovir/Triton X-100/H2O system.With the increase of Triton X-100 concentration in the system,the percentage of the free acyclovir increased from 58%-63% to 90%-94%.The static quenching constant and the association number of acyclovir to Hb decreased.The fluorescence spectrum,conductivity,zeta potential,fluorescence polarization and negative-staining morphology of Hb tended to recover to those of the original state of Hb in the same concentration of Hb.The interaction between Triton X-100 and Hb is stronger than that between acyclovir and Hb.Most Triton-X-100 was associated with Hb at low Triton X-100 concentration.But the interaction of Triton X-100 with Hb was apparently dominant in high Triton X-100 concentration.The Hb structure was unfolded and finally denatured.

  3. Formulation and evaluation of mucoadhesive buccal patch of acyclovir utilizing inclusion phenomenon

    Directory of Open Access Journals (Sweden)

    Ankita Saxena

    2011-12-01

    Full Text Available Mucoadhesive buccal patch releasing drug in the oral cavity at a predetermined rate may present distinct advantages over traditional dosage forms, such as tablets, gels and solutions. A buccal patch for systemic administration of acyclovir in the oral cavity was developed using polymers hydroxy propyl methyl cellulose (K4M, hydroxy propyl methyl cellulose (K15M, sodium carboxy methyl cellulose and poly vinyl pyrolidone (K30, plasticizer poly ethylene glycol (400 and a backing membrane of Eudragit (RL100. The films were evaluated in terms of swelling, residence time, mucoadhesion, release, and organoleptic properties. The optimized films showed lower release as compared to controlled drug delivery systems. Hence, an inclusion complex of acyclovir was prepared with hydrophilic polymer hydroxylpropyl beta-cyclodextrin in the molar ratio of 1:1. The inclusion complex was characterized by optical microscopy, FAB mass spectroscopy, and FTIR spectroscopy. Patches formulated with the acyclovir inclusion complex were evaluated along the same lines as those containing acyclovir alone. The in vitro release data revealed a substantial increase from 64.35% to 88.15% in the case of PS I and PS II batches, respectively, confirming the successful use of inclusion complexes for the formulation of buccal patch of acyclovir.Mucoadesivos bucais liberadores de fármacos para a cavidade oral com taxa de liberação pré-determinada podem apresentar distintas vantagens em relação às formas farmacêuticas convencionais como comprimidos, géis e soluções. Neste trabalho, um adesivo bucal para administração sistêmica de aciclovir através da cavidade oral foi desenvolvido empregando-se os polímeros hidroxipropilmetil celulose (K4M, hidroxipropilmetil celulose (K15M, carboximetil celulose sódica e polivinil pirrolidona (K30, polietilenoglicol plastificado (400 e uma membrana suporte de Eudragit (RL100. Os filmes obtidos foram avaliados em termos de

  4. Comparative permeability of some acyclovir derivatives through native mucus and crude mucin dispersions.

    Science.gov (United States)

    Legen; Kristl, A

    2001-08-01

    The permeability of some guanine derivatives (acyclovir [ACV], deoxyacyclovir [DCV], and their N-acetyl congeners) through native porcine mucus and crude porcine mucin dispersions (30% and 50% w/v) was investigated in two-compartment dialysis cells. High correlation between apparent permeability coefficients Papp of tested substances determined in these two models was observed, although the examined compounds permeated faster through the native mucus. It was also established that Papp values decrease with increasing hydrophilicity and molecular mass of the tested substances. Furthermore, the influence of some substances that affect mucus structure (cysteine, N-acetylcysteine [NCY], sodium taurocholate [ST], and sodium chloride) on the permeation rate of the examined compounds through mucus and mucin dispersions was examined. It was shown that the Papp values of guanine derivatives were generally lower after the addition of these substances to the native mucus and mucin dispersions, although the lowering effect was more pronounced in the case of native mucus.

  5. SEARCH OF INHIBITORS OF HERPES VIRAL REPLICATION: 30 YEARS AFTER ACYCLOVIR

    Directory of Open Access Journals (Sweden)

    Korovina A. N.

    2013-08-01

    Full Text Available Analysis of study and using of different chemical compounds as inhibitors of herpes virus replication is given in the review. However, it does not apply for full details of all the studies on active antiherpetic drugs finding. It’s been over 30 years since the discovery of the first antiherpetic drugs ? acyclovir. Meanwhile, lots of active chemical compounds appeared that have been brought to the antiviral drugs. An essential understanding of strategies for finding drugs came in, one of which was establishment of depot forms of antiherpetic drugs. On the basis of the vast published experimental material the authors concluded that the study of the herpes virus and search for inhibitors of its replication is still an important issue and requires the efforts of chemists, biologists, pharmacists.

  6. Latent acyclovir-resistant herpes simplex virus type 1 in trigeminal ganglia of immunocompetent individuals.

    Science.gov (United States)

    van Velzen, Monique; van Loenen, Freek B; Meesters, Roland J W; de Graaf, Miranda; Remeijer, Lies; Luider, Theo M; Osterhaus, Albert D M E; Verjans, Georges M G M

    2012-05-15

    Specific mutations within the hypervariable herpes simplex virus (HSV) gene thymidine kinase (TK) gene lead to acyclovir (ACV) resistance. To uncover the existence of latent ACV-resistant (ACV(R)) HSV-1, we determined the genetic and functional variability of the HSV-1 TK gene pool in paired trigeminal ganglia (TG) of 5 immunocompetent individuals. The latent virus pool consisted of a donor-specific HSV-1 quasispecies, including one major ACV-sensitive (ACV(S)) and multiple phylogenetic-related minor ACV(S) and ACV(R) TK variants. Contrary to minor variants, major TK variants were shared between paired TG. The data demonstrate the coexistence of phylogenetic-related ACV(S) and ACV(R) latent HSV-1 in human TG.

  7. Acyclovir-resistant corneal HSV-1 isolates from patients with herpetic keratitis.

    Science.gov (United States)

    Duan, Rui; de Vries, Rory D; Osterhaus, Albert D M E; Remeijer, Lies; Verjans, Georges M G M

    2008-09-01

    The prevalence and molecular characteristics of isolates from 173 immunocompetent patients with herpetic keratitis (HK) who were infected with acyclovir (ACV)-resistant (ACV(R)) corneal herpes simplex virus (HSV)-1 was determined. Isolates from 11 (6.4%) of the patients were ACV(R), and 9 of these 11 patients were refractory to therapy with ACV; the ACV(R) isolates from 5 and 1 of these 9 patients were cross-resistant to gancyclovir and to both gancyclovir and foscarnet, respectively. Of the 11 ACV(R) isolates, 10 had, in the thymidine kinase gene, mutations that presumably conferred the ACV(R) phenotype. These data demonstrate a relatively high prevalence of corneal HSV-1 ACV(R) isolates in patients with HK, which emphasizes the need to monitor for ACV susceptibility in patients with HK who are refractory to therapy with ACV.

  8. Acyclovir Injection

    Science.gov (United States)

    ... effects of your treatment using laboratory tests and physical examinations. It is important to keep all appointments ... health care provider as soon as possible: tenderness warmth irritation drainage redness swelling pain

  9. Acyclovir Prophylaxis Reduces the Incidence of Herpes Zoster Among HIV-Infected Individuals: Results of a Randomized Clinical Trial.

    Science.gov (United States)

    Barnabas, Ruanne V; Baeten, Jared M; Lingappa, Jairam R; Thomas, Katherine K; Hughes, James P; Mugo, Nelly R; Delany-Moretlwe, Sinead; Gray, Glenda; Rees, Helen; Mujugira, Andrew; Ronald, Allan; Stevens, Wendy; Kapiga, Saidi; Wald, Anna; Celum, Connie

    2016-02-15

    Human immunodeficiency virus (HIV)-infected persons have higher rates of herpes zoster than HIV-uninfected individuals. We assessed whether twice daily treatment with 400 mg of oral acyclovir reduces the incidence of herpes zoster in a randomized, double-blind, placebo-controlled trial among 3408 persons coinfected with HIV and herpes simplex virus type 2. During 5175 person-years of follow-up, 26 cases of herpes zoster occurred among those assigned acyclovir, compared with 69 cases among those assigned placebo (rates, 1.00 and 2.68/100 person-years, respectively), a relative decrease of 62% (hazard ratio, 0.38; 95% confidence interval, .24-.67; P herpes zoster incidence among HIV-infected persons.

  10. Acyclovir Lauriad(®): a muco-adhesive buccal tablet for the treatment of recurrent herpes labialis.

    Science.gov (United States)

    Downing, Christopher; Moayyad, Jonathan; Tamirisa, Aparna; Tyring, Stephen

    2014-03-01

    The treatment of recurrent herpes labialis remains a challenge in the 21st century. The virus is ubiquitous and there is no vaccine against the disease. Although recurrence episodes are usually of shorter duration than the primary episode, they are debilitating to patients and there is significant stigma associated with the disease. Acyclovir Lauriad(®) is a new topical agent that was approved by the US FDA in 2013 for the treatment of recurrent herpes labialis, which affects approximately 20-40% of the population worldwide. The drug is a muco-adhesive tablet, applied to the upper gum at the onset of prodromal symptoms. Utilizing Lauriad(®) technology, a biologically active compound traverses the mucous membrane to deliver a high concentration of acyclovir directly to the site of the herpes simplex virus infection. Data from a Phase III clinical trial shows that this may be a promising therapy for patients with recurrent herpes labialis.

  11. Comparison of the Efficacy of Combination Therapy of Prednisolone-Acyclovir with Prednisolone Alone in Bell’s Palsy

    Directory of Open Access Journals (Sweden)

    Ali KHAJEH

    2015-06-01

    Full Text Available How to Cite This Article: Khajeh A, Fayyazi A, Soleimani Gh, Miri-Aliabad Gh, Shaykh Veisi S, Khajeh B. Comparison of the Efficacy ofCombination Therapy of Prednisolone-Acyclovir with Prednisolone Alone in Bell’s Palsy. Iran J Child Neurol. Spring 2015; 9(2:17-20.AbstractObjectiveBell’s palsy is a rapid onset, usually, unilateral paralysis of the facial nerve that causes significant changes in an individual’s life such as a decline in personal, social, and educational performance. This study compared efficacy of combined prednisolone and acyclovir therapy with prednisolone alone.Materials & MethodsThis study is a randomized controlled trial conducted on 43 Children (2–18 years old with Bell’s palsy. The first group of 23 patients was treated with prednisolone and the remaining patients were treated with a combination of prednisolone and acyclovir. The required data were extracted, using an informational form based on the House-Brackmann Scale, which grades facial nerve paralysis. The data were analyzed with Mann-Whitney test using SPSS version 16.ResultsThe mean age of the first and second group were 8.65 ± 5.07 and 8.35 ± 4.92 years, respectively, (p=0.84. Sixty one percent and 39% of patients in the first group, and 45% and 55% of patients in the second group were male and female, respectively. No significant differences exist between the groups in terms of age and gender. The rate of complete recovery was 65.2% in group I and 90% in the group II (p=0.04.ConclusionThe results of this study showed that the combined prednisolone and acyclovir therapy of patients with Bell’s palsy is far more effective than treatment with prednisolone alone. Actually, age and gender had no impact on the rate of recovery.

  12. Chitosan and Kappa-Carrageenan Vaginal Acyclovir Formulations for Prevention of Genital Herpes. In Vitro and Ex Vivo Evaluation

    Science.gov (United States)

    Sánchez-Sánchez, María-Pilar; Martín-Illana, Araceli; Ruiz-Caro, Roberto; Bermejo, Paulina; Abad, María-José; Carro, Rubén; Bedoya, Luis-Miguel; Tamayo, Aitana; Rubio, Juan; Fernández-Ferreiro, Anxo; Otero-Espinar, Francisco; Veiga, María-Dolores

    2015-01-01

    Vaginal formulations for the prevention of sexually transmitted infections are currently gaining importance in drug development. Polysaccharides, such as chitosan and carrageenan, which have good binding capacity with mucosal tissues, are now included in vaginal delivery systems. Marine polymer-based vaginal mucoadhesive solid formulations have been developed for the controlled release of acyclovir, which may prevent the sexual transmission of the herpes simplex virus. Drug release studies were carried out in two media: simulated vaginal fluid and simulated vaginal fluid/simulated seminal fluid mixture. The bioadhesive capacity and permanence time of the bioadhesion, the prepared compacts, and compacted granules were determined ex vivo using bovine vaginal mucosa as substrate. Swelling processes were quantified to confirm the release data. Biocompatibility was evaluated through in vitro cellular toxicity assays, and the results showed that acyclovir and the rest of the materials had no cytotoxicity at the maximum concentration tested. The mixture of hydroxyl-propyl-methyl-cellulose with chitosan- or kappa-carrageenan-originated mucoadhesive systems that presented a complete and sustained release of acyclovir for a period of 8–9 days in both media. Swelling data revealed the formation of optimal mixed chitosan/hydroxyl-propyl-methyl-cellulose gels which could be appropriated for the prevention of sexual transmission of HSV. PMID:26393621

  13. Chitosan and Kappa-Carrageenan Vaginal Acyclovir Formulations for Prevention of Genital Herpes. In Vitro and Ex Vivo Evaluation

    Directory of Open Access Journals (Sweden)

    María-Pilar Sánchez-Sánchez

    2015-09-01

    Full Text Available Vaginal formulations for the prevention of sexually transmitted infections are currently gaining importance in drug development. Polysaccharides, such as chitosan and carrageenan, which have good binding capacity with mucosal tissues, are now included in vaginal delivery systems. Marine polymer-based vaginal mucoadhesive solid formulations have been developed for the controlled release of acyclovir, which may prevent the sexual transmission of the herpes simplex virus. Drug release studies were carried out in two media: simulated vaginal fluid and simulated vaginal fluid/simulated seminal fluid mixture. The bioadhesive capacity and permanence time of the bioadhesion, the prepared compacts, and compacted granules were determined ex vivo using bovine vaginal mucosa as substrate. Swelling processes were quantified to confirm the release data. Biocompatibility was evaluated through in vitro cellular toxicity assays, and the results showed that acyclovir and the rest of the materials had no cytotoxicity at the maximum concentration tested. The mixture of hydroxyl-propyl-methyl-cellulose with chitosan- or kappa-carrageenan-originated mucoadhesive systems that presented a complete and sustained release of acyclovir for a period of 8–9 days in both media. Swelling data revealed the formation of optimal mixed chitosan/hydroxyl-propyl-methyl-cellulose gels which could be appropriated for the prevention of sexual transmission of HSV.

  14. Turning an antiviral into an anticancer drug: nanoparticle delivery of acyclovir monophosphate.

    Science.gov (United States)

    Yao, Jing; Zhang, Yuan; Ramishetti, Srinivas; Wang, Yuhua; Huang, Leaf

    2013-09-28

    Anti-herpes simplex virus (HSV) drug acyclovir (ACV) is phosphorylated by the viral thymidine kinase (TK), but not the cellular TK. Phosphorylated ACV inhibits cellular DNA synthesis and kills the infected cells. We hypothesize that ACV monophosphate (ACVP), which is an activated metabolite of ACV, should be efficient in killing cells independent of HSV-TK. If so, ACVP should be a cytotoxic agent if properly delivered to the cancer cells. The Lipid/Calcium/Phosphate (LCP) nanoparticles (NPs) with a membrane/core structure were used to encapsulate ACVP to facilitate the targeted delivery of ACVP to the tumor. The LCP NPs showed entrapment efficiency of ~70%, the nano-scaled particle size and positive zeta potential. Moreover, ACVP-loaded LCP NPs (A-LCP NPs) exhibited concentration-dependent cytotoxicity against H460 cells and increased S-phase arrest. More importantly, a significant reduction of the tumor volume over 4 days following administration (pACV and ACVP) and blank LCP NPs showed little or no therapeutic effect. It was also found that the high efficacy of A-LCP NPs was associated with the ability to induce dramatic apoptosis of the tumor cells, as well as significantly inhibit tumor cell proliferation and cell cycle progression. In conclusion, with the help of LCP NPs, monophosphorylation modification of ACV can successfully modify an HSV-TK-dependent antiviral drug into an anti-tumor drug.

  15. Inclusion complex of the antiviral drug acyclovir with cyclodextrin in aqueous solution and in solid phase

    Directory of Open Access Journals (Sweden)

    Carlos von Plessing Rossel

    2000-12-01

    Full Text Available Complexation between acyclovir (ACV, an antiviral drug used for the treatment of herpes simplex virus infection, and beta-cyclodextrin (beta-CD was studied in solution and in solid states. Complexation in solution was evaluated using solubility studies and nuclear magnetic resonance spectroscopy (¹H-NMR. In the solid state, X-ray diffraction, differential scanning calorimetry (DSC, thermal gravimetric analysis (TGA and dissolution studies were used. Solubility studies suggested the existence of a 1:1 complex between ACV and beta-CD. ¹H-NMR spectroscopy studies showed that the complex formed occurs with a stoichiometry ratio of 1:1. Powder X-ray diffraction indicated that ACV exists in a semicrystalline state in the complexed form with beta-CD. DSC studies showed the existence of a complex of ACV with beta-CD. The TGA studies confirmed the DSC results of the complex. Solubility of ACV in solid complexes was studied by the dissolution method and it was found to be much more soluble than the uncomplexed drug.

  16. Preparation and characterization of nanoparticles of carboxymethyl cellulose acetate butyrate containing acyclovir

    Science.gov (United States)

    Vedula, Venkata Bharadwaz; Chopra, Maulick; Joseph, Emil; Mazumder, Sonal

    2016-02-01

    Nanoparticles of carboxymethyl cellulose acetate butyrate complexed with the poorly soluble antiviral drug acyclovir (ACV) were produced by precipitation process and the formulation process and properties of nanoparticles were investigated. Two different particle synthesis methods were explored—a conventional precipitation method and a rapid precipitation in a multi-inlet vortex mixer. The particles were processed by rotavap followed by freeze-drying. Particle diameters as measured by dynamic light scattering were dependent on the synthesis method used. The conventional precipitation method did not show desired particle size distribution, whereas particles prepared by the mixer showed well-defined particle size ~125-450 nm before and after freeze-drying, respectively, with narrow polydispersity indices. Fourier transform infrared spectroscopy showed chemical stability and intactness of entrapped drug in the nanoparticles. Differential scanning calorimetry showed that the drug was in amorphous state in the polymer matrix. ACV drug loading was around 10 wt%. The release studies showed increase in solution concentration of drug from the nanoparticles compared to the as-received crystalline drug.

  17. Proteomic characterization of acyclovir-induced nephrotoxicity in a mouse model.

    Science.gov (United States)

    Lu, Hong; Han, Ya-Juan; Xu, Jia-Dong; Xing, Wen-Min; Chen, Jie

    2014-01-01

    Acyclovir (ACV) is an effective and widely used antiviral agent. However, its clinical application is limited by severe nephrotoxicity. We assessed ACV-induced nephrotoxicity and identified the differentially expressed proteins using mass spectrometry-based proteomic analysis. In total, 30 ICR mice were intraperitoneally administrated ACV (150 or 600 mg/kg per day) for 9 days. After administration of ACV, levels of serum creatinine and urea nitrogen increased significantly. In addition, mouse kidneys exhibited histopathological changes and reduced expression levels of vascular endothelial growth factor (VEGF) and its receptor VEGFR2. In the proteomic analysis, more than 1,000 proteins were separated by two-dimensional polyacrylamide gel electrophoresis, and a total of 20 proteins were up- or down-regulated in the ACV group compared with the saline group. Among these, six proteins (MHC class II antigen, glyoxalase 1, peroxiredoxin 1, αB-crystallin, fibroblast growth factor receptor 1-IIIb, and cytochrome c oxidase subunit Vb) were identified in association with ACV-induced nephrotoxicity. These findings were confirmed by Western blotting analysis. The differential expression levels of α-BC, Prx1, Glo I and CcO Vb suggest that oxidative damage and mitochondrial injury may be involved in ACV-induced nephrotoxicity. Furthermore, VEGF and FGF may play a role in tissue repair and the restoration process following ACV nephrotoxicity.

  18. In vivo application of chitosan to facilitate intestinal acyclovir absorption in rats.

    Science.gov (United States)

    Masuda, Ayumi; Goto, Yuko; Kurosaki, Yuji; Aiba, Tetsuya

    2012-07-01

    The effect of chitosan on the intestinal absorption of acyclovir (ACV) was evaluated in rats, and factors influencing its facilitative effect on the ACV absorption were examined. When ACV solution containing 1% chitosan with an average molecular weight of 150 kDa was administered into the upper jejunum, a significant increase in the plasma ACV concentration was observed, with the peak ACV concentration being eight times greater than that observed with the chitosan-free solution. The chitosan-free ACV solution, whose viscosity was adjusted to remain unchanged with polyethylene glycol, did not cause an increase in the plasma concentration, and neither did the chitosan-free solutions substitutionally containing low molecular cationic compounds, triethanolamine and kanamycin. When chitosan was digested with chitosanase to shorten its polycationic polysaccharide structure, chitosan subjected to 150-min digestion retained its facilitative effect on ACV absorption, but that subjected to 420-min digestion no longer caused facilitation, in which its average molecular weight was reduced to around 10 kDa. It is therefore indicated that intestinal ACV absorption can be facilitated with chitosan, and that it is necessary for chitosan to have a certain length of polycationic polysaccharide structure to exert such facilitation.

  19. Antiherpetic properties of acyclovir 5'-hydrogenphosphonate and the mutation analysis of herpes virus resistant strains.

    Science.gov (United States)

    Gus'kova, Anna A; Skoblov, Mikhail Yu; Korovina, Anna N; Yasko, Maxim V; Karpenko, Inna L; Kukhanova, Marina K; Andronova, Valeria L; Galegov, George A; Skoblov, Yuri S

    2009-10-01

    In this study, we continued to study antiherpetic properties of acyclovir 5'-hydrogenphosphonate (Hp-ACV) in cell cultures and animal models. Hp-ACV was shown to inhibit the development of herpetic infection in mice induced by the HSV-1/L(2) strain. The compound suppressed replication of both ACV-sensitive HSV-1/L(2) and ACV-resistant HSV-1/L(2)/R strains in Vero cell culture. Viral population resistant to Hp-ACV (HSV-1/L(2)/R(Hp-ACV)) was developed much slower than ACV-resistant population. The analysis of Hp-ACV-resistant clones isolated from the HSV-1/L(2)/R(Hp-ACV) population demonstrated their partial cross-resistance to ACV. The mutations determining the resistance of HSV-1 clones to Hp-ACV were partly overlapped with mutations defining ACV resistance but did not always coincide. HSV-1/L(2)/R(Hp-ACV) herpes virus thymidine kinase is shortened from the C-terminus by 100 amino acid residues in length.

  20. Differential pulse voltammetric determination of acyclovir in pharmaceutical preparations using a pencil graphite electrode.

    Science.gov (United States)

    Dilgin, Didem Giray; Karakaya, Serkan

    2016-06-01

    In this study, a new selective and sensitive voltammetric procedure for determination of acyclovir (ACV) was proposed using a disposable electrode, pencil graphite electrode (PGE). Cyclic and differential pulse voltammograms of ACV were recorded in Britton-Robinson buffer solution containing 0.10 M KCl with pH of 4.0 at PGE. The PGE displayed a very good electrochemical behavior with significant enhancement of the peak current compared to a glassy carbon electrode (GCE). Under experimental conditions, the PGE had a linear response range from 1.0 μM to 100.0 μM ACV with a detection limit of 0.3 μM (based on 3 Sb). Relative standard deviations of 4.8 and 3.6% were obtained for five successive determinations of 10.0 and 50.0 μM ACV, respectively, which indicate acceptable repeatability. This voltammetric method was successfully applied to the direct determination of ACV in real pharmaceutical samples. The effect of various interfering compounds on the ACV peak current was studied.

  1. A newfangled study using risk silhouette and uncertainty approximation for quantification of acyclovir in diverse formulation

    Institute of Scientific and Technical Information of China (English)

    Karan Mittal; Riddhish Patadia; Chintan Vora; Rajashree C. Mashru

    2015-01-01

    Risk assessment and uncertainty approximation are two major and important parameters that need to be adopted for the development of pharmaceutical process to ensure reliable results. Additionally, there is a need to switch from the traditional method validation checklist to provide a high level of assurance of method reliability to measure quality attribute of a drug product. In the present work, evaluation of risk profile, combined standard uncertainty and expanded uncertainty in the analysis of acyclovir were studied. Uncertainty was calculated using cause-effect approach, and to make it more accurately applicable a method was validated in our laboratory as per the ICH guidelines. While assessing the results of validation, the calibration model was justified by the lack of fit and Levene’s test. Risk profile represents the future applications of this method. In uncertainty the major contribution is due to sample concentration and mass. This work demonstrates the application of theoretical concepts of calibration model tests, relative bias, risk profile and uncertainty in routine methods used for analysis in pharmaceutical field.

  2. The role of topical 5% acyclovir and 1% hydrocortisone cream (Xerese™) in the treatment of recurrent herpes simplex labialis.

    Science.gov (United States)

    Hull, Christopher M; Brunton, Stephen

    2010-09-01

    Recurrent herpes simplex labialis (HSL), also known as orofacial herpes or cold sores, is a common clinical presentation of herpes simplex virus (HSV) infection. It may manifest as painful, distressing, and cosmetically displeasing vesicles on the lips, nose, and nasal septum. Although oral or topical treatment with antiviral agents can reduce the replication of HSV-1, the primary benefits of antiviral therapies for recurrent HSL have been limited to modest reductions in healing time; they do not mitigate the accompanying immune-mediated response of the host to the virus. The addition of a topical corticosteroid to an antiviral cream has been hypothesized to improve the clinical outcome of HSL by decreasing the HSV-related immune-mediated inflammatory skin reaction. A recently developed topical cream containing 5% acyclovir and 1% hydrocortisone (AHC) in a novel cream vehicle has been shown to be safe and effective for the early treatment of recurrent HSL in immunocompetent adult and adolescent patients. In a well-controlled clinical trial, AHC cream significantly reduced the frequency of both ulcerative and nonulcerative recurrences (ie, the prevention of vesicular HSL lesions). Treatment was well tolerated, and there was no evidence of emergence of viral resistance to acyclovir with the addition of hydrocortisone. The AHC cream significantly reduced the recurrence of ulcerative and nonulcerative HSL lesions and shortened healing time with early treatment compared with acyclovir 5% cream and vehicle (placebo) cream. Herpes simplex labialis may not typically be considered a serious medical condition; however, the importance of treating HSL should not be overlooked, considering the continuous increase of the viral pool in the general population and the potential psychological and social consequences of the condition when left untreated.

  3. Phosphoramidate derivatives of acyclovir: synthesis and antiviral activity in HIV-1 and HSV-1 models in vitro.

    Science.gov (United States)

    Zakirova, Natalia F; Shipitsyn, Alexander V; Jasko, Maxim V; Prokofjeva, Maria M; Andronova, Valeria L; Galegov, Georgiy A; Prassolov, Vladimir S; Kochetkov, Sergey N

    2012-10-01

    The antiviral activity against HIV and HSV and the chemical stability of ACV phosphoramidate derivatives were studied. The phosphoramidates of ACV demonstrated moderate activity. The best compound appeared to be 9-(2-hydroxymethyl)guanine phosphoromonomorpholidate (7), which inhibited virus replication in pseudo-HIV-1 particles by 50% at 50 μM. It also inhibited replication of wild-type HSV-1 (9.7 μM) as well as an acyclovir-resistant strain (25 μM). None of the synthesised compounds showed any cytotoxicity.

  4. Prevalence of Intrathecal Acyclovir Resistant Virus in Herpes Simplex Encephalitis Patients.

    Science.gov (United States)

    Mitterreiter, Johanna G; Titulaer, Maarten J; van Nierop, Gijsbert P; van Kampen, Jeroen J A; Aron, Georgina I; Osterhaus, Albert D M E; Verjans, Georges M G M; Ouwendijk, Werner J D

    2016-01-01

    Herpes simplex encephalitis (HSE) is a life-threatening complication of herpes simplex virus (HSV) infection. Acyclovir (ACV) is the antiviral treatment of choice, but may lead to emergence of ACV-resistant (ACVR) HSV due to mutations in the viral UL23 gene encoding for the ACV-targeted thymidine kinase (TK) protein. Here, we determined the prevalence of intrathecal ACVR-associated HSV TK mutations in HSE patients and compared TK genotypes of sequential HSV isolates in paired cerebrospinal fluid (CSF) and blister fluid of mucosal HSV lesions. Clinical samples were obtained from 12 HSE patients, encompassing 4 HSV type 1 (HSV-1) and 8 HSV-2 encephalitis patients. HSV DNA load was determined by real-time PCR and complete HSV TK gene sequences were obtained by nested PCR followed by Sanger sequencing. All HSV-1 HSE patients contained viral TK mutations encompassing 30 unique nucleotide and 13 distinct amino acid mutations. By contrast, a total of 5 unique nucleotide and 4 distinct amino acid changes were detected in 7 of 8 HSV-2 patients. Detected mutations were identified as natural polymorphisms located in non-conserved HSV TK gene regions. ACV therapy did not induce the emergence of ACVR-associated HSV TK mutations in consecutive CSF and mucocutaneous samples of 5 individual patients. Phenotypic susceptibility analysis of these mucocutaneous HSV isolates demonstrated ACV-sensitive virus in 2 HSV-1 HSE patients, whereas in two HSV-2 HSE patients ACVR virus was detected in the absence of known ACVR-associated TK mutations. In conclusion, we did not detect intrathecal ACVR-associated TK mutations in HSV isolates obtained from 12 HSE patients.

  5. A comparison of the physicochemical properties and a sensory test of Acyclovir creams.

    Science.gov (United States)

    Inoue, Yutaka; Furuya, Kayoko; Matumoto, Miruto; Murata, Isamu; Kimura, Masayuki; Kanamoto, Ikuo

    2012-10-15

    In external medicine, types and ratios of additives are not necessarily the same for well-known brand-name drugs and generic drugs. This study sought to compare the physicochemical properties and sensory test results of a brand-name Acyclovir (ACV) cream and two generic ACV creams. Near-infrared (NIR) spectroscopy revealed changes in absorption spectra attributed to differences in the oil and water content of the 3 creams. In addition, ACV-B and ACV-C had similar NIR absorption spectra. Microscopic examination revealed crystallization in each of the creams and droplets in ACV-C. Powder X-ray diffraction measurement revealed diffraction peaks due to ACV for ACV-A and ACV-B. Assessment of viscoelasticity indicated that stress of subjection to 35 °C caused no changes in the viscoelasticity of ACV-B and ACV-C in comparison to stress of subjection to 25 °C but it did cause the viscoelasticity of ACV-A to decrease. ACV-A had a greater tolerance to stress and a higher viscosity, tan δ, and yield value than the other 2 creams. Results of a sensory test revealed significant differences in adhesiveness, spreadability, and feel for ACV-A in comparison to ACV-B and ACV-C. Thus, differences in the viscosity and elasticity of the creams due to differences in types and ratios of additives were noted. These differences are surmised to be differences in physical properties. In addition, results suggested that viscoelasticity and spreadability in the sensory test reflected differences in physical properties.

  6. Prevalence of Intrathecal Acyclovir Resistant Virus in Herpes Simplex Encephalitis Patients

    Science.gov (United States)

    Mitterreiter, Johanna G.; Titulaer, Maarten J.; van Nierop, Gijsbert P.; van Kampen, Jeroen J. A.; Aron, Georgina I.; Osterhaus, Albert D. M. E.; Verjans, Georges M. G. M.; Ouwendijk, Werner J. D.

    2016-01-01

    Herpes simplex encephalitis (HSE) is a life-threatening complication of herpes simplex virus (HSV) infection. Acyclovir (ACV) is the antiviral treatment of choice, but may lead to emergence of ACV-resistant (ACVR) HSV due to mutations in the viral UL23 gene encoding for the ACV-targeted thymidine kinase (TK) protein. Here, we determined the prevalence of intrathecal ACVR–associated HSV TK mutations in HSE patients and compared TK genotypes of sequential HSV isolates in paired cerebrospinal fluid (CSF) and blister fluid of mucosal HSV lesions. Clinical samples were obtained from 12 HSE patients, encompassing 4 HSV type 1 (HSV-1) and 8 HSV-2 encephalitis patients. HSV DNA load was determined by real-time PCR and complete HSV TK gene sequences were obtained by nested PCR followed by Sanger sequencing. All HSV-1 HSE patients contained viral TK mutations encompassing 30 unique nucleotide and 13 distinct amino acid mutations. By contrast, a total of 5 unique nucleotide and 4 distinct amino acid changes were detected in 7 of 8 HSV-2 patients. Detected mutations were identified as natural polymorphisms located in non-conserved HSV TK gene regions. ACV therapy did not induce the emergence of ACVR-associated HSV TK mutations in consecutive CSF and mucocutaneous samples of 5 individual patients. Phenotypic susceptibility analysis of these mucocutaneous HSV isolates demonstrated ACV-sensitive virus in 2 HSV-1 HSE patients, whereas in two HSV-2 HSE patients ACVR virus was detected in the absence of known ACVR-associated TK mutations. In conclusion, we did not detect intrathecal ACVR-associated TK mutations in HSV isolates obtained from 12 HSE patients. PMID:27171421

  7. Assessment of the physical properties and stability of mixtures of tetracycline hydrochloride ointment and acyclovir cream.

    Science.gov (United States)

    Inoue, Yutaka; Furuya, Kayoko; Maeda, Rikimaru; Murata, Isamu; Kanamoto, Ikuo

    2013-04-15

    In dermatology, ointments are often mixed as part of drug therapy, but mixing often leads to incompatibility. Three combinations of tetracycline ointment (TC-o) and acyclovir cream (ACV-cr) were prepared at a TC-o:ACV-cr ratio of 1:1 using a brand-name ACV-cr and two generic ACV-cr (samples TC-o+ACV-A, TC-o+ACV-B, and TC-o+ACV-C). Microscopic examination revealed separation in TC-o+ACV-C. Viscosity and elasticity measurement indicated that the storage modulus (G') and loss modulus (G″) of each of the TC-o+ACV-cr mixtures behaved similarly to those of an ACV-cr and the loss tangent (tanδ) behaved similarly to that of a TC ointment. In addition, differences in the storage modulus (G') and loss modulus (G″) of the TC-o+ACV-cr mixtures were noted. To assess stability, each TC-o+ACV-cr mixture was stored away from direct sunlight at 25 °C and an RH of 84% and at 4 °C (in a refrigerator). HPLC revealed that the ACV content in each TC-o+ACV-cr mixture remained at 95-105% for up to 14 days under both sets of storage conditions. A decline in TC content in each TC-o+ACV-cr mixture was not noted with storage at 4 °C but was noted over time with storage at 25 °C and an RH of 84%. In addition, significant differences in the percent decline in TC content in each TC-o+ACV-cr mixture occurred with storage at 25 °C and an RH of 84%. Thus, differences in physical properties and stability may occur when combining brand-name and generic drugs, and temperature and humidity may be the cause of the TC-o's incompatibility.

  8. The antiviral drug acyclovir is a slow-binding inhibitor of (D)-amino acid oxidase.

    Science.gov (United States)

    Katane, Masumi; Matsuda, Satsuki; Saitoh, Yasuaki; Sekine, Masae; Furuchi, Takemitsu; Koyama, Nobuhiro; Nakagome, Izumi; Tomoda, Hiroshi; Hirono, Shuichi; Homma, Hiroshi

    2013-08-20

    d-Amino acid oxidase (DAO) is a degradative enzyme that is stereospecific for d-amino acids, including d-serine and d-alanine, which are believed to be coagonists of the N-methyl-d-aspartate (NMDA) receptor. To identify a new class of DAO inhibitor(s) that can be used to elucidate the molecular details of the active site environment of DAO, manifold biologically active compounds of microbial origin and pre-existing drugs were screened for their ability to inhibit DAO activity, and several compounds were identified as candidates. One of these compounds, acyclovir (ACV), a well-known antiviral drug used for the treatment of herpesvirus infections, was characterized and evaluated as a novel DAO inhibitor in vitro. Analysis showed that ACV acts on DAO as a reversible slow-binding inhibitor, and interestingly, the time required to achieve equilibrium between DAO, ACV, and the DAO/ACV complex was highly dependent on temperature. The binding mechanism of ACV to DAO was investigated in detail by several approaches, including kinetic analysis, structural modeling of DAO complexed with ACV, and site-specific mutagenesis of an active site residue postulated to be involved in the binding of ACV. The results confirm that ACV is a novel, active site-directed inhibitor of DAO that can be a valuable tool for investigating the structure-function relationships of DAO, including the molecular details of the active site environment of DAO. In particular, it appears that ACV can serve as an active site probe to study the structural basis of temperature-induced conformational changes of DAO.

  9. Preparation and evaluation of novel in situ gels containing acyclovir for the treatment of oral herpes simplex virus infections.

    Science.gov (United States)

    Chaudhary, Binu; Verma, Surajpal

    2014-01-01

    The objective of this work was to develop an oral mucosal drug delivery system to facilitate the local and systemic delivery of acyclovir for the treatment of oral herpes infection caused by the herpes simplex virus (HSV). An in situ gelling system was used to increase the residence time and thus the bioavailability of acyclovir in oral mucosa. Temperature and pH trigged in situ gel formulations were prepared by cold method using polymers like poloxamer 407, carbopol 934, and HPMC. Glycerin and a mixture of tween 80 and ethanol (1 : 2 ratio) were used as the drug dissolving solvent. The pH of carbopol containing formulation was adjusted to pH 5.8 while the pH of poloxamer solution was adjusted to pH 7. These formulations were evaluated for sol-gel transition temperature, gelling capacity, pH, viscosity, spreadability, gel strength, drug content, ex-vitro permeation, and mucoadhesion. The gelation temperatures of all the formulations were within the range of 28-38°C. All the formulations exhibited fairly uniform drug content (98.15-99.75%). Drug release study of all the formulations showed sustained release properties. The release of drug through these in situ gel formulations followed the Higuchi model and Korsmeyer peppas model mechanism.

  10. Recent approval of Xerese in Canada: 5% acyclovir and 1% hydrocortisone topical cream in the treatment of herpes labialis.

    Science.gov (United States)

    Nguyen, H P; Stiegel, K R; Downing, C; Stiegel, K R

    2014-01-01

    Herpes labialis is a frequently occurring viral infection of the lips and oral mucosa. Recurring lesions are induced by viral reactivation and replication, but the symptoms leading to morbidity, such as pain and inflammation, are immune-mediated. The introduction of 5% acyclovir/1% hydrocortisone in a topical cream (Xerese™) represents a therapeutic strategy directed at both of these pathogenic processes. Applied at the onset of prodromal symptoms, this combination treatment has a good safety profile and is more effective in reducing healing time than antiviral or anti-inflammatory agents alone. Although it was US FDA-approved for herpes labialis in 2009, Xerese™ has only recently been approved for use in Canada in October 2013. Herein, we review the basic science and clinical studies that support the efficacy of this topical combination acyclovir-hydrocortisone product in treating herpes labialis and examine its safety profile, as well as touch upon other therapies that have been shown to be effective in treating this common viral condition.

  11. Genotypic detection of acyclovir-resistant HSV-1: characterization of 67 ACV-sensitive and 14 ACV-resistant viruses.

    Science.gov (United States)

    Frobert, Emilie; Cortay, Jean-Claude; Ooka, Tadamasa; Najioullah, Fatiha; Thouvenot, Danielle; Lina, Bruno; Morfin, Florence

    2008-07-01

    Infections due to herpes simplex virus (HSV) resistant to acyclovir (ACV) represent an important clinical concern in immunocompromised patients. In order to switch promptly to an appropriate treatment, rapid viral susceptibility assays are required. We developed herein a genotyping analysis focusing on thymidine kinase gene (TK) mutations in order to detect acyclovir-resistant HSV in clinical specimens. A total of 85 HSV-1 positive specimens collected from 69 patients were analyzed. TK gene could be sequenced directly for 81 clinical specimens (95%) and 68 HSV-1 specimens could be characterized as sensitive or resistant by genotyping (84%). Genetic characterization of 67 susceptible HSV-1 specimens revealed 10 polymorphisms never previously described. Genetic characterization of 14 resistant HSV-1 revealed 12 HSV-1 with either TK gene additions/deletions (8 strains) or substitutions (4 strains) and 2 HSV-1 with no mutation in the TK gene. DNA polymerase gene was afterwards explored. With this rapid PCR-based assay, ACV-resistant HSV could be detected directly in clinical specimens within 24 h.

  12. Novel water-soluble prodrugs of acyclovir cleavable by the dipeptidyl-peptidase IV (DPP IV/CD26) enzyme.

    Science.gov (United States)

    Diez-Torrubia, Alberto; Cabrera, Silvia; de Castro, Sonia; García-Aparicio, Carlos; Mulder, Gwenn; De Meester, Ingrid; Camarasa, María-José; Balzarini, Jan; Velázquez, Sonsoles

    2013-01-01

    We herein report for the first time the successful use of the dipeptidyl peptidase IV (DPPIV/CD26) prodrug approach to guanine derivatives such as the antiviral acyclovir (ACV). The solution- and solid-phase synthesis of the tetrapeptide amide prodrug 3 and the tripeptide ester conjugate 4 of acyclovir are reported. The synthesis of the demanding tetrapeptide amide prodrug of ACV 3 was first established in solution and successfully transferred onto solid support by using Ellman's dihydropyran (DHP) resin. In contrast with the valyl ester prodrug (valacyclovir, VACV), the tetrapeptide amide prodrug 3 and the tripeptide ester conjugate 4 of ACV proved fully stable in PBS. Both prodrugs converted to VACV (for 4) or ACV (for 3) upon exposure to purified DPPIV/CD26 or human or bovine serum. Vildagliptin, a potent inhibitor of DPPIV/CD26 efficiently inhibited the DPPIV/CD26-catalysed hydrolysis reaction. Both amide and ester prodrugs of ACV showed pronounced anti-herpetic activity in cell culture and significantly improved the water solubility in comparison with the parent drug.

  13. Silicone-Acyclovir Controlled Release Devices Suppress Primary Herpes Simplex Virus-2 and Varicella Zoster Virus Infections In Vitro

    Directory of Open Access Journals (Sweden)

    Carol L. Berkower

    2013-01-01

    Full Text Available Following initial infection, herpesviruses retreat into a permanent latent state with periodic reactivation resulting in an enhanced likelihood of transmission and clinical disease. The nucleoside analogue acyclovir reduces clinical symptoms of the three human alpha herpesviruses, HSV-1, HSV-2, and VZV. Long-term administration of acyclovir (ACV can reduce the frequency and severity of reactivation, but its low bioavailability and short half-life require a daily drug regimen. Our lab is working to develop a subcutaneous delivery system to provide long-lasting, sustained release of ACV. Previously, we demonstrated that an implantable silicone (MED-4050 device, impregnated with ACV protected against HSV-1 both in vitro and in vivo. Here, we extend our in vitro observations to include protection against both HSV-2 and VZV. We also demonstrate protection against HSV-2 in vitro using MED-4750, a silicone polymer designed for long-term use in humans. When release of ACV from MED-4750 is quantitated on a daily basis, an initial burst of 5 days is observed, followed by a long period of slow release with near-zero-order kinetics, with an average daily release of 1.3923 ± 0.5908 μg ACV over days 20–60. Development of a slow-release implant has the potential to significantly impact the treatment of human alpha herpesvirus infections.

  14. Influence of drug loading and type of ointment base on the in vitro performance of acyclovir ophthalmic ointment.

    Science.gov (United States)

    Al-Ghabeish, Manar; Xu, Xiaoming; Krishnaiah, Yellela S R; Rahman, Ziyaur; Yang, Yang; Khan, Mansoor A

    2015-11-30

    The availability of in vitro performance tests such as in vitro drug release testing (IVRT) and in vitro permeation testing (IVPT) are critical to comprehensively assure consistent delivery of the active component(s) from semisolid ophthalmic drug products. The objective was to study the impact of drug loading and type of ointment base on the in vitro performance (IVRT and IVPT) of ophthalmic ointments using acyclovir as a model drug candidate. The in vitro drug release for the ointments was evaluated using a modified USP apparatus 2 with Enhancer cells. The transcorneal permeation was carried out using rabbit cornea on modified vertical Franz cells. The drug retention in cornea (DRC) was also determined at the end of transcorneal drug permeation study. The in vitro drug release, transcorneal drug permeation as well as DRC exhibited a proportional increase with increasing drug loading in the ointment. On comparing the in vitro drug release profile with transcorneal permeation profile, it appears that drug release from the ointment is controlling acyclovir transport through the cornea. Furthermore, enhanced in vitro transcorneal permeation relative to the in vitro drug release underscores the importance of the interplay between the physiology of the ocular tissue and ointment formulation. The results indicated that IVRT and IVPT could be used to discriminate the impact of changes in drug load and formulation composition of ophthalmic ointments.

  15. Evaluation of sorivudine (BV-araU) versus acyclovir in the treatment of acute localized herpes zoster in human immunodeficiency virus-infected adults

    NARCIS (Netherlands)

    Bodsworth, NJ; Boag, F; Burdge, D; Genereux, M; Borleffs, JCC; Evans, BA; Modai, J; Colebunders, R; Thomas, M; DeHertogh, D; Pacelli, L; Thomis, J; Knight, E.L.; McNulty, AM; Delaney, C; VanHove, D; Sacks, S; Gage, L; McLeod, A; DiazMitoma, F; Fong, J; MacFadden, D; Martel, A; Rachlis, A; Salit, [No Value; Shafran, S; Szabo, J; Toma, E; Deschenes, L; Gill, J; Lalonde, R; Kaufhold, R; Molina, JM; Dellamonica, P; Rozenbaum, W; Kolsters, FP; Meenhorst, PL; Danner, S; Sprenger, HG; EllisPegler, RB; Moragas, J; Moyle, G; Colman, J; Parnell, A; McLean, KA; Holmes, DA; Kitchen, C.M.R.; Linde, A; Dahl, H; Dwyer, D

    1997-01-01

    The clinical efficacy and safety of sorivudine as treatment for acute cutaneous tester in human immunodeficiency virus-infected adults was compared with that of acyclovir in a double-blinded randomized study, A total of 125 patients with laboratory-confirmed tester rash present for less than or equa

  16. Efficacy of Topical 5% Acyclovir-1% Hydrocortisone Cream (ME-609 for Treatment of Herpes Labialis: a systematic review

    Directory of Open Access Journals (Sweden)

    MARIA INÊS DA ROSA

    2015-08-01

    Full Text Available We performed a systematic review with the objective of verifying the efficacy of topical use 5% Acyclovir-1% Hydrocortisone cream compared to the placebo group for herpes simplex labialis treatment. We performed a literature search using MEDLINE, Embase, BIOSIS, LILACS, Scopus, Grey literature, the Cochrane Central Register of Controlled Trials, the ISI Web of Science and IBECS from 1990 to June 2014. We reported the outcomes using relative risk (RR with 95% confidence intervals. The literature search yielded 180 potentially relevant publications. Reviews of the reference lists yielded two further citations. Among these papers, two were considered eligible for inclusion in this review. Both trials included 1,213 patients. A meta-analysis of these studies showed a RR = 0.77, (95% CI 0.70-0.86; p<0.001.This result suggests that an early episodic treatment with the combination of an antiviral and a steroid is beneficial for herpes simplex labialis treatment.

  17. Efficacy of Topical 5% Acyclovir-1% Hydrocortisone Cream (ME-609) for Treatment of Herpes Labialis: a systematic review.

    Science.gov (United States)

    Rosa, Maria Inês da; Souza, Suéli L; Farias, Bruna F de; Pires, Patrícia D S; Dondossola, Eduardo R; dos Reis, Maria Eduarda F

    2015-08-01

    We performed a systematic review with the objective of verifying the efficacy of topical use 5% Acyclovir-1% Hydrocortisone cream compared to the placebo group for herpes simplex labialis treatment. We performed a literature search using MEDLINE, Embase, BIOSIS, LILACS, Scopus, Grey literature, the Cochrane Central Register of Controlled Trials, the ISI Web of Science and IBECS from 1990 to June 2014. We reported the outcomes using relative risk (RR) with 95% confidence intervals. The literature search yielded 180 potentially relevant publications. Reviews of the reference lists yielded two further citations. Among these papers, two were considered eligible for inclusion in this review. Both trials included 1,213 patients. A meta-analysis of these studies showed a RR = 0.77, (95% CI 0.70-0.86; pherpes simplex labialis treatment.

  18. Absence of rapid selection for acyclovir or penciclovir resistance following suboptimal oral prodrug therapy of HSV-infected mice

    Directory of Open Access Journals (Sweden)

    Bacon Teresa H

    2001-12-01

    Full Text Available Abstract Background Acyclovir (ACV resistant herpes simplex virus (HSV isolates can be readily selected in animal infection models receiving suboptimal ACV treatment, however no comparative studies of the emergence of resistance following suboptimal treatment with valacyclovir (VCV or famciclovir (FCV, the prodrugs of acyclovir and penciclovir, respectively, have been reported. Methods Mice (n = 30 were infected with HSV type 1 or 2 in the ear pinnae and administered oral prodrugs at one fifth a dose previously shown to be effective. To select and amplify drug-resistant HSV, a total of seven consecutive in vivo passages with suboptimal treatment were performed for each virus sample and progeny virus from each passage was characterized by the plaque reduction (PRA and plating efficiency assays (PEA. Results No drug-resistant HSV-2 and only a single drug-resistant HSV-1 variant were identified. Virus recovered from the first three sequential passages of this HSV-1 sample was susceptible by PRA, although the proportion of resistant virus recovered gradually increased upon passage. The resistant HSV-1 phenotype was confirmed by PRA after four sequential passages in mice. Unexpectedly, this in vivo-selected drug-resistant HSV-1 failed to yield an infection completely refractory to treatment in subsequent passages. Conclusions Sub-optimal therapy of immunocompetent mice with either VCV or FCV did not readily select for HSV-mutants resistant to either ACV or PCV, suggesting that selection of resistance with either prodrug remains difficult using this system. Futhermore, this study suggests that the PEA may represent a useful adjunct to the PRA for monitoring alterations in the proportion of drug-resistant virus even when no change in IC50 is apparent.

  19. Screening of herpes simplex virus type 1 isolates for acyclovir resistance using DiviTum® assay.

    Science.gov (United States)

    Sauerbrei, Andreas; Vödisch, Susanne; Bohn, Kathrin; Schacke, Michael; Gronowitz, Simon

    2013-03-01

    Rapid alternative methods are required to evaluate easily acyclovir (ACV) sensitivity of clinical herpes simplex virus (HSV) isolates. The objective of this study was to screen 54 ACV-sensitive and 41 ACV-resistant clinical HSV-1 isolates, well characterized by phenotypic and genotypic methods, for the phosphorylation activity of the viral thymidine kinase (TK) using a commercially available and modified non-radioactive DiviTum® test on the basis of an indirect enzyme linked immunosorbent assay. The ACV-sensitive HSV-1 isolates had high TK activity values between 31.5±6.4 DiviTum® Units per liter (DU/L) and 487.4±60.1 DU/L. The mean activity of all ACV-sensitive isolates was calculated as 212.3±15.7 DU/L. By contrast, the mean activity of all ACV-resistant HSV-1 isolates was significantly lower at 5.5±1.3 DU/L. Out of the 41 ACV-resistant HSV-1 isolates, 38 had no or very low phosphorylation activities of the viral TK between 0 DU/L and 9.3±3.2 DU/L. The remaining three ACV-resistant viral isolates had TK activities between 44.6±5.1 DU/L and 80.9±13.3D U/L. In conclusion, the modified DiviTum® test can be used to screen HSV-1 isolates for their sensitivity to ACV. Acyclovir-sensitive HSV-1 isolates show TK activities >30 DU/L and ACV-resistant isolates have activity values ACV-resistant HSV-1 isolates can have TK activity values >30 DU/L. These strains are most likely ACV-resistant TK-altered mutants, but no evidence was provided for an alteration of the TK.

  20. Successful clearance of cutaneous acyclovir-resistant, foscarnet-refractory herpes virus lesions with topical cidofovir in an allogeneic hematopoietic stem cell transplant patient.

    Science.gov (United States)

    Muluneh, B; Dean, A; Armistead, P; Khan, T

    2013-06-01

    Cidofovir is a deoxycytidine monophosphate analog with broad spectrum activity against various deoxyribonucleic acid viruses. Cidofovir is marketed as an injectable for intravenous use; however, there is a topical cidofovir formulation utilized for viral dermatologic infections. Here, we present a case of a successful clearance of a perianal acyclovir resistant and foscarnet refractory herpes simplex virus (HSV1) ulcer in a 34 year-old woman who had undergone allogeneic hematopoietic stem cell transplantation. After 1 week of therapy with cidofovir gel, the patient's ulcer was clinically improved, and the lesion was negative for herpes simplex virus transcripts by real-time polymerase chain reaction testing. The wound remained herpes simplex virus negative by real-time polymerase chain reaction on repeat testing 1 week later. Based on this and other reports in HIV/AIDS patients, we believe that cidofovir gel has utility in the management of cutaneous, acyclovir-resistant HSV infections.

  1. A comparative study of lamellar gel phase systems and emzaloids as transdermal drug delivery systems for acyclovir and methotrexate / Sonique Reynecke

    OpenAIRE

    Reynecke, Sonique

    2004-01-01

    The skin forms an attractive and accessible route for systemic delivery of drugs as alternative to other methods of administration, such as the oral and parental methods because of the problems associated with last mentioned methods. The lipophilic character of the stratum corneum, coupled with its intrinsic tortuosity, ensures that it almost always provides the principal barrier to the entry of drug molecules into the skin. Due to the fact that methotrexate (MTX) and acyclovir...

  2. Utilization of nanotechnology to enhance percutaneous absorption of acyclovir in the treatment of herpes simplex viral infections

    Directory of Open Access Journals (Sweden)

    Al-Subaie MM

    2015-06-01

    Full Text Available Mutlaq M Al-Subaie,1 Khaled M Hosny,1,2 Khalid Mohamed El-Say,1,3 Tarek A Ahmed,1,3 Bader M Aljaeid1 1Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; 2Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Beni Suef University, Beni Suef, 3Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt Abstract: This study aimed to formulate an optimized acyclovir (ACV nanoemulsion hydrogel in order to provide a solution for the slow, variable, and incomplete oral drug absorption in patient suffering from herpes simplex viral infection. Solubility of ACV in different oils, surfactants, and cosurfactants was explored utilizing a cubic model mixture design to obtain a nanoemulsion with minimum globule size. Preparation of an optimized ACV nanoemulsion hydrogel using a three-factor, three-level Box–Behnken statistical design was conducted. The molecular weight of chitosan (X1, percentage of chitosan (X2, and percentage of Eugenol as a skin permeation enhancer (X3 were selected to study their effects on hydrogel spreadability (Y1 and percent ACV permeated through rat skin after 2.5 hours (Y2. A pharmacokinetic study of the optimized ACV nanoemulsion hydrogel was conducted in rats. Mixtures of clove oil and castor oil (3:1 ratio, Tween 80 and Span 80 (3:1 ratio, and propylene glycol and Myo-6V (3:1 ratio were selected as the oil, surfactant, and cosurfactant phases, respectively. Statistical analysis indicated that the molecular weight of chitosan has a significant antagonistic effect on spreadability, but has no significant effect on the percent ACV permeated. The percentage of chitosan also has a significant antagonistic effect on the spreadability and percent ACV permeated. On the other hand, the percentage of Eugenol has a significant synergistic effect on percent ACV permeated, with no effect on

  3. Impact of Pluronic F-68 vs Tween 80 on Fabrication and Evaluation of Acyclovir SLNs for Skin Delivery.

    Science.gov (United States)

    Newton, Maria John; Kaur, Bhupinder

    2016-07-24

    The solid lipid nanoparticles (SLNs) of Acyclovir (ACV) were fabricated with Soya lecithin and Fractionated Coconut oil (medium chain glyceride) as a first time combination. The research was focused on developing ACV-SLN by using high pressure hot-homogenization technique. The ingredients were used in different concentrations and ratios to identify the best formulation design. The tween 80 and Pluronic F-68 were used in various concentrations in formulation design to assess the impact on the fabrication and evaluation of SLNs. The SLNs were subjected to various characterization techniques such as XRD ,FTIR, Master sizer analysis and zeta potential. The mean particle size was determined by master sizer and zeta sizer. Transmission electron microscopy (TEM) was used as a tool to analyze the morphology and other features. The zeta potential and drug entrapment efficiency (EE%) were also determined for the prepared ACV-SLNs. The efficiency of drug release from prepared formulations was studied by using in vitro study with the utilization of dialysis membrane technique. SLN dispersions exhibited the average size in nano range. SLNs with small particle size found to have predetermined encapsulation efficiency, and relatively high loading capacity and predetermined in vitro drug release profile.

  4. Mechanisms associated with HIV-1 resistance to acyclovir by the V75I mutation in reverse transcriptase.

    Science.gov (United States)

    Tchesnokov, Egor P; Obikhod, Aleksandr; Massud, Ivana; Lisco, Andrea; Vanpouille, Christophe; Brichacek, Beda; Balzarini, Jan; McGuigan, Christopher; Derudas, Marco; Margolis, Leonid; Schinazi, Raymond F; Götte, Matthias

    2009-08-01

    It has recently been demonstrated that the anti-herpetic drug acyclovir (ACV) also displays antiviral activity against the human immunodeficiency virus type 1 (HIV-1). The triphosphate form of ACV is accepted by HIV-1 reverse transcriptase (RT), and subsequent incorporation leads to classical chain termination. Like all approved nucleoside analogue RT inhibitors (NRTIs), the selective pressure of ACV is associated with the emergence of resistance. The V75I mutation in HIV-1 RT appears to be dominant in this regard. By itself, this mutation is usually not associated with resistance to currently approved NRTIs. Here we studied the underlying biochemical mechanism. We demonstrate that V75I is also selected under the selective pressure of a monophosphorylated prodrug that was designed to bypass the bottleneck in drug activation to the triphosphate form (ACV-TP). Pre-steady-state kinetics reveal that V75I discriminates against the inhibitor at the level of catalysis, whereas binding of the inhibitor remains largely unaffected. The incorporated ACV-monophosphate (ACV-MP) is vulnerable to excision in the presence of the pyrophosphate donor ATP. V75I compromises binding of the next nucleotide that can otherwise provide a certain degree of protection from excision. Collectively, the results of this study suggest that ACV is sensitive to two different resistance pathways, which warrants further investigation regarding the detailed resistance profile of ACV. Such studies will be crucial in assessing the potential clinical utility of ACV and its derivatives in combination with established NRTIs.

  5. Resistance of herpes simplex viruses to acyclovir: an update from a ten-year survey in France.

    Science.gov (United States)

    Frobert, Emilie; Burrel, Sonia; Ducastelle-Lepretre, Sophie; Billaud, Geneviève; Ader, Florence; Casalegno, Jean-Sébastien; Nave, Viviane; Boutolleau, David; Michallet, Mauricette; Lina, Bruno; Morfin, Florence

    2014-11-01

    The widespread use of acyclovir (ACV) and the increasing number of immunocompromised patients have raised concern about an increase in ACV-resistant herpes simplex virus (HSV). ACV resistance has traditionally been a major concern for immunocompromised patients with a frequency reported between 2.5% and 10%. The aim of this study was to reassess the status of HSV resistance to ACV in immunocompetent and immunocompromised patients over a ten year period, between 2002 and 2011. This was done by retrospectively following 1425 patients. In immunocompetent patients, prevalence of resistance did not exceed 0.5% during the study period; whereas in immunocompromised patients, a significant increase was observed, rising from 3.8% between 2002 and 2006 (7/182 patients) to 15.7% between 2007 and 2011 (28/178) (p=0.0001). This sharp rise in resistance may largely be represented by allogeneic hematopoietic stem cell transplant patients, in which the prevalence of ACV resistance rose similarly from 14.3% (4/28) between 2002 and 2006 to 46.5% (26/56) between 2007 and 2011 (p=0.005). No increase in ACV resistance was detected in association with other types of immune deficiencies. Genotypic characterization of HSV UL23 thymidine kinase and UL30 DNA polymerase genes revealed 11 and 7 previously unreported substitutions, respectively. These substitutions may be related to potential polymorphisms, drug resistance, or other mutations of unclear significance.

  6. A metabolic profiling analysis of the nephrotoxicity of acyclovir in rats using ultra performance liquid chromatography/mass spectrometry.

    Science.gov (United States)

    Xing, Wenmin; Gu, Lili; Zhang, Xinyue; Xu, Jiadong; Lu, Hong

    2016-09-01

    Acyclovir (ACV) exposure is a common cause of acute kidney injury (AKI). The toxicity mechanism of ACV has always been a matter of debate. The present study investigated into the time-effect relationship and dose-effect relationship of ACV-induced nephrotoxicity in rats using metabonomics. Twenty-four rats were randomly divided into four groups: a 0.9% NaCl solution group, and 100, 300, and 600mg/kg ACV-treated groups; the ACV or vehicle solution was administered with a single intravenous injection. Urine was collected at different time periods (12h before administration, and 0-6h, 7-12h, and 13-24h after administration). Routine urinalysis was conducted by a urine automatic analyzer. Renal markers, including urine urea nitrogen, urine creatinine, and urinary N-acetyl-β-d-glucosaminidase (NAG) activity, were determined using established protocols. Urinary metabolites were evaluated using ultra performance liquid chromatography/mass spectrometry (UPLC/MS). In the ACV-treated rats, increased levels of protein (PRO), occult blood (BLD), white blood cell (WBC), and NAG activity in urine were observed, while the urine creatinine and urea nitrogen levels showed a decrease compared with the control. Moreover, urine metabolites significantly changed after the treatment with ACV, and all the effects induced by ACV were dose-time dependent. Finally, 4 metabolites (guanine, 4-guanidinobutyric acid, creatinine, and urea) were identified, which can be used for further research on the mechanism of ACV-induced nephrotoxicity.

  7. Monitoring of bystander effect of herpes simplex virus thymidine kinase/acyclovir system using fluorescence resonance energy transfer technique.

    Science.gov (United States)

    Xiong, Tao; Li, Yongjun; Ni, Fenge; Zhang, Feng

    2012-02-01

    Cytotoxic gene therapy mediated by gene transfer of the herpes simplex virus thymidine kinase (HSV-tk) gene followed by acyclovir (ACV) treatment has been reported to inhibit malignant tumor growth in a variety of studies. The magnitude of "bystander effect" is an essential factor for this anti-tumor approach in vivo. However, the mechanism by which HSV-tk/ACV brings "bystander effect" is poorly understood. In this report, the plasmid CD3 (ECFP-CRS-DsRed) and TK-GFP were transferred to the human adenoid cystic carcinoma line ACC-M cell line. The CD3-expressing cells apoptosis was monitored using fluorescence resonance energy transfer (FRET) technique. First, CD3 and TK-GFP co-expressing ACC-M cells apoptosis was monitored using FRET technique. The apoptosis was induced by ACV and initiated by caspase3. The FRET efficient was remarkably decreased and then disappeared during cellular apoptosis, which indicated that the TK-GFP expressing ACC-M cells apoptosis, induced by ACV, was via a caspase3-dependent pathway. Secondly, CD3 and TK-GFP mixed expressing ACC-M cells apoptosis, induced by ACV, were monitored using FRET technique. The apoptotic phenomena appeared in the CD3-expressing ACC-M cells. The results show that HSV-tk/ACV system killed ACC-M cells using its bystander effect. These results confirm that HSV-tk/ACV system is potential for cancer gene therapy.

  8. Conformational Analysis, Molecular Structure and Solid State Simulation of the Antiviral Drug Acyclovir (Zovirax Using Density Functional Theory Methods

    Directory of Open Access Journals (Sweden)

    Margarita Clara Alvarez-Ros

    2014-06-01

    Full Text Available The five tautomers of the drug acyclovir (ACV were determined and optimised at the MP2 and B3LYP quantum chemical levels of theory. The stability of the tautomers was correlated with different parameters. On the most stable tautomer N1 was carried out a comprehensive conformational analysis, and the whole conformational parameters (R, β, Φ, φ1, φ2, φ3, φ4, φ5 were studied as well as the NBO Natural atomic charges. The calculations were carried out with full relaxation of all geometrical parameters. The search located at least 78 stable structures within 8.5 kcal/mol electronic energy range of the global minimum, and classified in two groups according to the positive or negative value of the torsional angle j1. In the nitrogen atoms and in the O2' and O5' oxygen atoms of the most stable conformer appear a higher reactivity than in the natural nucleoside deoxyguanosine. The solid state was simulated through a dimer and tetramer forms and the structural parameters were compared with the X-ray crystal data available. Several general conclusions were emphasized.

  9. 阿昔洛韦过量致急性肾衰竭诊治分析%Acyclovir-induced acute renal failure and a review of the literature

    Institute of Scientific and Technical Information of China (English)

    侯欣; 王磊; 范晋海; 吕晶; 冯婕; 谭峰

    2011-01-01

    目的 探讨阿昔洛韦过量导致急性肾功能衰竭的组织学特点、临床表现、治疗以及预后.方法 报告1例阿昔洛韦过量导致的急性肾功能衰竭患者的临床、病理及预后资料,系统复习相关文献进行讨论.结果 患者中年男性,因右侧颈背部"带状疱疹"给予阿昔洛韦静滴联合口服治疗,于每次静滴半小时内出现突发腰痛、下腹坠胀,治疗2d后发生尿量减少、全身不适等症状.查肾功示:血尿素氮(BUN)20.7mmol/L,血清肌酐(CRE)560.3μmol/L;肾脏病理检查示:急性肾小管坏死伴轻度系膜增生及个别肾小球硬化.给予停药、紧急血液透析2次及对症支持治疗7d后痊愈.结论 阿昔洛韦导致肾功能衰竭最常见症状是突发腰痛、恶心,病理学多为肾小管病变,患者经过停药、透析及对症支持治疗后均能痊愈.%Objective To investigate the histological features, clinical manifestations, treatment options and prognosis of Acyclovir-induced acute renal failure. Methods The clinical, pathological and prognosis of 1 case of Acyclovir-induced acute renal failure were reviewed respectively, and the related literature was reviewed. ResultS A middle-aged man suffering from cutaneous herpes zoster was given Acyclovir by intravenous drip and per os, when he developed acute abdominal pain and general malaise. Renal examin on showed, his serum creatinine (CRE) and blood urea nitrogen (BUN) concentrations rose to 560.3 μmol/L and 20. 7 mmol/L, respectively. The pathology of kidney exhibited acute renal tubular necrosis acompanied with slight glomerular sclerosis. Renal impairment was restored after discontinuation of Acyclovir, hemodialysis and symptomatic treatment. Conclusion Acute abdominal pain and nausea are the most common symptoms of Acyclovir-induced acute renal failure. The pathology revealed acute renal tubular necrosis. Hemodialysis, symptomatic treatment and discontinuation of Acyclovir are the effective

  10. Treatment of relapse in herpes simplex on labial and facial areas and of primary herpes simplex on genital areas and "area pudenda" with low-power He-Ne laser or Acyclovir administered orally

    Science.gov (United States)

    Velez-Gonzalez, Mariano; Urrea-Arbelaez, Alejandro; Nicolas, M.; Serra-Baldrich, E.; Perez, J. L.; Pavesi, M.; Camarasa, J. M.; Trelles, Mario A.

    1996-01-01

    Sixty patients (greater than 16 yrs old) suffering primary or relapse genital herpes simplex viruses (HSV) and relapse labial HSV were appointed for this study. Three or more relapses were experienced per year. Patients (under treatment) were divided into two groups (distribution areas), corresponding to either labial herpes or genital herpes. These groups were sub-divided into 3 groups. The total number of labial or facial HSV patients was 36 (10 in group 1, 12 in group 2, 14 in group 3) and 24 for genital, buttocks, or 'area pudenda' HSV patients (6 in group 1, 8 in group 2, 10 in group 3). The design was a randomized, double- blind study. The setting was hospital and outpatient. The patients diagnosed as having the HVS disease were sent to the dermatology department and were assigned to a group at random. Treatment was begun as follows: During the treatment signs and symptoms were assessed and after the treatment, the relapses were also assessed (biochemical and hematological tests before and after the treatment) and the diagnosis of the HSV type I and II. The statistical evaluation of the results was performed and carried out with the SPSS and BMDP program. The relapses of the herpes infection in the lips and the face were significantly reduced (p less than 0.026) in patients treated with laser He-Ne and laser He-Ne plus Acyclovir. The interim between the relapses also increased significantly (p less than 0.005) in relation with the group treated with Acyclovir. The duration of the herpetic eruptions was clearly reduced in all locations in patients treated with laser He-Ne plus Acyclovir. No differences were noted between patients treated with laser He-Ne only or Acyclovir only. Therefore it is probable that therapeutic synergism took place. In relation with this, laser He-Ne shows the same therapeutic efficacy as Acyclovir taken orally. The association of Acyclovir and laser Ne-Ne could be an alternative method for the treatment of HSV in the face. The number

  11. Evaluation of the in vitro skin permeation of antiviral drugs from penciclovir 1% cream and acyclovir 5% cream used to treat herpes simplex virus infection

    Directory of Open Access Journals (Sweden)

    Bader Marlene

    2009-04-01

    Full Text Available Abstract Background Herpes simplex virus infection (HSV is a common and ubiquitous infection of the skin which causes mucocutaneous lesions called cold sores (herpes labialis or fever blisters. It is estimated that approximately 80% of the population worldwide are carriers of the Herpes simplex virus, approximately 40% suffer from recurrent recurrent infections. This study evaluates the in vitro skin permeation and penetration of penciclovir and acyclovir from commercialized creams for the treatment of herpes labialis (cold sores, using non viable excised human abdominal skin samples, which were exposed to 5 mg/cm2 of acyclovir 5% cream or penciclovir 1% cream. Methods After 24 h of cream application, excess cream was washed off and layers of stratum corneum were removed by successive tape stripping. Amounts of active ingredients having penetrated through the skin were measured, as well as the amounts in the washed-off cream, in skin strips and creams remaining in the skin. Molecular modelling was used to evaluate physico-chemical differences between the drugs. Western blot analysis enabled to determine whether the marker of basal cells keratin 5 could be detected in the various tape strips. Results Application of penciclovir 1% cream yielded higher concentration of drug in the deeper layers of the epidermis as well as a higher drug flux through the skin. Molecular modelling showed two higher hydrophobic moieties for acyclovir. Presence of the basal cell marker keratin 5 was underscored in the deeper tape strips from the skin, giving evidence that both drugs can reach their target cells. Conclusion Penciclovir 1% cream has the tendency to facilitate the diffusion of the drug through the stratum corneum into the deeper epidermis layers, in which it could reach the target basal cells at effective therapeutical concentration. The small difference in the surface properties between both molecules might also contribute to favour the passage of

  12. Self-collected genital swabs compared with cervicovaginal lavage for measuring HIV-1 and HSV-2 and the effect of acyclovir on viral shedding.

    Science.gov (United States)

    McNicholl, Janet M; Leelawiwat, Wanna; Whitehead, Sara; Hanson, Debra L; Evans-Strickfaden, Tammy; Cheng, Chen Y; Chonwattana, Wannee; Mueanpai, Famui; Kittinunvorakoon, Chonticha; Markowitz, Lauri; Dunne, Eileen F

    2017-03-01

    HIV-1 and HSV-2 are frequent genital co-infections in women. To determine how self-collected genital swabs compare to provider-collected cervicovaginal lavage, paired self-collected genital swabs and cervicovaginal lavage from women co-infected with HIV-1 and HSV-2 were evaluated. Women were in an acyclovir clinical trial and their samples were tested for HIV-1 RNA (361 samples) and HSV-2 DNA (378 samples). Virus shedding, quantity and acyclovir effect were compared. HIV-1 and HSV-2 were more frequently detected in self-collected genital swabs: 74.5% of self-collected genital swabs and 63.6% of cervicovaginal lavage had detectable HIV-1 (p ≤ 0.001, Fisher's exact test) and 29.7% of self-collected genital swabs and 19.3% of cervicovaginal lavage had detectable HSV-2 (p ≤ 0.001) in the placebo month. Cervicovaginal lavage and self-collected genital swabs virus levels were correlated (Spearman's rho, 0.68 for HIV; 0.61 for HSV-2) and self-collected genital swabs levels were generally higher. In multivariate modeling, self-collected genital swabs and cervicovaginal lavage could equally detect the virus-suppressive effect of acyclovir: for HIV-1, proportional odds ratios were 0.42 and 0.47 and for HSV-2, they were 0.10 and 0.03 for self-collected genital swabs and cervicovaginal lavage, respectively. Self-collected genital swabs should be considered for detection and measurement of HIV-1 and HSV-2 in clinical trials and other studies as they are a sensitive method to detect virus and can be collected in the home with frequent sampling.

  13. Clinical and virologic response to episodic acyclovir for genital ulcers among HIV-1 seronegative, herpes simplex virus type 2 seropositive African women: a randomized, placebo-controlled trial.

    Science.gov (United States)

    Baeten, Jared M; Reid, Stewart E; Delany-Moretlwe, Sinead; Hughes, James P; Wang, Richard S; Wilcox, Ellen; Limbada, Mohammed; Akpomiemie, Godspower; Corey, Lawrence; Wald, Anna; Celum, Connie

    2012-01-01

    In a randomized trial among African women with recurrent genital herpes, episodic acyclovir therapy resulted in modestly greater likelihood of lesion healing (hazard ratio [HR] = 1.48, P = 0.098; mean, 5.1 vs. 6.0 days) and cessation of herpes simplex virus shedding (HR = 1.88, P = 0.008; mean, 3.0 vs. 5.0 days) compared with placebo, similar to results of studies in high-income countries (ClinicalTrials.gov registration NCT00808405).

  14. Safety and tolerability of combination acyclovir 5% and hydrocortisone 1% cream in adolescents with recurrent herpes simplex labialis.

    Science.gov (United States)

    Strand, Anders; Böttiger, Disa; Gever, Larry N; Wheeler, William

    2012-01-01

    A Phase 3, open-label, multicenter study was conducted to assess the safety of the combination of 5% acyclovir and 1% hydrocortisone cream (AHC cream) in the treatment of recurrent herpes simplex labialis (HSL) in immunocompetent adolescents. Eligible subjects were aged 12 to 17 years and had a history of recurrent labial herpes with two or more episodes during the last 12 months. Subjects initiated treatment at the first signs or symptoms of a herpes recurrence-at the earliest prodromal phase and preferably before the presence of papules or vesicles. Subjects applied the cream topically five times per day for 5 days. Adverse events, categorization of recurrence (ulcerative or nonulcerative), and maximum lesion area (maximum area of an ulcerative lesion) were assessed. Of the 134 subjects analyzed for safety, 131 had data for categorization of recurrence at the post-treatment visit 3 ± 1 weeks after the last dose. Seventy-eight subjects (59.5%) had nonulcerative recurrences, and 53 (40.5%) had ulcerative recurrences. All 131 subjects reached the stage of normal skin, with no signs or symptoms, at the follow-up visit. The mean maximum lesion area in the 53 subjects with ulcerative herpes lesion was 39 mm(2). Five subjects reported five adverse events (secondary herpes labialis recurrences, n = 2; infectious rhinitis, n = 1; application site inflammation, n = 1; bronchial asthma, n = 1). All adverse events were of mild to moderate intensity. The results of this study demonstrate that the combination of AHC cream is well tolerated in the treatment of recurrent HSL in adolescents.

  15. Utilization of nanotechnology to enhance percutaneous absorption of acyclovir in the treatment of herpes simplex viral infections.

    Science.gov (United States)

    Al-Subaie, Mutlaq M; Hosny, Khaled M; El-Say, Khalid Mohamed; Ahmed, Tarek A; Aljaeid, Bader M

    2015-01-01

    This study aimed to formulate an optimized acyclovir (ACV) nanoemulsion hydrogel in order to provide a solution for the slow, variable, and incomplete oral drug absorption in patient suffering from herpes simplex viral infection. Solubility of ACV in different oils, surfactants, and cosurfactants was explored utilizing a cubic model mixture design to obtain a nanoemulsion with minimum globule size. Preparation of an optimized ACV nanoemulsion hydrogel using a three-factor, three-level Box-Behnken statistical design was conducted. The molecular weight of chitosan (X1), percentage of chitosan (X2), and percentage of Eugenol as a skin permeation enhancer (X3) were selected to study their effects on hydrogel spreadability (Y1) and percent ACV permeated through rat skin after 2.5 hours (Y2). A pharmacokinetic study of the optimized ACV nanoemulsion hydrogel was conducted in rats. Mixtures of clove oil and castor oil (3:1 ratio), Tween 80 and Span 80 (3:1 ratio), and propylene glycol and Myo-6V (3:1 ratio) were selected as the oil, surfactant, and cosurfactant phases, respectively. Statistical analysis indicated that the molecular weight of chitosan has a significant antagonistic effect on spreadability, but has no significant effect on the percent ACV permeated. The percentage of chitosan also has a significant antagonistic effect on the spreadability and percent ACV permeated. On the other hand, the percentage of Eugenol has a significant synergistic effect on percent ACV permeated, with no effect on spreadability. The ex vivo study demonstrated that the optimized ACV nanoemulsion hydrogel showed a twofold and 1.5-fold higher permeation percentage than the control gel and marketed cream, respectively. The relative bioavailability of the optimized ACV nanoemulsion hydrogel improved to 535.2% and 244.6% with respect to the raw ACV hydrogel and marketed cream, respectively, confirming improvement of the relative bioavailability of ACV in the formulated nanoemulsion

  16. Pharmacokinetics of amino acid ester prodrugs of acyclovir after oral administration: interaction with the transporters on Caco-2 cells.

    Science.gov (United States)

    Katragadda, Suresh; Jain, Ritesh; Kwatra, Deep; Hariharan, Sudharshan; Mitra, Ashim K

    2008-10-01

    In vivo systemic absorption of the amino acid prodrugs of acyclovir (ACV) after oral administration was evaluated in rats. Stability of the prodrugs, L-alanine-ACV (AACV), L-serine-ACV (SACV), L-isoleucine-ACV (IACV), gamma-glutamate-ACV (EACV) and L-valine-ACV (VACV) was evaluated in various tissues. Interaction of these prodrugs with the transporters on Caco-2 cells was studied. In vivo systemic bioavailability of these prodrugs upon oral administration was evaluated in jugular vein cannulated rats. The amino acid ester prodrugs showed affinity towards various amino acid transporters as well as the peptide transporter on the Caco-2 cells. In terms of stability, EACV was most enzymatically stable compared to other prodrugs especially in liver homogenate. In oral absorption studies, ACV and AACV showed high terminal elimination rate constants (lambda(z)). SACV and VACV exhibited approximately five-fold increase in area under the curve (AUC) values relative to ACV (pACV. C(last(T)) (concentration at the last time point) of SACV was observed to be 0.18+/-0.06 microM in plasma which is two times better than VACV and three times better than ACV. Amino acid ester prodrugs of ACV were absorbed at varying amounts (C(max)) and eliminated at varying rates (lambda(z)) thereby leading to varying extents (AUC). The amino acid ester prodrug SACV owing to its enhanced stability, higher AUC and better concentration at last time point seems to be a promising candidate for the oral treatment of herpes infections.

  17. The use of local concentrated heat versus topical acyclovir for a herpes labialis outbreak: results of a pilot study under real life conditions

    Directory of Open Access Journals (Sweden)

    Wohlrab J

    2013-11-01

    Full Text Available Johannes Wohlrab,1 Franziska Voß,2 Christian Müller,2 Lars C Brenn21Department of Dermatology and Venereology, Martin Luther University of Halle-Wittenberg, Halle, 2Department of Medical Science and Operations, Riemser Pharma GmbH, Greifswald, GermanyBackground: Frequent outbreak of herpes labialis can affect quality of life by prodromes like burning, itching, and swelling. Topical applied preparations aim to shorten the duration of symptoms, inhibit the virus replication and/or accelerate the healing process. Local concentrated heat (LCH can reduce burning, itching, or swelling of the skin by influence of mechano-heat sensitive afferent neurons.Patients and methods: To examine the effectiveness of two different topical applications (LCH versus topical acyclovir [TACV] under real life conditions, we conducted a prospective, observational, reference-controlled cohort pilot study with 103 patients. Occurrence of prodromal burning, itching, swelling, and quality of life were assessed.Results: The LCH observation group (OG showed a significantly faster improvement in all symptoms after 1-day of application than the TACV OG. The burden and duration of disease was lower and shorter in the LCH OG than in the TACV OG.Conclusions: The prodromal symptoms in recurrent herpes labialis were attenuated more effectively by LCH than by TACV.Keywords: herpes labialis, local concentrated heat, acyclovir

  18. Synthesis and biological evaluation of nucleoside analogues than contain silatrane on the basis of the structure of acyclovir (ACV) as novel inhibitors of hepatitis B virus (HBV).

    Science.gov (United States)

    Han, Anyue; Li, Lingna; Qing, Kuiyou; Qi, Xiaolu; Hou, Leping; Luo, Xintong; Shi, Shaohua; Ye, Faqing

    2013-03-01

    Hepatitis B virus (HBV) infection causes major public health problems worldwide. Acyclovir (ACV) is mainly used to inhibit herpes simplex virus (HSV) rather than HBV. In this study, we used the combination principle to design and synthesize nucleoside analogues that contain silatrane on the basis of the structure of ACV. We found that the compounds were effective inhibitors of HBV, both in vitro and in vivo. All of the compounds showed suppressive activity on the expression of HBV surface antigen (HBsAg) and HBV e antigen (HBeAg) in the HepG2.2.15 cell line with low cytotoxicity. One of compounds was studied in HBV transgenic mice model, and the test results showed its ability to reduce the levels of HBsAg, HBeAg and HBV DNA by ELASE and qPCR. Furthermore, significant improvement of T lymphocyte was observed after treatment, as evaluated by flow cytometry (FCM).

  19. Modification of glassy carbon electrode with a bilayer of multiwalled carbon nanotube/tiron-doped polypyrrole: Application to sensitive voltammetric determination of acyclovir

    Energy Technology Data Exchange (ETDEWEB)

    Shahrokhian, Saeed, E-mail: shahrokhian@sharif.edu [Department of Chemistry, Sharif University of Technology, Tehran 11155-3516 (Iran, Islamic Republic of); Institute for Nanoscience and Technology, Sharif University of Technology, Tehran (Iran, Islamic Republic of); Azimzadeh, Mahnaz [Department of Chemistry, Sharif University of Technology, Tehran 11155-3516 (Iran, Islamic Republic of); Amini, Mohammad K. [Department of Chemistry, Isfahan University, Isfahan (Iran, Islamic Republic of)

    2015-08-01

    A novel voltammetric sensor based on glassy carbon electrode (GCE) modified with a thin film of multi-walled carbon nanotubes (MWCNTs) coated with an electropolymerized layer of tiron-doped polypyrrole was developed and the resulting electrode was applied for the determination of acyclovir (ACV). The surface morphology and property of the modified electrode were characterized by field emission scanning electron microscopy and electrochemical impedance spectroscopy techniques. The electrochemical performance of the modified electrode was investigated by means of linear sweep voltammetry (LSV). The effect of several experimental variables, such as pH of the supporting electrolyte, drop size of the cast MWCNTssuspension, number of electropolymerization cycles and accumulation time was optimized by monitoring the LSV response of the modified electrode toward ACV. The best response was observed at pH 7.0 after accumulation at open circuit for 160 s. Under the optimized conditions, a significant electrochemical improvement was observed toward the electrooxidation of ACV on the modified electrode surface relative to the bare GCE, resulting in a wide linear dynamic range (0.03–10.0 μM) and a low detection limit (10.0 nM) for ACV. Besides high sensitivity, the sensor represented high stability and good reproducibility for ACV analysis, and provided satisfactory results for the determination of this compound in pharmaceutical and clinical preparations. - Highlights: • A simple method was employed to construct a thin film modified electrode. • Tiron-doped polypyrrole was electropolymerized on MWCNT precast glassy carbon electrode. • Electrode surface characterization was performed by microscopic and spectroscopic techniques. • The modified electrode showed nano-molar detection limit for acyclovir. • The modified electrode was applied for the detection of ACV in pharmaceutical and clinical preparations.

  20. QbD-Enabled Development of Novel Stimuli-Responsive Gastroretentive Systems of Acyclovir for Improved Patient Compliance and Biopharmaceutical Performance.

    Science.gov (United States)

    Singh, Bhupinder; Kaur, Anterpreet; Dhiman, Shashi; Garg, Babita; Khurana, Rajneet Kaur; Beg, Sarwar

    2016-04-01

    The current studies entail systematic quality by design (QbD)-based development of stimuli-responsive gastroretentive drug delivery systems (GRDDS) of acyclovir using polysaccharide blends for attaining controlled drug release profile and improved patient compliance. The patient-centric quality target product profile was defined and critical quality attributes (CQAs) earmarked. Risk assessment studies, carried out through Ishikawa fish bone diagram and failure mode, effect, and criticality analysis, helped in identifying the plausible risks or failure modes affecting the quality attributes of the drug product. A face-centered cubic design was employed for systematic development and optimization of the concentration of sodium alginate (X 1) and gellan (X 2) as the critical material attributes (CMAs) in the stimuli-responsive formulations, which were evaluated for CQAs viz. viscosity, gel strength, onset of floatation, and drug release characteristics. Mathematical modeling was carried out for generation of design space, and optimum formulation was embarked upon, exhibiting formulation characteristics marked by excellent floatation and bioadhesion characteristics along with promising drug release control up to 24 h. Drug-excipient compatibility studies through FTIR and DSC revealed absence of any interaction(s) among the formulation excipients. In vivo pharmacokinetic studies in Wistar rats corroborated extension in the drug absorption profile from the optimized stimuli-responsive GR formulations vis-à-vis the marketed suspension (ZOVIRAX®). Establishment of in vitro/in vivo correlation (IVIVC) revealed a high degree of correlation between the in vitro and in vivo data. In a nutshell, the present investigations report the successful development of stimuli-responsive GRDDS of acyclovir, which can be applicable as a platform approach for other drugs too.

  1. 阿昔洛韦、干扰素治疗传染性单核细胞增多症疗效对比%Comparing the efficacy of acyclovir and interferon on treating infectious mononucleosis

    Institute of Scientific and Technical Information of China (English)

    黄冬梅

    2012-01-01

      ObjectiveTo compare the efficacy and satety of acyclovir and α-interferon on treating infectious mononucleosis(IM).Methods46 children with infectious mononucleosis were randomly divided into two groups and treated with acyclovir and α-interferon respectively.The efficacy and multipce clinical indicators of two groups were observed.ResultsThe excelence rate of acyclovir group and α-interferon group were respectively 86.96% and 82.61%,The two groups were no signifiant difference(p>0.05).ConclusionThe efficacy of acyclovir andα-interferon for the treatment of infectious mononuclrosis are without difference.%  目的比较阿昔洛韦、α-干扰素治疗传染性单核细胞增多症的疗效及安全性.方法将46例传染性单核细胞增多症患儿随机分成两组,分别给予阿昔洛韦及α-干扰素治疗.观察两组患儿治疗疗效及多个临床指标的差异.结果阿昔洛韦组与α-干扰素组有效率分别为86.96%和82.61%,阿昔洛韦组与α-干扰素组比较无显著差异(P>0.05).结论阿昔洛韦、α-干扰素用于治疗传染性单核细胞增多症临床疗效无差异.

  2. Hybrid molecularly imprinted polymers synthesized with 3-aminopropyltriethoxysilane-methacrylic acid monomer for miniaturized solid-phase extraction: A new and economical sample preparation strategy for determination of acyclovir in urine.

    Science.gov (United States)

    Yan, Hongyuan; Wang, Mingyu; Han, Yehong; Qiao, Fengxia; Row, Kyung Ho

    2014-06-13

    The miniaturized molecularly imprinted solid-phase extraction (mini-MISPE) coupled with high-performance liquid chromatography was proposed for the determination of acyclovir in urine. 1.5-mL tapered plastic centrifuge tube filled with hybrid molecularly imprinted polymers (HMIPs) was used as the cartridge of mini-MISPE, and the HMIPs synthesized with 3-aminopropyltriethoxy silane-methacrylic acid as monomer exhibited good recognition and selectivity for acyclovir. Under the optimized condition, good linear calibration was obtained in a range of 0.5-15μgmL(-1) with the correlation coefficient of 0.9994, and the recoveries at three spiked levels were 91.6-103.3% in urine with the relative standard deviation (RSD) of ≤3.5%. Excellent intra-day and inter-day repeatability were achieved with RSD of ≤2.6% and 4.0% in three different concentrations. This method combined the advantages of HMIPs and mini-MISPE, and it could become an alternative tool for analyzing the residues of acyclovir in complex urine matrices.

  3. Genotypic and phenotypic characterization of the thymidine kinase of ACV-resistant HSV-1 derived from an acyclovir-sensitive herpes simplex virus type 1 strain.

    Science.gov (United States)

    Saijo, Masayuki; Suzutani, Tatsuo; De Clercq, Erik; Niikura, Masahiro; Maeda, Akihiko; Morikawa, Shigeru; Kurane, Ichiro

    2002-12-01

    Twenty-four strains of acyclovir (ACV)-resistant (ACV(r)) herpes simplex virus type 1 (HSV-1) were generated from the HSV-1 TAS strain by exposure to ACV, and the genotype and phenotype of the thymidine kinase (TK) from these mutants were analyzed. The TK polypeptide of the ACV(r) HSV-1 strains was examined by Western blot using an anti-HSV-1 TK rabbit serum. The sensitivity of each strain to ACV, foscarnet and cidofovir (CDV) was also determined. A single guanine (G) insertion or a single cytosine (C) deletion was detected in 12 of the 24 ACV(r) strains at the G or C homopolymer stretches within the TK gene. Genotypic analysis predicted that two thirds of the ACV(r) HSV-1 strains expressed truncated TK polypeptides, while one third expressed viral TK polypeptide with a single amino acid substitution at various sites. Western blot abnormalities in the viral TK polypeptides were identified in 21 ACV(r) strains. There was an inverse correlation between the susceptibility of the HSV-1 mutant strains to ACV and that to CDV. Nucleotide sequencing of the TK gene and Western blot analysis of the viral TK polypeptides are considered to be one of the methods for predicting virus sensitivity to ACV and CDV.

  4. Characterization of DNA polymerase-associated acyclovir-resistant herpes simplex virus type 1: mutations, sensitivity to antiviral compounds, neurovirulence, and in-vivo sensitivity to treatment.

    Science.gov (United States)

    Wang, Li-Xin; Takayama-Ito, Mutsuyo; Kinoshita-Yamaguchi, Hitomi; Kakiuchi, Satsuki; Suzutani, Tatsuo; Nakamichi, Kazuo; Lim, Chang-Kweng; Kurane, Ichiro; Saijo, Masayuki

    2013-01-01

    Acyclovir (ACV)-resistant (ACV(r)) mutants were generated from plaque-purified ACV-sensitive herpes simplex virus type 1 (HSV-1) by culturing the virus in Vero cells in the presence of 2-amino-7-(1,3-dihydroxy-2-propoxymethyl) purine (S2242). Three DNA polymerase (DNApol)-associated ACV(r) HSV-1 generated under ACV selection in a previous study (Suzutani, T., Ishioka, K., De Clercq, E., et al., Antimicrob. Agents Chemother., 47, 1707-1713, 2003) were also included. The sensitivity of the mutants to other antivirals and their neurovirulence were determined. The treatment efficacy of ACV and ganciclovir (GCV) against ACV(r) HSV-1 infections was evaluated in mice. Amino acid substitutions were demonstrated in conserved regions II and III in DNApol in 5 of the 6 mutants, while the other substitution was located in non-conserved regions. DNApol-associated ACV(r) clones showed cross-resistance to foscarnet, penciclovir, and vidarabine but were sensitive or hypersensitive to GCV, brivudin, sorivudine, and spongothymidine. The ACV(r) clone with an N815S mutation in DNApol showed similar neurovirulence to that of the parent virus; however, those with other mutations showed attenuation. GCV was effective in the treatment of the ACV(r) clone with similar virulence to that of parent HSV-1, while ACV was less effective in mice. These results indicate the importance of the characterization of HSV-1 isolates for the proper treatment of HSV-1 infections exhibiting ACV-resistance.

  5. Binding characteristics of homogeneous molecularly imprinted polymers for acyclovir using an (acceptor-donor-donor)-(donor-acceptor-acceptor) hydrogen-bond strategy, and analytical applications for serum samples.

    Science.gov (United States)

    Wu, Suqin; Tan, Lei; Wang, Ganquan; Peng, Guiming; Kang, Chengcheng; Tang, Youwen

    2013-04-12

    This paper demonstrates a novel approach to assembling homogeneous molecularly imprinted polymers (MIPs) based on mimicking multiple hydrogen bonds between nucleotide bases by preparing acyclovir (ACV) as a template and using coatings grafted on silica supports. (1)H NMR studies confirmed the AAD-DDA (A for acceptor, D for donor) hydrogen-bond array between template and functional monomer, while the resultant monodisperse molecularly imprinted microspheres (MIMs) were evaluated using a binding experiment, high performance liquid chromatography (HPLC), and solid phase extraction. The Langmuir isothermal model and the Langmuir-Freundlich isothermal model suggest that ACV-MIMs have more homogeneous binding sites than MIPs prepared through normal imprinting. In contrast to previous MIP-HPLC columns, there were no apparent tailings for the ACV peaks, and ACV-MIMs had excellent specific binding properties with a Ka peak of 3.44 × 10(5)M(-1). A complete baseline separation is obtained for ACV and structurally similar compounds. This work also successfully used MIMs as a specific sorbent for capturing ACV from serum samples. The detection limit and mean recovery of ACV was 1.8 ng/mL(-1) and 95.6%, respectively, for molecularly imprinted solid phase extraction coupled with HPLC. To our knowledge, this was the first example of MIPs using AAD-DDA hydrogen bonds.

  6. Analysis of the combined effect of local UV and acyclovir on herpes zoster%局部紫外线联合阿昔洛韦治疗带状疱疹的疗效观察

    Institute of Scientific and Technical Information of China (English)

    李智忠

    2010-01-01

    目的 观察局部紫外线照射联合阿昔洛韦治疗带状疱疹的临床疗效.方法 138例带状疱疹患者分为2组.治疗组用阿昔洛韦口服治疗加局部紫外线照射;对照组单用阿昔洛韦治疗带状疱疹.结果 治疗组有效率(97.92%)明显高于对照组(P<0.05),带状疱疹后遗神经痛发生率亦比对照组明显降低.结论 局部紫外线联合阿昔洛韦治疗带状疱疹起效快,疗程短,疗效显著,且能防止后神经痛的发生.%Objective To understand partial response of herpes zoster to ultraviolet radiation,and find other methods of herpes zoster treatment.Methods 138 cases of herpes zoster were divided into two groups.The treatment group received oral acyclovir and local ultraviolet irradiation while the control group received acyclovir alone.Results Treatment efficacy was significantly higher in the treatment group(97.92%)compared to the control( P < 0.05),and the incidence of postherpetic neuralgia was also significantly lower in the treatment group.Conclusion Local UV combined with acyclovir treatment of herpes zoster produces fast,brief duration,significant effects,and can prevent the occurrence of postherpetic neuralgia.

  7. Protocol for German trial of Acyclovir and corticosteroids in Herpes-simplex-virus-encephalitis (GACHE: a multicenter, multinational, randomized, double-blind, placebo-controlled German, Austrian and Dutch trial [ISRCTN45122933

    Directory of Open Access Journals (Sweden)

    Schielke Eva

    2008-10-01

    Full Text Available Abstract Background The treatment of Herpes-simplex-virus-encephalitis (HSVE remains a major unsolved problem in Neurology. Current gold standard for therapy is acyclovir, a drug that inhibits viral replication. Despite antiviral treatment, mortality remains up to 15%, less than 20% of patients are able to go back to work, and the majority of patients suffer from severe disability. This is a discouraging, unsatisfactory situation for treating physicians, the disabled patients and their families, and constitutes an enormous burden to the public health services. The information obtained from experimental animal research and from recent retrospective clinical observations, indicates that a substantial benefit in outcome can be expected in patients with HSVE who are treated with adjuvant dexamethasone. But currently there is no available evidence to support the routine use of adjuvant corticosteroid treatment in HSVE. A randomized multicenter trial is the only useful instrument to address this question. Design GACHE is a multicenter, randomized, double-blind, placebo-controlled, parallel group clinical trial of treatment with acyclovir and adjuvant dexamethasone, as compared with acyclovir and placebo in adults with HSVE. The statistical design will be that of a 3-stage-group sequential trial with potential sample size adaptation in the last stage. Conclusion 372 patients with proven HSVE (positive HSV-DNA-PCR, aged 18 up to 85 years; with focal neurological signs no longer than 5 days prior to admission, and who give informed consent will be recruited from Departments of Neurology of academic medical centers in Germany, Austria and The Netherlands. Sample size will potentially be extended after the second interim analysis up to a maximum of 450 patients. Trial Registration Current Controlled Trials ISRCTN45122933

  8. 中药佐治老年HIV/AIDS合并带状疱疹疗效观察%Effect of traditional Chinese medicine combined with acyclovir on herpes zoster in elderly with HIV/AIDS

    Institute of Scientific and Technical Information of China (English)

    梁飞立; 苏文桂; 何艳英; 余丰; 方鹏

    2012-01-01

    Objective It is to observe the effect of traditional Chinese medicine combined with acyclovir on herpes zoster in 30 elderly patients with HIV/AIDS. Methods Sixty elderly patients with HIV/AIDS were randomly divided into two groups. Thirty patients in treatment group were treated with external application of traditional Chinese medicine combined with acyclovir; thirty patients in control group were treated with acyclovir only. Results In treatment group, 17 cases were cured and 9 cases were improved, the effective rate was 87% . In control group, 14 cases were cured and 4 cases were improved, the effective rate was 60% . There was significantly difference in effective rate between both groups. The cured time of skin lesions was ( 16.17 ± 5. 47 ) days in treatment group, and was ( 20. 50 ± 6. 35 ) days in control group, there was significant difference between both groups. Conclusion External application of traditional Chinese medicine combined with acyclovir can shorten healing time of skin lesions caused by herpes zoster in the elderly with IV/AIDS and increase cure rate.%目的 探讨中药外敷配合阿昔洛韦治疗老年HIV/AIDS合并带状疱疹的疗效.方法 60例患者随机分为2组,治疗组30例用中药外敷及阿昔洛韦静脉滴注,对照组30例单用阿昔洛韦静脉滴注.结果 治疗组治愈17 例,好转9例,未愈4例,治愈好转率87%(26/30);对照组治愈14 例,好转4例,未愈12例,治愈好转率60%(18/30);2组治愈好转率比较有显著性差异(2 =5.455,P<0.05).治疗组疱疹愈合时间(16.17±5.47)d,对照组(20.50±6.35)d,2组疱疹愈合时间比较有显著性差异(t=-2.833,P<0.05).结论 中药外敷配合阿昔洛韦治疗老年HIV/AIDS 合并带状疱疹患者能缩短疱疹愈合时间,提高治愈好转率.

  9. 单纯口服阿昔洛韦治疗单疱病毒性角膜炎57例临床观察%Clinical Observation of 57 Cases of Herpes Simplex Keratitis Treated with Oral Acyclovir

    Institute of Scientific and Technical Information of China (English)

    梁柯

    2015-01-01

    目的探讨单纯口服阿昔洛韦治疗单疱病毒性角膜炎疗效。方法单疱病毒性角膜炎患者了57例82只眼,其中上皮型49例74只眼(90.2%);深层型8例8只眼(9.8%)。口服阿昔洛韦1g/d,分5次口服,当病情好转稳定后,改阿昔洛韦800mg/d,分2次口服。结果上皮型49例74只眼及深层型7例7只眼痊愈,治愈率为98.7%,1例1只眼(深层型),好转,总有效率为100%。随访6个月~2年,平均随访1.2年,仅1眼复发。结论单纯口服无环鸟苷治疗单疱病毒性角膜炎具有复发率低,用法简单、安全、有效的优点。%Objective To investigate a simple oral acyclovir treatment of herpes simplex virus keratitis ef icacy.Methods Patients with herpes simplex virus keratitis 82 eyes of 57 cases,including 49 cases of epithelial type 74 eyes (90.2%);8 cases of deep 8 eyes (9.8%).Oral acyclovir daily lg,5 times oral y,when her condition improved stability,change of acyclovir 800 mg/d,2 times a day oral y. Results 49 cases of epithelial type 74 deep eyes and 7 cases seven eyes healed,the cure rate was 98.7%,one case of an eye (deep type),improved,the total ef ective rate was 100%.Fol ow-up in June to 2 years,with an average fol ow-up of 1.2 years,only one relapse.Conclusion The simple oral acyclovir treatment of herpes simplex virus keratitis have recur ence rate,usage is simple,safe and ef ective advantages.

  10. Desenvolvimento e validação de um método analítico simples e rápido por espectroscopia UV para quantificação de aciclovir em matrizes hidrofílicas de liberação prolongada Development and validation of a simple and rapid analytical method by UV spectroscopy for acyclovir quantification in hydrophilic matrices for sustained release

    Directory of Open Access Journals (Sweden)

    Fernanda Malaquias Barboza

    2010-01-01

    Full Text Available This work reports the validation of an analytical UV spectrophotometric method to assay acyclovir in hydrophilic matrices (assay and dissolution studies. The method was linear in the range between 2.5-20 µg mL-1, presenting a good correlation coefficient ( r = 0,9999. Precision and accuracy analysis showed low relative standart deviation (< 2.0 % and a good recoveries percentual (98.9-100 %. The procedure was linear, accurate, and robust. The method is simple and cheap. It does not use polluting reagents and can be applied in dissolution studies, being an adequate alternative to assay acyclovir in hydrophilic matrices tablets.

  11. Effect of Acyclovir on the Neurological Function and Cytokines of Children with Viral Meningitis%阿昔洛韦对病毒性脑膜炎患儿神经功能及细胞因子的作用

    Institute of Scientific and Technical Information of China (English)

    肖平; 罗毅

    2015-01-01

    OBJECTIVE:To observe the effect of acyclovir on neurological function and cytokines of children with viral menin-gitis. METHODS:Totally 70 children with viral meningitis were randomly divided into control group and observation group. All children were given routine treatment,including defervescence,reducing intracranial pressure and regulating water and electrolyte balance,etc. Based on it,the control group was treated by Ribavirin glucose injection 15 mg/kg,iv,bid;observation group was treated by Acyclovir glucose injection 5 mg/kg,iv,tid. The course for both was 7 d. The clinical data was compared,including the vascular endothelial growth factor (VEGF),matrix metalloproteinase-9 (MMP-9) in cerebrospinal fluid (CSF) and serum,insu-lin-like growth factor-Ⅱ(IGF-Ⅱ) and insulin like growth factor binding protein-3(IGFBP-3) in CSF before and after treatment and the incidence of adverse reactions. There were no obvious adverse reactions during the treatment. RESULTS:After treatment, the VEGF and MMP-9 in serum and the VEGF,MMP-9,IGF-Ⅱ and IGFBP-3 in CSF in 2 groups were significantly lower than before,and observation group was lower than control group,with significant differences(P<0.05). There was no adverse reactions in 2 groups during the treatment. CONCLUSIONS:Compared with ribavirin,acyclovir can more obviously improve the neurological function and cytokines of children with viral meningitis,with similar safety.%目的:观察阿昔洛韦对病毒性脑膜炎患儿神经功能及细胞因子的作用。方法:70例病毒性脑膜炎患儿随机均分为对照组和观察组。两组患儿均给予退热、降低颅内压、调节水电解质平衡等常规治疗。在此基础上,对照组患儿给予利巴韦林葡萄糖注射液15 mg/kg静脉滴注,每日2次;观察组患儿给予阿昔洛韦葡萄糖注射液5 mg/kg静脉滴注,每日3次。两组患儿疗程均为7 d。观察两组患儿治疗前后血清及脑脊液中内皮生长因子

  12. 阿昔洛韦在小儿病毒性脑膜炎中的疗效与安全性分析%Study on the effectivesess and safety of acyclovir in the treatment of children with viral meningitis

    Institute of Scientific and Technical Information of China (English)

    郭泽丽

    2014-01-01

    目的:分析阿昔洛韦在小儿病毒性脑膜炎中的疗效与安全性。方法选取2010-08-2013-06于本院进行治疗的76例病毒性脑膜炎患儿为研究对象,随机分为对照组(利巴韦林组)38例和观察组(阿昔洛韦组)38例,然后将2组中轻症与重症患儿的总有效率、不良反应发生率及治疗前后的血清、脑脊液NSE、PCT、IL-6水平进行比较。结果观察组中轻症与重症患儿的总有效率分别高于对照组,不良反应发生率低于对照组,而治疗后的血清、脑脊液NSE、PCT、IL-6水平均低于观察组治疗前及对照组治疗后( P<0.05)。结论阿昔洛韦在小儿病毒性脑膜炎中的疗效与安全性均相对较佳,对于改善神经功能及控制炎症均有积极作用。%Objective To study and analyze the effectiveness and safety of acyclovir in the treatment of children with viral meningitis .Methods 76 children with viral meningitis in our hospital from August 2010 to June 2013 were selected as research objects ,and were randomly divided into control group(ribavirin group)38 cases and observation group(acyclovir group)38 ca-ses ,then the total effective rates of mild and severe viral meningitis ,incidence of adverse reaction and NSE ,PCT ,IL-6 levels in serum ,cerebrospinal fluid before and after the treatment of two groups were compared .Results The total effective rates of mild and severe viral meningitis in observation group were respectively higher than those of control group ,incidence of adverse reaction was lower than that of control group ,serum and cerebrospinal fluid NSE ,PCT and IL-6 levels after the treatment were all lower than those of observation group before treatment and those of control group after the treatment ,all(P<0 .05) ,there were all significant differences .Conclusion The effect and safety of acyclovir in the treatment of children with viral meningitis is relatively better ,and it plays an active role in improving

  13. Bone marrow transplantation in a child with Wiskott-Aldrich syndrome latently infected with acyclovir-resistant (ACV(r)) herpes simplex virus type 1: emergence of foscarnet-resistant virus originating from the ACV(r) virus.

    Science.gov (United States)

    Saijo, Masayuki; Yasuda, Yukiharu; Yabe, Hiromasa; Kato, Shunichi; Suzutani, Tatsuo; De Clercq, Erik; Niikura, Masahiro; Maeda, Akihiko; Kurane, Ichiro; Morikawa, Shigeru

    2002-09-01

    A human leukocyte antigen (HLA)-matched unrelated bone marrow transplantation (BMT) was performed in a 13-year-old patient with the congenital immunodeficiency syndrome, Wiskott-Aldrich syndrome. The patient had a history of acyclovir (ACV)-resistant (ACV(r)) herpes simplex virus type 1 (HSV-1) infections prior to BMT. After BMT, the skin lesions caused by HSV-1 relapsed on the face and genito-anal areas. Ganciclovir (GCV) therapy was initiated, but the mucocutaneous lesions worsened. An HSV-1 isolate recovered from the lesions during this episode was resistant to both ACV and GCV. The ACV(r) isolate was confirmed to have the same mutation in the viral thymidine kinase (TK) gene as that of the previously isolated ACV(r) isolates from the patient. After treatment switch to foscarnet (PFA), there was a satisfactory remission but not a complete recovery. Although the mucocutaneous lesions improved, a PFA-resistant (PFA(r)) HSV-1 was isolated 1 month after the start of PFA therapy. The PFA(r) HSV-1 isolate coded for the same mutation in the viral TK gene as the ACV(r) HSV-1 isolates. Furthermore, the PFA(r) isolate also expressed a mutated viral DNA polymerase (DNA pol) with an amino acid (Gly) substitution for Val at position 715. This is the first report on the clinical course of a BMT-associated ACV(r) HSV-1 infection that subsequently developed resistance to foscarnet as well.

  14. Evaluation of effectiveness of acyclovir and interferon in treatment of genital herpes%对无环乌苷及干扰素治生殖器疱疹的效果评价

    Institute of Scientific and Technical Information of China (English)

    邢立亚; 张忠祥; 崔荣

    1997-01-01

    114 patients with genital herpes(GH)divided into three groups at random were treated separately with acyclovir(ACV,0.8g daily orally),interferon(IFN,one million u.in.)and routine external therapy,such as 3% boric acid solution or 0.1% rivanol solution.There was no difference in age and time of onset between these three groups.The effect of drugs was observed at the fourth and eighth days of treatment.A definite effectiveness was manifested in 10(37%)and 21 cases(77.8%)in ACV group,14(48.3%)and 25 cases(86.2%)in IFN group,and only 9(6.9%)and 13cases(22.4%)in routine therapy group.Statistical analysis revealed that ACV and IFN were much mor effective than routine therapy in terms of shortened course and symptoms relieved(P<0.05),but they could not prevent the recurrence of CH.

  15. Effect of acyclovir combined with narrow-band ultraviolet-B radiation and Carnation 33 NM-B in treating immunocompromised host with herpes zoster%阿昔洛韦联合高能红光和窄谱中波紫外线治疗免疫功能下降带状疱疹患者的疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈胜平; 陈锦华; 陈向齐; 吴洁; 牛高祥

    2013-01-01

      Objective To compare the effect of acyclovir combined with narrow-band ultraviolet-B radiation (NB-UVB) and Carnation 33 NM-B with that of acyclovir in the treatment of herpes zoster in immunocompromised patients. Methods Sixty-four immunocompromised patients with herpes zoster were divided into two groups, test group and control group randomly. The test group was treated with acyclovir combined with NB-UVB and the Carnation 33 NM-B;while the control group was treated with acyclovir. The efficacy was observed 14 days after treatment and the follow-up had been carried out for more than 1 months. Results The effective rate was 90.63%in the test group versus 68.75%in the control group (P=0.011). The effect of test group on vesicular scab, subside, pain relief and pain complete remission time was superior to that of the control group (P0.05). Conclusion The treatment with acyclovir combined with NB-UVB and the Carnation 33 NM-B is superior to acyclovir in immunocompromised patients with herpes zoster.%  目的比较阿昔洛韦联合高能红光和窄谱中波紫外线与单用阿昔洛韦治疗免疫功能下降带状疱疹患者的疗效,寻求一种更好的治疗方法。方法64例免疫功能下降带状疱疹患者随机分为试验组和对照组。试验组采用阿昔洛韦静脉滴注联合高能红光照射支配皮损区域的神经根体表投射部位和窄谱中波紫外线照射皮损局部,对照组单独静脉滴注阿昔洛韦,疗程均为14 d,随访1个月。结果试验组有效率为90.63%,高于对照组(68.75%)(P=0.011);试验组开始结痂时间、结痂脱落时间、疼痛开始缓解时间、疼痛基本缓解时间均低于对照组(P<0.001)。两组患者止疱时间、后遗神经痛发生率比较,差异无统计学意义(P>0.05)。结论阿昔洛韦联合高能红光和窄谱中波紫外线治疗免疫功能下降并发带状疱疹患者的疗效优于单用阿昔洛韦者。

  16. 清热散瘟口服液联合更昔洛韦治疗传染性单核细胞增多症的疗效观察%Effect of Qingre Sanwen Oral Liquid Combined with Acyclovir for Infectious Mononucleosis

    Institute of Scientific and Technical Information of China (English)

    王淑梅; 杨德光; 杨杰; 赵永生; 石军祥; 史桂荣

    2015-01-01

    目的:探讨清热散瘟口服液联合更昔洛韦治疗传染性单核细胞增多症的疗效与安全性。方法将46例患儿随机分为观察组和对照组,观察组24例采用清热散瘟口服液联合更昔洛韦治疗,对照组22例,单纯给予更昔洛韦治疗,观察比较两组临床症状的转归及临床疗效,并对观察结果进行研究分析。结果观察组的临床效果高于对照组,显效率明显优于对照组,差异有统计学意义(P<0.05)。结论使用清热散瘟口服液联合更昔洛韦治疗传染性单核细胞增多症能够显着提高有效率。%Objective Observe the acyclovir and Qingre Sanwen oral liquid for the treatment of infectious mononucleosis. Method 46 cases of infectious mononucleosis children were randomly divided into two groups, Observation group of 24 patients with acyclovir and therapy, and the observation results of the 22patients analysis for the treatment of infectious mononucleosis. Compare of two groups of clinical symptoms and clinical curative effect. Result The effect of observation group was obviously higher than that of control group, significant efficiency was better than control group, the difference was statistically signiifcant(P<0.05). Conclusion Using the Qingre Sanwen oral liquid with acyclovir therapy type infectious mononucleosis can signiifcantly improve the efifciency.

  17. Curative effects of triple therapy by electric acupuncture, acyclovir, and prednisone on 25 cases of facial neuritis%电针、阿昔洛韦、泼尼松三联疗法治疗面神经炎25例疗效观察

    Institute of Scientific and Technical Information of China (English)

    卜宪聪; 刘诗翔; 周建丽

    2012-01-01

    目的 观察电针、阿昔洛韦、泼尼松联合治疗面神经炎的疗效.方法 选择确诊的面神经炎患者75例,随机分为3组.治疗组25例,予电针、阿昔洛韦、泼尼松三联疗法;对照Ⅰ组25例,采用电针、泼尼松及B族维生素等常规治疗;对照Ⅱ组25例,采用阿昔洛韦、泼尼松及B族维生素等常规治疗;疗程均为20d.结果 治疗组与对照Ⅰ组、对照Ⅱ组总有效率比较差异有统计学意义(P<0.05),治疗组与对照Ⅰ组、对照Ⅱ组治疗后潜伏期及波幅相比,差异有统计学意义(P<0.05).结论 采用电针、阿昔洛韦、泼尼松三联疗法比单独使用电针联合泼尼松治疗或阿昔洛韦联合泼尼松治疗面神经炎疗效更显著.%Objective To observe the curative effects of therapeutic alliance of electric acupuncture, acyclovir, and prednisone on facial neuritis. Methods 75 patients diagnosed as facial neuritis were randomly divided into three groups with 25 cases in each group. The treatment group received the triple therapy of electric acupuncture, acyclovir, and prednisone; control group I received conventional treatment with electric acupuncture, prednisone, and vitamin B; control group E received acyclovir, prednisone, and vitamin B. The course of treatment was 20 d. Results There were significant differences in the total effective rate between the treatment group and the control groups (P < 0. 05 ). There were significant differences in latency and amplitude of wave between the treatment group and the control groups after the treatment (P < 0. 05 ). Conclusion The curative effects of the triple therapy on facial neuritis are more significant than those of electric acupuncture combined with prednisone or acyclovir combined with prednisone.

  18. The Epstein-Barr virus (EBV)-encoded protein kinase, EBV-PK, but not the thymidine kinase (EBV-TK), is required for ganciclovir and acyclovir inhibition of lytic viral production.

    Science.gov (United States)

    Meng, Qiao; Hagemeier, Stacy R; Fingeroth, Joyce D; Gershburg, Edward; Pagano, Joseph S; Kenney, Shannon C

    2010-05-01

    Ganciclovir (GCV) and acyclovir (ACV) are guanine nucleoside analogues that inhibit lytic herpesvirus replication. GCV and ACV must be monophosphorylated by virally encoded enzymes to be converted into nucleotides and incorporated into viral DNA. However, whether GCV and/or ACV phosphorylation in Epstein-Barr virus (EBV)-infected cells is mediated primarily by the EBV-encoded protein kinase (EBV-PK), the EBV-encoded thymidine kinase (EBV-TK), or both is controversial. To examine this question, we constructed EBV mutants containing stop codons in either the EBV-PK or EBV-TK open reading frame and selected for stable 293T clones latently infected with wild-type EBV or each of the mutant viruses. Cells were induced to the lytic form of viral replication with a BZLF1 expression vector in the presence and absence of various doses of GCV and ACV, and infectious viral titers were determined by a green Raji cell assay. As expected, virus production in wild-type EBV-infected 293T cells was inhibited by both GCV (50% inhibitory concentration [IC(50)] = 1.5 microM) and ACV (IC(50) = 4.1 microM). However, the EBV-PK mutant (which replicates as well as the wild-type (WT) virus in 293T cells) was resistant to both GCV (IC(50) = 19.6 microM) and ACV (IC(50) = 36.4 microM). Expression of the EBV-PK protein in trans restored GCV and ACV sensitivity in cells infected with the PK mutant virus. In contrast, in 293T cells infected with the TK mutant virus, viral replication remained sensitive to both GCV (IC(50) = 1.2 microM) and ACV (IC(50) = 2.8 microM), although susceptibility to the thymine nucleoside analogue, bromodeoxyuridine, was reduced. Thus, EBV-PK but not EBV-TK mediates ACV and GCV susceptibilities.

  19. Combined effects of interferon and acyclovir on herpes simplex virus in vitro%干扰素联合无环鸟苷抑制单纯疱疹病毒

    Institute of Scientific and Technical Information of China (English)

    胡楠; 龚启荣; 管怀进

    2003-01-01

    目的探讨干扰素( interferon, IFN )与无环鸟苷( acyclovir,ACV)联合使用抑制单纯疱疹病毒 (herpes simplex virus ,HSV) 时的药效及病毒耐药性产生情况.方法将HSV-Ⅰ分别接种于经IFN-α作用24h及未经IFN-α处理的非洲绿猴肾细胞中,加入不同浓度的ACV,培养72h后固定、染色、清点空斑数并计算ACV的半数有效剂量(ED50).将HSV-Ⅰ在含ACV及IFN-α与ACV的环境中连续培养10代, 分别在第3、5、7和10代测定ACV的ED50.结果 ACV对野生HSV-Ⅰ的ED50为142.0×10-9mol* L-1, IFN-α与ACV联合用药时ACV对野生HSV-Ⅰ的ED50为47.4×10-9mol* L-1 .HSV-Ⅰ在含ACV的环境中连续培养7代后即产生了耐药性,其ED50为第1代的82倍,而HSV-Ⅰ在含有ACV和IFN-α的环境中培养10代后未产生耐药性.结论 IFN和ACV联合应用具有协同作用,可以减少ACV的用量,提高疗效;联合用药可以有效延缓病毒对ACV耐药性的产生.

  20. Influence of the treatment protocol upon the in vivo efficacy of cidofovir (HPMPC) and of acyclovir (ACV) formulations in topical treatment of cutaneous HSV-1 infection in hairless mice.

    Science.gov (United States)

    Afouna, M I; Mehta, S C; Ghanem, A H; Higuchi, W I; Kern, E R; DeClercq, E; El-Shattawy, H H

    1999-05-01

    In recent studies we found that the topical effectiveness of acyclovir (ACV) formulations was a single-valued function of C-the target site free drug concentration. The topical efficacy was the same when the therapy was initiated 0, 1, or 2 days after intracutaneous herpes simplex virus type-1 (HSV-1) inoculation in hairless mice. The purpose of the present study was to examine the hypothesis that the topical effectiveness of cidofovir (HPMPC) would not be a single valued function of C and that it would be dependent upon when the therapy was initiated relative to the time of viral infection. Formulations of HPMPC and ACV in 95% DMSO as a vehicle were used. Hairless mice intracutaneously infected with HSV-1 were used, and 20 microL of the test formulation was topically applied twice a day. In protocol A, the treatment was continued until the fourth day after virus inoculation, whereas in protocol B the treatment was terminated on the day of virus inoculation. Treatment was initiated on various days ranging from day -6 to day 4, and the lesions were scored on day 5. Treatment of ACV according to protocol A proved efficacious whether started as early as 6 days before virus inoculation or later, whereas the efficacy of ACV was annihilated if applied following protocol B. For HPMPC, on the other hand, the in vivo efficacies were found to be strongly dependent on how early the therapy was initiated, and significant efficacy was observed even when the treatment was terminated on the day of virus inoculation. This difference was attributed to the virus-independent intracellular phosphorylation of HPMPC and slow clearance of its metabolites from the cell. It was also noted that, similar to ACV, for HPMPC the topical efficacy is likely to be a function of C for a fixed protocol. However, unlike for ACV, for HPMPC the efficacy was not a single-valued function of C.

  1. Lights and shadows in the challenge of binding acyclovir, a synthetic purine-like nucleoside with antiviral activity, at an apical-distal coordination site in copper(II)-polyamine chelates.

    Science.gov (United States)

    Pérez-Toro, Inmaculada; Domínguez-Martín, Alicia; Choquesillo-Lazarte, Duane; Vílchez-Rodríguez, Esther; González-Pérez, Josefa María; Castiñeiras, Alfonso; Niclós-Gutiérrez, Juan

    2015-07-01

    Several nucleic acid components and their metal complexes are known to be involved in crucial metabolic steps. Therefore the study of metal-nucleic acid interactions becomes essential to understand these biological processes. In this work, the synthetic purine-like nucleoside acyclovir (acv) has been used as a model of guanosine recognition with copper(II)-polyamine chelates. The chemical stability of the N9-acyclic arm in acv offers the possibility to use this antiviral drug to deepen the knowledge of metal-nucleoside interactions. Cu(II) chelates with cyclam, cyclen and trien were used as suitable receptors. All these copper(II) tetraamine chelates have in common the potential ability to yield a Cu-N7(apical) bond assisted by an appropriate (amine)N-H⋯O6(acv) intra-molecular interligand interaction. A series of synthesis afforded the following compounds: [Cu(cyclam)(ClO4)2] (1), {[Cu(cyclam)(μ2-NO3)](NO3)}n (2), {[Cu(cyclam)(μ2-SO4)]·MeOH}n (3), {[Cu(cyclam)(μ2-SO4)]·5H2O}n (4), [Cu(cyclen)(H2O)]SO4·2H2O (5), [Cu(cyclen)(H2O)]SO4·3H2O (6), [Cu(trien)(acv)](NO3)2·acv (7) and [Cu(trien)(acv)]SO4·0.71H2O (8). All these compounds have been characterized by X-ray crystallography and FT-IR spectroscopy. Our results reveal that the macrochelates Cu(cyclen)(2+) and Cu(cyclam)(2+) are unable to bind acv at an apical site. In contrast, the Cu(trien)(2+) complex has proved to be an efficient receptor for acv in compounds (7) and (8). In the ternary complex [Cu(trien)(acv)](2+), the metal binding pattern of acv consists of an apical Cu-N7 bond assisted by an intra-molecular (primary amino)N-H⋯O6(acv) interligand interaction. Structural comparisons reveal that this unprecedented apical role of acv is due to the acyclic nature of trien together with the ability of the Cu(trien)(2+) chelate to generate five-coordinated (type 4+1) copper(II) complexes.

  2. 阿昔洛韦口服治疗晚期妊娠生殖器疱疹的血药浓度和疗效评价%Plasma concentration and efficacy evaluation of oral acyclovir for genital herpes in late pregnancy

    Institute of Scientific and Technical Information of China (English)

    邓红梅; 刘敏

    2016-01-01

    Objective To evaluate the clinical efficacy of oral acyclovir for genital herpes in third trimester pregnant women and plasma concentration in delivery .Methods Altogether 23 patients of recurrent genital herpes were selected from March 2010 to December 2015. They orally administered acyclovir tablets 0.4g (tid) from gestation 32 to 36 week to the end of delivery.Acyclovir plasma concentration was detected in umbilical venous blood , umbilical artery blood and maternal venous blood sampled after delivery .Results Twenty patients underwent vaginal delivery .One case of malposition and 2 cases of fetal distress were changed to cesarean section .None of pregnant women complained of herpes activity during delivery , and no neonate appeared HSV infection .Plasma concentration of acyclovir in umbilical venous blood, umbilical artery blood and maternal venous blood was 251.38ng/mL, 231.57ng/mL and 430.64ng/mL, respectively. Acyclovir plasma concentration in 60.87%(14/23) of umbilical venous blood , 47.83%(11/23) of umbilical artery blood and 17.39%(4/23) of maternal venous blood samples was less than acyclovir steady-state plasma concentration (180ng/mL).There were no significant correlation between maternal weight and plasma concentration in umbilical venous blood , umbilical artery blood and maternal venous blood (r value was -0.207, 0.130 and 0.164, respectively, P value was 0.381, 0.876 and 0.773, respectively, all P>0.05). There was no correlation between childbirth process and plasma concentration in umbilical venous blood , umbilical artery blood and maternal venous blood (r value was -0.382, 0.264 and 0.139, respectively, P value was 0.076, 0.533 and 0.413, respectively, all P>0.05).Last dose interval was negatively associated with plasma concentration in umbilical venous blood , umbilical artery blood and maternal venous blood (r value was -0.584, -0.624 and -0.613, respectively,P value was 0.003, 0.001 and 0.002, respectively, all P<0.05).Conclusion Oral

  3. 牛痘疫苗致炎兔皮提取物注射液联合阿昔洛韦治疗老年带状疱疹的临床观察%Clinical Observation of Extracts from Rabbit Skin Inflamed by Vaccinia Virus for Injection Combined with Acyclovir in the Treatment of Senile Herpes Zoster

    Institute of Scientific and Technical Information of China (English)

    刘国海; 张贵田; 刘庆明

    2013-01-01

    目的:观察牛痘疫苗致炎兔皮提取物注射液联合阿昔洛韦治疗老年带状疱疹的疗效和安全性.方法:将120例患者均分成治疗组和对照组,治疗组给予牛痘疫苗致炎兔皮提取物注射液、阿昔洛韦、维生素B1、维生素B12联合治疗;对照组给予阿昔洛韦、维生素B1、维生素B12常规治疗,观察两组止疱时间、止痛时间、结痂时间、痊愈时间;并于治疗前及治疗第3、7、10天进行疼痛视觉模拟评分(VAS)评价,治疗过程中观察患者不良反应发生情况.结果:治疗组的止疱时间、止痛时间、结痂时间、痊愈时间、VAS评分等方面均优于对照组(P<0.05).两组均未见明显不良反应发生.结论:牛痘疫苗致炎兔皮提取物注射液联合阿昔洛韦治疗老年带状疱疹疗效较好、安全性较高,可明显减少后遗神经痛.%OBJECTIVE: To observe therapeutic efficacy and safety of Extracts from rabbit skin inflamed by vaccinia virus for injection (analgecine) combined with acyclovir in the treatment of senile herpes zoster. METHODS: 120 patients were randomly divided into treatment group and control group; treatment group received analgecine, acyclovir, vitamin B1 and vitamin B12, and control group was given conventional treatment of acyclovir, vitamin B1 and vitamin B12. The time of response and analgesia, duration of lesion clearance and recovery time were observed in 2 groups. Pain visual analog scale (VAS) evaluation was conducted before treatment, 3, 7 and 10 days after treatment. The adverse drug reaction in the treatment were observed. RESULTS: The time of response and analgesia, duration of lesion clearance and recovery time in treatment group were better than in control group (P< 0.05). VAS scores decreased significantly. There was no significant ADR found in both groups. CONCLUSION: Analgecine combined with acyclovir is effective in the treatment of herpes zoster, and can significantly reduce postherpetic

  4. 带状疱疹性角膜炎采用阿昔洛韦联合玻璃酸钠及氟米龙眼液治疗的临床体会%The Clinical Experience of Acyclovir Combined With Sodium Hyaluronate and Fluorometholone Eye Drops in Treatment of Herpes Zoster Keratitis

    Institute of Scientific and Technical Information of China (English)

    赵艳辉

    2015-01-01

    目的:对带状疱疹性角膜炎采用阿昔洛韦联合玻璃酸钠及氟米龙眼液治疗的临床效果进行研究分析。方法选取我院收治的带状疱疹性角膜炎患者进行临床研究。结果治疗组总有效率90.00%、畏光消失时间(8.02±3.11)min,荧光素染色阴性时间(12.13±3.02)min,同对照组患者的70.00%(、11.05±2.61)min和(15.47±2.38)min相比,P<0.05。结论阿昔洛韦联合玻璃酸钠及氟米龙眼液治疗带状疱疹性角膜炎疾病效果显著。%ObjectiveAnalysis the clinical effect of herpes zoster keratitis with acyclovir combined with sodium hyaluronate and fluorometholone eye drops in the treatment of Herpes zoster keratitis.Methods Selected patients with herpes zoster keratitis in our hospital.Results The total effective rate of treatment group reached to 90%, photophobia disappeared time (8.02 ± 3.11) min, lfuorescein staining negative time (12.13 ± 3.02) min with 70% of control patients, (11.05 ± 2.61) min and (15.47 ± 2.38) min,P<0.05.Conclusion Acyclovir combined with sodium hyaluronate and lfuorometholone eye drops in treatment of herpes zoster keratitis disease has clinically signiifcant.

  5. Effects of honey to acyclovir in the rabbit eye transport kinetics%蜂蜜对阿昔洛韦在兔眼内转运动力学特性的影响

    Institute of Scientific and Technical Information of China (English)

    何群; 王适; 张湘晖; 张健; 姜宇; 许江丽

    2011-01-01

    目的:从药动学角度探索蜂蜜增强阿昔洛韦(ACV)治疗单纯疱疹病毒性角膜炎(HSK)药效的作用机制,为2药合用处方及给药方案设计提供依据.方法:分别单次给予兔眼内含5%蜂蜜和0%蜂蜜的目安眼膏,于不同时间取兔眼房水,高效液相色谱法测房水内ACV含量,建立数学模型,通过数学及统计学处理提取药动学参数,比较各参数差异.结果:含5%蜂蜜和0%蜂蜜的目安眼膏在兔眼内的转运均属于二室模型,含5%蜂蜜的目安眼膏在房水中吸收半衰期为不含蜂蜜目安眼膏的2.30倍,分布半衰期为2.12倍,达峰浓度为1.17倍,达峰时间为1.36倍,AUC为1.41倍.结论:蜂蜜可显著提高ACV在眼内的浓度及生物利用度,延长ACV在靶细胞内的作用时间,提高ACV在靶分子的滞留能力,使ACV在靶组织药效持久,从而提高疗效.%Objective: Using phaimacokinetics to explore the mechanism of honey to enhance the efficacy of acyclovir ( ACV) treatment of herpes simplex keratitis (HSK) , providing the basis for combination of the prescription of two drugs and dosage regimen designed. Method: Single dosages of 5% honey and 0% honey Meyasu eye ointment are injected into rabbit eyes. The aqueous humor of rabbit eye is measured at different times, specifically the content of ACV in aqueous humor by HPLC. Mathematical models are established, from which pharmacokinetic parameters are extracted and compared by mathematics and statistics methods. Result; Both the 5% and 0% honey Meyasu eye ointment in rabbit eyes are belong to a two-compartment model. The absorption half-life of the 5% Meyasu eye ointment in aqueous humor is as 2. 30 times longer, the distribution half-life is 2. 12 times longer, the peak concentration is 1. 17 times longer, the peak time is 1. 36 times longer, AUC is 1. 41 times longer when compared to the 0% Meyasu eye ointment. Conclusion: Honey can significantly increase the ACV concentration and bioavailability

  6. Clinical study of liquid nitrogen cryotherapy combined with acyclovir and mecobalamin in elderly patients with herpes zoster%液氮冷冻疗法联合阿昔洛韦片及甲钴胺分散片治疗老年人带状疱疹临床观察

    Institute of Scientific and Technical Information of China (English)

    曹鸿玮; 王菲菲; 杨俊亚; 王瑞; 郑晓红

    2014-01-01

    目的 探讨液氮冷冻疗法联合阿昔洛韦片、甲钴胺分散片口服治疗老年人带状疱疹的疗效和安全性. 方法 将520例老年人带状疱疹患者随机数字表法分为试验组和对照组,每组各260例,对照组患者口服阿昔洛韦片和甲钴胺分散片治疗,试验组在对照组用药的基础上加用液态氮冷冻治疗,用棉签蘸取液氮在皮损处轻擦,1次/d,共5次.在治疗的第5、14、30天随访患者,观察两组患者是否有新水疱出现、干燥、结痂情况,记录皮疹止疱时间、结痂时间、结痂脱落时间、疼痛消退时间和后遗神经痛(postherpetic neuralgia,PHN)情况. 结果 试验组有效率为93.9%(244/260),高于对照组84.2%(219例),差异有统计学意义(x2=12.32,P<0.05).试验组患者结痂、水疱干燥、疼痛消退时间分别为(2.6±0.8)d、(8.2±1.7)d、(9.2±2.5)d,均低于对照组(4.8±1.4)d,(11.3±2.2)d,(12.8±3.1)d(均P<0.01).试验组止疱时间(1.9±0.6)d与对照组(1.8±0.8)d比较,差异无统计学意义(t=0.933,P>0.05).试验组患者后遗神经痛发生率6.9%(18/260),与对照组患者后遗神经痛发生率18.1%(47/260),差异有统计学意义(x2=14.787,P<0.01). 结论 液氮冷冻联合阿昔洛韦片、甲钴胺分散片口服疗效优于阿昔洛韦片、甲钴胺分散片口服治疗,试验组具有水疱干燥、结痂时间缩短、疼痛消退快、后遗神经痛发生减少的优点.%Objective To compare the efficacy and safety of liquid nitrogen cryotherapy combined with acyclovir and mecobalamin in the treatment of herpes zoster in elderly patients.Methods 520 elderly patients with herpes zoster were randomly divided into two groups,experimental group and control group (n=260,each).Patients in experimental group were treated with liquid nitrogen cryotherapy,using liquid nitrogen cotton swab to graze the skin lesions 2-3 times per day for successive 5 days,combined with acyclovir and mecobalamin.Patients in control

  7. Ternary complexes metal [Co(II), Ni(II), Cu(II) and Zn(II)]--ortho-iodohippurate (I-hip)--acyclovir. X-ray characterization of isostructural [(Co, Ni or Zn)(I-hip)(2)(ACV)(H(2)O)(3)] with stacking as a recognition factor.

    Science.gov (United States)

    Barceló-Oliver, M; Terrón, A; García-Raso, A; Fiol, J J; Molins, E; Miravitlles, C

    2004-11-01

    Four ternary metal--ortho-iodohippurate (I-hip)--acyclovir (ACV) complexes, [M(I-hip)(2)(ACV)(H(2)O)(3)] where M is Co(II) (1), Ni(II) (2), Cu (3) and Zn(II) have been obtained by reaction between the corresponding binary complexes M(II)(I-hip)(2)xnH(2)O and ACV. Three ternary complexes (M=Co, Ni and Zn) and the corresponding Zn(II)--ortho-iodohippurate binary derivative have been structurally characterized by X-ray diffraction: The studies show these three ternary complexes are isostructural and present, in solid state, an interesting stacking between the nucleobase and the aryl ring of the hippurate moiety, which probably promotes the formation of ternary complexes. Moreover, the two different ligands interact between them by means of ancillary hydrogen bonds with water molecules coordinated to the metal ion. It must be mentioned that these two recognition factors, hydrogen bonds plus stacking, could explain the reason for the isostructurality of these ternary derivatives with so different three metal ions, with diverses trends in coordination numbers and geometries. In solid state, there are two enantiomeric molecules that are related by an inversion center as the crystal-building unit (as a translational motif) for the ternary complexes.

  8. Effect of different doses of acyclovir on renal function and its mechanism in mice%不同剂量阿昔洛韦对小鼠肾功能的影响及其机制

    Institute of Scientific and Technical Information of China (English)

    袁堂娟; 许家栋; 谷丽丽; 梁培; 陆红

    2016-01-01

    Objective To explore the effect of different dosage of acyclovir( ACV)on renal function and its mechanism in mice. Methods Thirty ICR mice were divided into the control,ACV 150 μg/ g and 600 μg/ g groups by complete randomization method. Each group comprised 10 mice. The mice in the ACV 150 and 600 μg/ g groups were injected with different dosage of ACV,the control group were injected with same volume of 0. 9% sodium chloride via caudal vein once daily for 7 days. The mice'body weight before the first medication and after the last medication was weighed. The levels of serum creatinine(Scr)and urea nitrogen(BUN)after medication were detected. The mice were sacrificed after collecting the blood samples. The mice kidneys were weighed and the renal coefficient was calculated. One kidney was used for pathologic examinations,and the other was for detection of expression of kidney injury factor-1(KIM-1),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and transforming growth factor-β1( TGF-β1)by immunohistochemical Envision two-step method. The expression score was calculated according to the staining intensity and the percentage of positive cells. Results On day 7 of medication, the body weight of mice in the ACV 150,600 μg/ g groups were lower than that in the control group [(29. 0 ± 0. 59)g,(23. 6 ± 3. 0)g vs.(31. 9 ± 2. 4)g,P < 0. 05,P < 0. 01],the renal coefficient and the levels of BUN and Scr in ACV 600 μg/ g group were higher than those in the control group[(8. 52 ± 0. 77)% vs.(6. 04 ± 0. 71)% ,P < 0. 01;(204 74)μmol/ L vs.(133 ± 30)μmol/ L,P < 0. 01;(13. 8 ± 2. 8)mmol/ L vs. (6. 9 ± 1. 2) mmol/ L,P < 0. 05]. There were renal tubular dilatation and few inflammatory response cell in renal interstitium in the ACV 150 μg/ g group and infiltration of flammatory cells in renal interstitium. There were infiltration of flammatory cells and fibroplasia in renal interstitium and some renal tubular deformation and necrosis in ACV 600 μg/ g group. The

  9. In vitro Study on the Transdermal Penetration Enhancement of N-trimethyl Chitosan in Acyclovir Gel%N-三甲基壳聚糖对阿昔洛韦凝胶透皮吸收促进作用的体外研究

    Institute of Scientific and Technical Information of China (English)

    顾莉群

    2011-01-01

    目的:探讨N-三甲基壳聚糖(TMC60)对阿昔洛韦(ACV)凝胶的透皮吸收促进作用.方法:配制三种ACV凝胶,即不含促渗刺的阴性组,含3%薄荷醇的阳性组,舍3%TMC60的TMC60组.用Franz扩散池,对三种凝胶的体外透皮程度及速度进行考察.结果:三种ACV凝胶体外透皮吸收的累积透过量Q与时间t呈现线性关系,且TMC60组和阳性组的稳态透皮速率J均大于阴性组(P0.05).结论:与同浓度薄荷醇相比,TMC60 有相似的透皮吸收促进效果,值得进一步研究.%Objective: To study the penetration enhancement of N-trimethyl chitosan (TMC60) in acyclovir (ACV) gel in vitro.Method: Three kinds of ACV gels were prepared, those were negative group without any enhancer, positive group with 3% menthol as the enhancer and TMC60 group with 3% TMC60 as the enhancer. The Franz diffusion cells were employed to study the penetration amount and rate of the ACV gels in vitro. Result: Accumulation penetration amount (Q) had linear relationship with time in ACV gels.Compared with that of negative group, stable-state penetration rates (J) of TMC60 group and positive group were both significantly increased ( P < 0. 05 ) while there was no notable difference between the latter two groups ( P > 0. 05 ). Conclusion: TMC60 has the similar enhancement compared with menthol and is valuable to be studied further.

  10. Preparation and Influence Factors of Acyclovir-loaded Bioadhesive Microspheres by Emulsification-Solvent Extraction Method%乳化-溶媒萃取法制备阿昔洛韦生物黏附缓释微球及其工艺影响因素

    Institute of Scientific and Technical Information of China (English)

    罗文卿; 柴妙琳; 侯佳朋; 胡星; 潘俊

    2013-01-01

    Acyclovir(l)-loaded bioadhesive microspheres were prepared by emulsification-solvent extraction method with ethylcellulose as matrix, Carbopol 974P NF (Cb) as bioadhesive material, acetone as dispersion phase and light liquid paraffin with Span-80 as continuous phase. The influences of the particle size of bulk drug powder on the morphology, drug loading, encapsulation efficiency and in vitro release of the microspheres were investigated. The results showed that product prepared with smaller particle size (<50 urn) drug powder possessed the properties of higher encapsulation efficiency and lower initial burst release. Based on this, a scale-up preparation was successfully carried out and then the bioadhesiveness and pharmacokinetics were determined. Compared with the microspheres without Cb, the microspheres with Cb showed better bioadhesive effect and the resident time in gastrointestinal tract of mice and rats was significantly prolonged. In the pharmacokinetic study in rats, the bioadhesive microspheres also indicated an improved bioavailability in comparison with 1 suspension at the same dose.%采用乙基纤维素(EC)为骨架材料、卡波姆974P为生物黏附材料、丙酮为分散相溶剂、含Span-80的轻质液体石蜡为连续相,采用乳化-溶媒萃取法制备阿昔洛韦(1)生物黏附缓释微球.考察了1原药粉体的粒径对微球形态、载药量、包封率及体外释放行为的影响.结果表明,采用较小粒径(<50 μm)原药可制得包封率较高、突释效应较小的微球.在此基础上进行了工艺放大试验,并用以进行体内外黏附性和大鼠体内药动学研究.与未添加卡波姆的1-EC微球相比,所制生物黏附微球在小鼠及大鼠的胃及小肠黏膜表面具有较好的黏附性,显著延长了药物在胃肠道内的滞留时间.大鼠药动学试验表明,本品与1混悬液相比能显著提高生物利用度.

  11. The Use of Iontophoretically Applied Acyclovir on Recurrent Herpes Labialis

    Science.gov (United States)

    1988-08-01

    family with diabetes Respiratory System: Yes/No Respiratory disease Yes/No Asthma, hayfever, or allergies Yes/No Tuberculosis Yes/No Chronic cough...infection (Openshaw et al. 1979). Once the acute infection has been resolved, the latent stage of ganglionic infection begins. Two hypotheses have been... latent virus within the ganglia results in the transportation of viral genomes, in some unknown form, to the sites of recurrent outbreaks on the skin

  12. Effect of acyclovir and steroid in a young immunocompetent male with herpes zoster myelitis

    DEFF Research Database (Denmark)

    El-Safadi, Louay; Arngrim, Nanna; Amin, Faisal Mohammad

    2014-01-01

    Herpes zoster myelitis is a rare condition, usually seen in aged and immunocompromised patients. Due to atypical presen-tations it can be hard to diagnose. Intraspinal lesions on magnetic resonance imaging (MRI) support the diagnosis. We present a 39-year-old otherwise healthy male with symptoms ...

  13. Study of Antiherpetic Efficiency of Phosphite of Acycloguanosine Ableto Over come the Barrier of Resistance to Acyclovir

    Science.gov (United States)

    Andronova, V. L.; Jasko, M.V.; Kukhanova, M.K.; Galegov, G.A.; Skoblov, Yr.S.; Kochetkov, S.N.

    2016-01-01

    As has been shown previously, phosphite of acycloguanosine (Hp-ACG) exhibits equal efficacy against ACV-sensitive and ACV-resistant HSV-1 strains in cell culture. Intraperitoneal administration of Hp-ACG to model mice with herpetic encephalitis caused by HSV-1 infection was shown to be effective in protecting against death. In the present work, we continue the study of the antiviral efficiency of Hp-ACG against HSV administered non-invasively; namely in vivo, orally and in the form of ointment formulations. It has been first shown that oral administration of Hp-ACG twice daily for five days prevents systemic infection in mice caused by HSV-1. Mortality in the control group of animals was 57%. Administration of Hp-ACG at doses of 600, 800 and 1,000 mg/kg per day significantly increased the survival and median day of death of the animals compared to the placebo-treated control group. A comparative evaluation of the therapeutic efficacy parameters of polyethylene glycol-based ACV ointment and Hp-ACG ointment was carried out after a 5-day course in the model of an experimental cutaneous infection of HSV-1 in guinea pigs. It was found that Hp-ACG has a significant therapeutic effect resulting in a statistically significant reduction in the lesion’s surface area and the amount of vesicular structures. The exhibited therapeutic effect of 10% Hp-ACG in ointment form compares well with that of 5% ACG ointment. PMID:27099786

  14. Effects of herpes simplex virus thymidine kinase/acyclovir system on growth of human pulmonary adenocarcinoma A549 cell line in vitro and in vivo

    Institute of Scientific and Technical Information of China (English)

    HE Xiang-liang; HE Dong-hua; GUO Xian-jian; QIAN Gui-sheng; HUANG Gui-jun; CHEN Wei-zhong; LI Shu-ping

    2002-01-01

    Objective: To observe the effect of anciclovir (ACV) treatment on tumors induced by inoculation of TK gene-transfected human pulmonary adenocarcinoma A549 cells in nude mice. Methods: A recombinant plasmid containing TK gene was constructed and transfected into A549 cells by electroporation. The sensitivity of the transgenic cells (A549-TK) to ACV was examined by MTT assay in vitro and for in vivo observation, inoculation of A549-TK and A-549 cells into nude mice was separately performed to induce tumor growth, the response of which to ACV treatment was observed, and the tumor tissues were pathologically examined. Results: A recombinant plasmid containing TK gene was successfully constructed and transfected into A549 cells. The sensitivity of A549-TK cells to ACV was 43 times higher than that of A549 cells. The tumors induced by A549-TK cells showed no significant increase in size after ACV treatment (P>0. 05), and light microscopy revealed local tissue necrosis, karyoklasis, and nuclei disappearance. Conclusion: A549-TK cells acquires sensitivity to ACV both in vitro and in vivo, and ACV can inhibit the growth of tumors induced by A549-TK cell inoculation in nude mice.

  15. The effect of treatment with zidovudine with or without acyclovir on HIV p24 antigenaemia in patients with AIDS or AIDS-related complex

    DEFF Research Database (Denmark)

    Pedersen, C; Cooper, D A; Brun-Vézinet, F;

    1992-01-01

    with AIDS, AIDS-related complex (ARC) or Kaposi's sarcoma (KS). DESIGN: Double-blind, placebo-controlled randomized clinical trial of less than or equal to 6 months' therapy. SETTING: Samples were obtained from patients attending teaching hospital outpatient clinics in seven European countries and Australia...

  16. Profile and behavior of antiviral drugs in aquatic environments of the Pearl River Delta, China.

    Science.gov (United States)

    Peng, Xianzhi; Wang, Chunwei; Zhang, Kun; Wang, Zhifang; Huang, Qiuxin; Yu, Yiyi; Ou, Weihui

    2014-01-01

    Occurrence and behavior of six antiviral pharmaceuticals (acyclovir, ganciclovir, oseltamivir, ribavirin, stavudine and zidovudine) and one active metabolite oseltamivir carboxylate were investigated in wastewater, landfill leachate, river water, reservoir and well water in the vicinity of municipal landfills in the Pearl River Delta, China. Acyclovir was the only antiviral detected in the wastewater at 177-406 (mean=238) and 114-205 (mean=154) ng L(-1) in the influent and final effluent, respectively. Aerobic biodegradation appeared to be the main process for the elimination of acyclovir in the wastewater. Acyclovir was also the only antiviral quantitatively detected in the Pearl River and its tributaries, with a maximum concentration up to 113 ng L(-1). Treated wastewater was a major source of acyclovir in the rivers. The highest concentration of acyclovir was observed in winter in the river water and the dilution effect by precipitation was suggested to be the dominant factor impacting the seasonal pattern of acyclovir in the rivers. No antivirals were quantitatively detected in the well water whereas acyclovir was frequently detected in the reservoirs at a maximal concentration of 33.6 ng L(-1) in the vicinity of the municipal landfills. However, source identification and fate of acyclovir in the reservoirs pend on further research.

  17. Preparation and evaluation of ophthalmic pH sensitive in-situ gel of acyclovir%阿昔洛韦眼用pH敏感原位凝胶剂的制备和评价

    Institute of Scientific and Technical Information of China (English)

    李馨儒; 雷耀龙; 沈传勇; 周艳霞; 陈星伟; 刘艳

    2009-01-01

    目的:制备并评价阿昔洛韦眼用pH敏感原位凝胶剂.方法:用旋转粘度计测定不同pH值、不同温度下制剂的粘度,考察制剂的流变学特征;用荧光示踪法测定凝胶剂的眼部滞留时间;采用同体自身对照法考察凝胶剂的眼部刺激性;采用Franz扩散池法考察了制剂的离体角膜渗透性能,采用HPLC法测定渗透药量.结果:所制备的阿昔洛韦原位凝胶剂为假塑性流体,对兔眼无刺激;该原位凝胶剂的眼部滞留时间为(22.4±1.4)min,比阿昔洛韦滴眼液增加4.6倍;兔离体角膜渗透实验结果表明,该原位凝胶剂在给药0.25 h以后各时间点的累积透过量均高于阿昔洛韦滴眼液,角膜有一定的贮库作用.结论:阿昔洛韦原位凝胶剂的刺激性低,眼部滞留时间长,具有一定的缓释效果.

  18. 五种阿昔洛韦软膏释放与透皮性质比较%The comparison of five ointment formulations of acyclovir on release rate and percutaneous rate in vitro

    Institute of Scientific and Technical Information of China (English)

    马晓微; 何飞燕; 梁文权

    1999-01-01

    目的:探讨不同的软膏基质对阿昔洛韦(ACV)透皮性能的影响.方法:设计四种不同基质的处方,测定ACV从处方中的释放与经皮渗透性质,并与商品ACV软膏进行比较.结果:四种软膏基质中ACV的释放速率与透皮速率均大于商品ACV软膏,乳膏基质、Ⅰ号凝胶基质、PEG基质、Ⅱ号凝胶基质中药物的透皮速率分别是商品软膏的2.47,4.98,12.79与17.85倍.结论:由卡巴浦、月桂氮酮、丙二醇、薄荷油及辅助促透剂组成的ACV软膏为较好的处方.

  19. 用硼酸作为显色剂光度法测定阿昔洛韦%Spectrophotometric determination of acyclovir with boric acid as a chromogenic agent

    Institute of Scientific and Technical Information of China (English)

    李晶; 汪瑾; 魏献军; 李全民

    2010-01-01

    在pH 12.00的缓冲溶液中,阿昔洛韦(ACV)与H_3BO_3形成组成比为1∶1的反应产物,其最大吸收波长λ_max=289 nm,ACV的质量浓度在0.48~57.6 mg/L范围内与吸光度成良好关系,线性回归方程A=-0.01796+0.01624ρ,相关系数r=0.9990,表观摩尔吸光系数ε=3.7×10~3 L·mol~(-1)·cm~(-1),回收率为99.9%~101.6%. 据此建立了测定ACV的新方法,能够直接用于药物样品中ACV的测定.

  20. 阿昔洛韦与羟丙基-β-环糊精在水溶液中的包合作用%The Complexation of Acyclovir with Hydroxypropyl-β-Cyclodextrin in Aqueous Solution

    Institute of Scientific and Technical Information of China (English)

    肖若蕾; 罗兵华

    2007-01-01

    目的 研究阿昔洛韦(ACV)与羟丙基-β-环糊精(HP-β-CD)在水溶液中的包合作用.方法 采用相溶解度法测定ACV与HP-β-CD在水溶液中的包合作用、包合比及包合过程中的热力学参数变化.结果 ACV与HP-β-CD可形成1:1摩尔比可溶性包合物,相溶解度图呈AL-型;ACV与HP-β-CD在水溶液中的包合过程可自发进行(△G<0).结论 ACV与HP-β-CD在水溶液中可自发形成1:1摩尔比可溶性包合物.

  1. 喷昔洛韦与阿昔洛韦治疗豚鼠单纯疱疹的疗效比较%The Comparison of Efficacies of Penciclovir and Acyclovir Treating the Herpes Simplex in Guinea-Pigs

    Institute of Scientific and Technical Information of China (English)

    李向群; 毛琳; 文莉; 侯伟; 肖红; 杨占秋

    2000-01-01

    为比较喷昔洛韦(PCV)与阿昔洛韦(ACV)对单纯疱疹的疗效,建立了豚鼠皮肤单纯疱疹的模型,比较不同时间的疗效积分和皮损处1型单纯疱疹病毒(HSV-1)发现:0.2%PCV组对疱疹疗效及对HSV-1抑制作用要比1%ACV组好,表明PCV治疗单纯疱疹的疗效要比ACV好,其抗HSV-1活性也比ACV高.

  2. Comparison of Efficacies of Acyclovir with Glycyrrhizin Against Herpes Simple Virus Type 1 in Vitro%阿昔洛韦与甘草酸苷体外抗HSV-1活性比较

    Institute of Scientific and Technical Information of China (English)

    赵艳丽; 王微; 王松

    2013-01-01

    目的:研究阿昔洛韦片剂(ACV)与复方甘草酸苷注射液(GLI)对HSV-1体外抗病毒活性.方法:通过观察病毒感染细胞病变效应(CPE),按照Reed-Muench法进行病毒的半数感染浓度TCID50的测定;采用噻唑蓝(MTT)比色法,分别测定ACV及GH对叙利亚仓鼠肾细胞(BHK-21)毒性,且考察不同浓度的阿昔洛韦片剂和复方甘草酸苷注射液对HSV-1不同作用阶段的抑制效果.结果:阿昔洛韦片剂和复方甘草酸苷注射液分别在11.72μM及0.375mM浓度以下,对BHK-21细胞无毒性作用.两种药物均对HSV-1四种作用模式的病毒抑制率成浓度及时间依赖性.ACV与GLI抗病毒机制不同.

  3. 无环鸟苷抑制小鼠单纯疱疹性角膜炎潜伏病毒激活作用的研究%Inhibition of Latent Virus Reactivation by Acyclovir in Murine Herpes Simplex Keratitis

    Institute of Scientific and Technical Information of China (English)

    贺冰; 郝倩

    2000-01-01

    目的证实无环鸟苷能够作用于潜伏单疱病毒的激活阶段,抑制病毒活化。方法以Balb/c小鼠作为潜伏感染模型,以紫外线B照射为激活条件,治疗组给予无环鸟苷口服,停药后1天处死动物检测活化病毒。结果治疗组30例中无1例,而对照组30例中有12例检测出活化病毒(P<0.01);治疗至照射后2天的10只鼠无1例,而相应对照组10只中6例检出活化病毒(P<0.01)。结论预防性应用ACV特异作用于病毒激活期,有效的抑制病毒活化。

  4. 75 FR 4570 - Government-Owned Inventions; Availability for Licensing

    Science.gov (United States)

    2010-01-28

    ... offers such good commercial potential. Inventors: Han Wen and Vinay Pai (NHLBI). Relevant Articles: 1... more information. Method for the Treatment of HIV/AIDS Infection Using Acyclovir in Identified Subjects Description of Invention: The invention provides the novel method to treat HIV infections with acyclovir...

  5. Progressive varicella syndrome in the setting of pediatric AIDS: An eye opener

    Directory of Open Access Journals (Sweden)

    Adityan Subramania

    2009-01-01

    Full Text Available Varicella zoster virus (VZV infections are known to be atypical and severe in immunocompromised patients. An eight-year-old girl presented with extremely painful, atypical skin lesions and features of meningitis and pneumonitis. On investigation, she was found to be human immunodeficiency virus (HIV infected, with very low CD4 count. A diagnosis of ′progressive varicella syndrome′ was made, and the child was started on antiretroviral therapy and IV acyclovir. This resulted in a complete resolution of all the clinical features. However, the skin lesions promptly relapsed when acyclovir was withdrawn. Oral Acyclovir was started, and had to be continued to keep the disease under control.

  6. Drug: D00222 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D00222 Drug Aciclovir (JP16/INN); Acyclovir (USP); Sitavig (TN); Zovirax (TN) C8H11...Ophthalmic agents 1319 Others D00222 Aciclovir (JP16/INN); Acyclovir (USP) 6 Agents against pathologic organ...isms and parasites 62 Chemotherapeutics 625 Antivirals 6250 Antivirals D00222 Aciclo...SE D06BB Antivirals D06BB03 Aciclovir D00222 Aciclovir (JP16/INN); Acyclovir (USP...eosides and nucleotides excl. reverse transcriptase inhibitors J05AB01 Aciclovir D00222 Aciclovir (JP16/INN)

  7. Neurotoxicity caused by valacyclovir in a patient on hemodialysis

    NARCIS (Netherlands)

    Linssen-Schuurmans, CD; van Kan, EJM; Feith, GW; Uges, DRA

    1998-01-01

    The authors report toxicity caused by valacyclovir in a patient on hemodialysis. After initial recuperation resulting from treatment with hemodialysis, the patient experienced a relapse of neurologic symptoms, again necessitating hemodialysis. Although acyclovir and its analogues are generally safe

  8. Zidovudine Injection

    Science.gov (United States)

    ... severe side effects, such as liver damage, blood toxicities, and muscle disorders. If you experience any of ... prescription and nonprescription medications you are taking, especially acetaminophen, acyclovir (Zovirax), aspirin, cancer chemotherapy, cimetidine (Tagamet), fluconazole ( ...

  9. Clinical characteristics of hypertrophic herpes simplex genitalis and treatment outcomes of imiquimod: a retrospective observational study

    Directory of Open Access Journals (Sweden)

    Charussri Leeyaphan

    2015-04-01

    Conclusions: Atypical manifestations of herpes simplex genitalis require careful consideration because their frequency is rising, particularly in patients with HIV infection. Although acyclovir is important in their treatment, imiquimod provides an additional benefit in resistant cases.

  10. Recurrent Herpes Labialis in Adults: New Tricks for an Old Dog.

    Science.gov (United States)

    Rosen, Ted

    2017-03-01

    Herpes labialis remains a common worldwide affliction. Recent advances in understanding the basic pathogenesis have led to new therapeutic intervention, both on-label and off-label. Aside from reducing the duration and symptomatology of acute outbreaks, another goal of treatment is to decrease the frequency of future episodes. Oral and topical acyclovir and its analogues are the mainstay of both chronic suppressive and episodic therapy. A new muco-adhesive formulation of acyclovir provides a decrease in outbreaks, probably due to a diminution of herpesvirus load in all reservoir sites. Acyclovir-resistant strains are rare in immunocompetent hosts; parenteral foscarnet and cidofovir are administered in this situation. Parenteral acyclovir is the drug of choice for eczema herpeticum, which may begin as herpes labialis in an atopic dermatitis patient. Thermotherapy may be beneficial, and a certified device to deliver heat is available outside the United States. J Drugs Dermatol. 2017;16(3 Suppl):s49-53..

  11. Disease: H00368 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available cytomegalic endothelial cells (owl's eye nucleus) Skin biopsies (vascular injury) Ganciclo...vir [DR:D00333 D04301] Valganciclovir [DR:D02495 D03256] Foscarnet [DR:D00579 D02267] Acyclovir [DR

  12. Creutzfeldt-Jakob Disease

    Science.gov (United States)

    ... found in specific kinds of animals. These include bovine spongiform encephalopathy (BSE), which is found in cows ... including amantadine, steroids, interferon, acyclovir, antiviral agents, and antibiotics. Studies of a variety of other drugs are ...

  13. Optimization of the technological process to prepare acyclovir poly (DL-lactic-co-glycolic acid) nanoparticles%阿昔洛韦-乙交酯-丙交酯共聚物毫微粒制备工艺的优化选择

    Institute of Scientific and Technical Information of China (English)

    徐颖; 周世文

    2000-01-01

    目的:筛选制备阿昔洛韦-乙交酯-丙交酯共聚物毫微粒(ACV-PLGA-NP)的优化工艺.方法:单因素试验初选制备ACV-PLGA-NP的pH值范围、聚乙烯醇(Polyvinyl alcohol,PVA)浓度范围、PLGA分子量、药物及丙酮浓度范围.按均匀设计表设计实验,进行结果预测及验证.结果:优化工艺与367%分子量及丙酮浓度无关,Ph值为1.5,PVA浓度为50mg/ml,ACV浓度为0.8mg/ml.按优化条件制备的ACV-PLGA-NP平均包封率为61.00%,载药量为6.79%.结论:按照均匀设计法优选的条件制备ACV-PLGA-NP,其目标量在预测值范围内.

  14. Quantification of acyclovir in human plasma——the metabolite of valaciclovir hydrochloride by high performance liquid chromatography%高效液相色谱荧光法测定人血浆中盐酸伐昔洛韦的代谢产物阿昔洛韦

    Institute of Scientific and Technical Information of China (English)

    李扬; 宋丽洁; 李可欣; 刘蕾

    2006-01-01

    目的:建立高效液相色谱荧光分析方法测定人血浆中盐酸伐昔洛韦的代谢产物阿昔洛韦(ACV).方法:20例受试者单次、交叉口服盐酸伐昔洛韦片300 mg后,以喷昔洛韦为内标,用沉淀法去除蛋白,用HPLC-荧光法测定.结果:ACV在0.02~5 μg·mL-1的浓度范围内有良好的线性关系(r=0.999 95),最低检测浓度为0.02 μg·mL-1(S/N>3),ACV的相对回收率为96.08%~97.28%,绝对回收率为69.62%~72.02%(n=5),目内精密度RSD为3.33%~6.12%,目间精密度为2.37%~6.81%.结论:本方法简便、灵敏、特异性强,可用于血浆中ACV的测定及人体药动学研究.

  15. The Prevalence and Molecular Characteristics of Acyclovir-Resistant HSV-1 Isolates from Patients with Herpetic Lips%唇疱疹分离无环鸟苷耐受HSV1株的发生率和分子鉴定

    Institute of Scientific and Technical Information of China (English)

    张萍; 张修发; 江凡; 祝爱霞; 邹建话

    2010-01-01

    目的:检测120名门诊口腔科唇疱疹患者分离的无环鸟苷(ACV)耐受HSV-1毒株的发生率和分子鉴定.方法:采用病毒培养,实时定量PCR和基因测序分析这些临床分离株.结果:分离到无环鸟苷耐受毒株为6株(6/120=5%)在6份ACV耐受毒株中,TK基因发生突变,这可能与ACV耐受相关.结论:本研究表明唇疱疹患者中存在ACV耐受毒株,对于难于治疗的患者有必要检测毒株对ACV的敏感性.

  16. The Calculation of Drug Absorption Rate of Oral Acyclovir Using the Theory of Linear System and its Dependability%线性系统理论计算口服阿昔洛韦的吸收速度及其可靠性

    Institute of Scientific and Technical Information of China (English)

    陆瑜; 朱家壁; 梁秉文

    2006-01-01

    目的研究口服阿昔洛韦吸收动力学,建立验证药物吸收脱卷积计算可靠性的方法.方法用线性系统的理论对药物的吸收过程进行解析,并对口服阿昔洛韦吸收动力学过程进行分析计算.结果推导出计算药物吸收分数F和平均吸收时间MAT及其百分误差△F%和△MAT%的公式,口服阿昔洛韦的△F%在0.41%~2.55%之间,△MAT%在2.45%~9.39%之间.结论用值△F%和△MAT%值做为标准验证药物吸收动力学计算结果的可靠性具有科学性和实用性.

  17. COMBINED USE OF ACYCLOVIR VITAMIN C AND INTERFERON IN TREATING HERPES SIMPLE VIRAL KERATITIS%无环鸟苷 维生素C联合干扰素治疗单纯疱疹病毒性角膜炎的临床观察

    Institute of Scientific and Technical Information of China (English)

    曹蔚云

    2007-01-01

    目的 观察干扰素联合无环鸟苷眼液、维生素C治疗单纯疱疹病毒性角膜炎的疗效.方法 在Hep-2(喉癌)细胞上进行单纯疱疹病毒-I型(HSV-1)接种培养,制作兔单胞病毒性角膜炎模型,将其随机分为治疗组、对照组、无环鸟苷组、干扰素组.对照组:不用任何药物治疗.无环鸟苷组给予ACV治疗.干扰素组:给予滴宁眼液(IFN)点眼.治疗组:给予IFN和ACV交替点眼,每次间隔10 min,另外每周每只兔球结膜下注射VitC 1次,每次30 mg (每眼各15 mg),共2次.结果 CEIS分值:种毒后第6天,各组达到最高,以后又呈逐渐下降趋势.对照组种毒后各时间段CEIS分值均高于其他各组(P<0.01),其他各组之间的差异无统计学意义(P>0.05).平均治愈时间:治疗组为(10.3±0.9)d,干扰素组为(13.7±0.51)d,无环鸟苷组为(13.4±0.583)d,3组比较有统计学意义(F=45.23,P<0.01).病理结果:治疗组角膜上皮及基质病变程度同期比明显轻于其他3组.结论 干扰素与无环鸟苷、维生素C联合应用治疗单胞病毒性角膜炎能增强药物的抗病毒作用、抑制HSV复制、提高机体的免疫力,与单独使用干扰素、无环鸟苷相比,提高了疗效,缩短了病程,取得了较满意的效果.

  18. 泛昔洛韦和阿昔洛韦体内外抗疱疹病毒活性的比较研究%Comparison of efficacies of famciclovir with acyclovir against herpes simple virus type 1 and 2 in vitro and in vivo

    Institute of Scientific and Technical Information of China (English)

    李建农; 滕立; 陈鸿珊; 蒋宁; 蒋建东

    2003-01-01

    目的观察泛昔洛韦和阿昔洛韦在体内外实验模型中的抗疱疹病毒药效.方法用CPE,MTT染色法和空斑法观察两药在Vero细胞培养内对疱疹病毒1型(HSV-1)和2型(HSV-2)病毒的抑制作用;在疱疹病毒1型小鼠急性脑炎和豚鼠皮肤感染模型以及疱疹病毒2型小鼠阴道炎模型上观察两药体内对HSV-1和HSV-2感染的治疗效果.结果在细胞培养内,泛昔洛韦对HSV-1和HSV-2无明显抑制活性(IC50>1 000 μg*mL-1),阿昔洛韦对HSV有显著的抑制作用. 动物口服泛昔洛韦和阿昔洛韦能显著降低HSV-1腹腔感染小鼠引起的死亡和延长小鼠生命,泛昔洛韦和阿昔洛韦保护小鼠死亡的ED50分别为29.9 mg*kg-1和>100 mg*kg-1,延长小鼠生命的ED50分别为43.6 mg*kg-1和>100 mg*kg-1;对HSV-1感染豚鼠皮肤疱疹的抑制率,口服泛昔洛韦为75.0%~77.8%,阿昔洛韦为45.0%~41.7%,泛昔洛韦优于阿昔洛韦;对HSV-2阴道感染小鼠死亡率和延长小鼠生命,口服泛昔洛韦和阿昔洛韦的ED50分别是53.4,53.4和44.6,39.5mg*kg-1.结论①在细胞培养内,泛昔洛韦无抗疱疹病毒作用,阿昔洛韦有很强的抗疱疹病毒活性.②对于HSV-1引起的脑炎和皮肤感染,口服泛昔洛韦优于阿昔洛韦;对于HSV-2引起的阴道炎,口服两药作用相似.

  19. Effect of HSV-2 Suppressive Therapy on Genital Tract HIV-1 RNA Shedding among Women on HAART: A Pilot Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    A. E. Nijhawan

    2012-01-01

    Full Text Available Background. The role of suppressive HSV therapy in women coinfected with HSV-2 and HIV-1 taking highly active antiretroviral therapy (HAART is unclear. Methods. 60 women with HIV-1/HSV-2 coinfection on HAART with plasma HIV-1 viral load (PVL ≤75 copies/mL were randomized to receive acyclovir (N=30 or no acyclovir (N=30. PVL, genital tract (GT HIV-1, and GT HSV were measured every 4 weeks for one year. Results. Detection of GT HIV-1 was not significantly different in the two arms (OR 1.23, P=0.67, although this pilot study was underpowered to detect this difference. When PVL was undetectable, the odds of detecting GT HIV were 0.4 times smaller in the acyclovir arm than in the control arm, though this was not statistically significant (P=0.07. The odds of detecting GT HSV DNA in women receiving acyclovir were significantly lower than in women in the control group, OR 0.38, P<0.05. Conclusions. Chronic suppressive therapy with acyclovir in HIV-1/HSV-2-positive women on HAART significantly reduces asymptomatic GT HSV shedding, though not GT HIV shedding or PVL. PVL was strongly associated with GT HIV shedding, reinforcing the importance of HAART in decreasing HIV sexual transmission.

  20. OBSERVATION ON THE THERAPEUTIC EFFECT OF PLUM-BLOSSOM NEEDLE TAPPING PLUS MEDICATION FOR HERPES ZOSTER

    Institute of Scientific and Technical Information of China (English)

    WANG Li-kang; YIN Li-li

    2005-01-01

    Objective: To observe the therapeutic effect of plum-blossom needle tapping combined with intravenous drip of Acyclovir for herpes zoster. Methods: A total of 40 herpes zoster patients were randomized into acupuncture plus medication group (n=21) and medication group (n=19) which were treated respectively with topical plum-blossom needle tapping in the focus region combined with intravenous drip of Acyclovir (250 mg+250 mL normal saline, twice daily) and simple intravenous drip of Acyclovir. Results: After treatment, of the 21 and 19 cases in acupuncture plus medication and medication groups, 18 (85.7%) and 10 (52.6%) were cured, 3 (14.3%) and 7 (36.8%) had marked improvement, 0 (0) and 2 (10.5%) failed, with the effective rates being 100.0% and 89.5% respectively. The cure duration of acupuncture plus medication and medication groups were (2.5±1.0) days and (4.0±2.3) days separately. The therapeutic effect of the former group was significantly superior to that of the later group (P<0.05) and the duration of cure of acupuncture plus medication group was evidently shorter than that of medication group (P<0.05). Conclusion: The therapeutic effect of plum-blossom needle tapping plus Acyclovir is significantly superior to that of simple Acyclovir in relieving pain, promoting scabbing, and shortening the therapeutic duration.

  1. Infant safety during and after maternal valacyclovir therapy in conjunction with antiretroviral HIV-1 prophylaxis in a randomized clinical trial.

    Directory of Open Access Journals (Sweden)

    Alison L Drake

    Full Text Available BACKGROUND: Maternal administration of the acyclovir prodrug valacyclovir is compatible with pregnancy and breastfeeding. However, the safety profile of prolonged infant and maternal exposure to acyclovir in the context of antiretrovirals (ARVs for prevention of mother-to-child HIV-1 transmission (PMTCT has not been described. METHODS: Pregnant Kenyan women co-infected with HIV-1/HSV-2 with CD4 counts > 250 cells/mm(3 were enrolled at 34 weeks gestation and randomized to twice daily 500 mg valacyclovir or placebo until 12 months postpartum. Women received zidovudine from 28 weeks gestation and single dose nevirapine was given to women and infants at the time of delivery for PMTCT. Infant blood was collected at 6 weeks for creatinine and ALT. Breast milk specimens were collected at 2 weeks postpartum from 71 women in the valacyclovir arm; acyclovir levels were determined for a random sample of 44 (62% specimens. Fisher's Exact and Wilcoxon rank-sum tests were used for analysis. RESULTS: One hundred forty-eight women were randomized and 146 mother-infant pairs were followed postpartum. PMTCT ARVs were administered to 98% of infants and all mothers. Valacyclovir was not associated with infant or maternal toxicities or adverse events, and no congenital malformations were observed. Infant creatinine levels were all normal (< 0.83 mg/dl and median creatinine (median 0.50 mg/dl and infant growth did not differ between study arms. Acyclovir was detected in 35 (80% of 44 breast milk samples collected at 2 weeks postpartum. Median and maximum acyclovir levels were 2.62 and 10.15 mg/ml, respectively (interquartile range 0.6-4.19. CONCLUSIONS: Exposure to PMTCT ARVs and acyclovir after maternal administration of valacyclovir during pregnancy and postpartum to women co-infected with HIV-1/HSV-2 was not associated with an increase in infant or maternal toxicities or adverse events. TRIAL REGISTRATION: ClinicalTrials.gov NCT00530777.

  2. Evaluation of microporous polycaprolactone matrices for controlled delivery of antiviral microbicides to the female genital tract.

    Science.gov (United States)

    Asvadi, Naghme Hajarol; Dang, Nhung T T; Davis-Poynter, Nicholas; Coombes, Allan G A

    2013-12-01

    Acyclovir (ACV) as a model antiviral microbicide, was incorporated in controlled-release polycaprolactone (PCL) matrices designed for application as intra-vaginal ring inserts (IVRs). Microporous materials incorporating acyclovir up to a level of ~10 % w/w were produced by rapidly cooling suspensions of drug powder in PCL solution followed by solvent extraction from the hardened matrices. Around 21, 50 and 78 % of the drug content was gradually released from matrices over 30 days in simulated vaginal fluid at 37 °C, corresponding to drug loadings of 5.9, 7.0 and 9.6 % w/w. The release behaviour of matrices having the lowest drug loading followed a zero order model, whereas, the release kinetics of 7.0 and 9.6 % ACV-loaded PCL matrices could be described effectively by the Higuchi model, suggesting that Fickian diffusion is controlling drug release. Corresponding values of the diffusion co-efficient for ACV in the PCL matrices of 3.16 × 10(-9) and 1.07 × 10(-8) cm(2)/s were calculated. Plaque reduction assays provided an IC50 value of 1.09 μg/mL for acyclovir against HSV-2 and confirmed the antiviral activity of released acyclovir against HSV-2 replication in primate kidney cells (Vero) at levels ~70 % that of non-formulated acyclovir at day 30. Estimated minimum in vivo acyclovir concentrations produced by a PCL IVR (19 μg/mL) exceeded by a factor of 20 the IC50 value against HSV-2 and the reported ACV vaginal concentrations in women (0.5-1.0 μg/mL) following oral administration. These findings recommend further investigations of PCL matrices for vaginal delivery of antiviral agents in the treatment and prevention of sexually transmitted infections such as AIDS.

  3. Corticosteroid therapy of zoster-associated pain

    Directory of Open Access Journals (Sweden)

    Cvjetković Dejan M.

    2004-01-01

    Full Text Available Introduction Lack of exact clinical studies on effects of corticosteroids in therapy and prevention of herpes zoster-related pain, elicited many controversies in the past. The aim of our study was to estimate effects of prednisone on frequency, intensity and duration of postherpetic neuralgia. Material and methods 68 immunocompetent herpes zoster patients, 8-90 years of age (37 females and 31 males, mean age 55,7 years were enrolled for study; 30 patients were treated with acyclovir (5x800 mg daily for a 7-day period and prednisone (initial daily dose 60 mg, tapering over 14 days, and the control group of 38 patients with acyclovir only. Patients were clinically followed up for 3 months after complete resolution of skin lesions. Chi-square test was used in statistical data analysis. Results The difference regarding incidence of postherpetic neuralgia in acyclovir/prednisone group and acyclovir group (although slightly less in the former one was not significant. Duration of postherpetic neuralgia over 3 months was similar in both groups. Mild postherpetic pain was more common in the acyclovir/prednisone group (44.4% than in the acyclovir group (28.6%; however, statistical validation requires more patients to be studied. Discussion Results of our study didn’t confirm efficiency of prednisone regarding occurrence and characteristics of postherpetic neuralgia. Failure of prednisone therapy may be partly contributed to advanced age of patients and delayed onset of therapy. Conclusion Use of corticosteroids in zoster patients gives neither reliable protection from appearance of postherpetic neuralgia, nor shortens its duration. Further investigations are necessary to estimate their effects on postherpetic pain.

  4. Drug: D02764 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available OTHERAPEUTICS FOR DERMATOLOGICAL USE D06B CHEMOTHERAPEUTICS FOR TOPICAL USE D06BB Antivirals D06BB03 Aciclov...NTIINFECTIVES S01AD Antivirals S01AD03 Aciclovir D02764 Acyclovir sodium (USAN) USP drug classification [BR:...Antiinfectives [BR:br08307] Antivirals Anti-HSV agent DNA polymerase inhibitor Purine analogue Aciclovir [AT...ECT ACTING ANTIVIRALS J05AB Nucleosides and nucleotides excl. reverse transcripta...se inhibitors J05AB01 Aciclovir D02764 Acyclovir sodium (USAN) S SENSORY ORGANS S01 OPHTHALMOLOGICALS S01A A

  5. Coin-shaped epithelial lesions following an acute attack of erythema multiforme minor with confocal microscopy findings

    Directory of Open Access Journals (Sweden)

    Babu Kalpana

    2010-01-01

    Full Text Available We report an interesting ocular finding of bilateral multiple coin-shaped epithelial lesions along with the confocal microscopy findings in a patient following an acute attack of erythema multiforme (EM minor. A 30-year-old male presented with a history of watering and irritation in both eyes of three days duration. He was diagnosed to have EM minor and was on oral acyclovir. Slit-lamp examination revealed multiple coin-shaped epithelial lesions. Confocal microscopy showed a corresponding conglomerate of hyper-reflective epithelial lesions. The corneal lesions resolved over six weeks with oral steroids and acyclovir. An immunological mechanism is suspected.

  6. Herpes zoster-associeret morbiditet hos børn i kemoterapi for akut lymfoblastaer leukaemi

    DEFF Research Database (Denmark)

    Sørensen, Gitte Vrelits; Helgestad, Jon; Rosthøj, Steen

    2009-01-01

    receiving chemotherapy. All eruptions were treated with acyclovir, in eight cases intravenously, and in six cases chemotherapy was interrupted. Cutaneous dissemination occurred in two cases, visceral dissemination in none. One child had postherpetic trigeminal neuralgia for two months. The eruption rate...

  7. Compendium 0f Dental Residents’ Research Projects and Literature Reviews

    Science.gov (United States)

    1989-05-01

    9826), Periodontics (9846), Prosthodontics (9856), Orthodontics (9866), and Endodontics (9886). The authors submitted their reports during 1988, in...specialty discipline: 9826 - General dentistry 9836 - Oral and maxillofacial surgery 9846 - Periodontics 9856 - Prosthodontics 9866 - Orthodontics 9876 - Oral...PLATELET-DERIVED GROWTH FACTOR J. E. Piche. ..................................... 11 No. 88 46 05 THE USE OF IONTOPHORETICALLY APPLIED ACYCLOVIR ON RECURRENT

  8. Antiviral Activity of Hatay Propolis Against Replication of Herpes Simplex Virus Type 1 and Type 2.

    Science.gov (United States)

    Yildirim, Ayse; Duran, Gulay Gulbol; Duran, Nizami; Jenedi, Kemal; Bolgul, Behiye Sezgin; Miraloglu, Meral; Muz, Mustafa

    2016-02-09

    BACKGROUND Propolis is a bee product widely used in folk medicine and possessing many pharmacological properties. In this study we aimed to investigate: i) the antiviral activities of Hatay propolis samples against HSV-1 and HSV-2 in HEp-2 cell line, and ii) the presence of the synergistic effects of propolis with acyclovir against these viruses. MATERIAL AND METHODS All experiments were carried out in HEp-2 cell cultures. Proliferation assays were performed in 24-well flat bottom microplates. We inoculated 1x105 cells per ml and RPMI 1640 medium with 10% fetal calf serum into each well. Studies to determine cytotoxic effect were performed. To investigate the presence of antiviral activity of propolis samples, different concentrations of propolis (3200, 1600, 800, 400, 200, 100, 75, 50, and 25 μg/mL) were added into the culture medium. The amplifications of HSV-1 and HSV-2 DNA were performed by real-time PCR method. Acyclovir (Sigma, USA) was chosen as a positive control. Cell morphology was evaluated by scanning electron microscopy (SEM). RESULTS The replication of HSV-1 and HSV-2 was significantly suppressed in the presence of 25, 50, and 100 μg/mL of Hatay propolis. We found that propolis began to inhibit HSV-1 replication after 24 h of incubation and propolis activity against HSV-2 was found to start at 48 h following incubation. The activity of propolis against both HSV-1 and HSV-2 was confirmed by a significant decrease in the number of viral copies. CONCLUSIONS We determined that Hatay propolis samples have important antiviral effects compared with acyclovir. In particular, the synergy produced by antiviral activity of propolis and acyclovir combined had a stronger effect against HSV-1 and HSV-2 than acyclovir alone.

  9. Episodic therapy for genital herpes in sub-saharan Africa: a pooled analysis from three randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Helen A Weiss

    Full Text Available BACKGROUND: A randomized controlled trial in South Africa found a beneficial effect of acyclovir on genital ulcer healing, but no effect was seen in trials in Ghana, Central African Republic and Malawi. The aim of this paper is to assess whether the variation in impact of acyclovir on ulcer healing in these trials can be explained by differences in the characteristics of the study populations. METHODOLOGY/PRINCIPAL FINDINGS: Pooled data were analysed to estimate the impact of acyclovir on the proportion of ulcers healed seven days after randomisation by HIV/CD4 status, ulcer aetiology, size and duration before presentation; and impact on lesional HIV-1. Risk ratios (RR were estimated using Poisson regression with robust standard errors. Of 1478 patients with genital ulcer, most (63% had herpetic ulcers (16% first episode HSV-2 ulcers, and a further 3% chancroid, 2% syphilis, 0.7% lymphogranuloma venereum and 31% undetermined aetiology. Over half (58% of patients were HIV-1 seropositive. The median duration of symptoms before presentation was 6 days. Patients on acyclovir were more likely to have a healed ulcer on day 7 (63% vs 57%, RR = 1.08, 95% CI 0.98-1.18, shorter time to healing (p = 0.04 and less lesional HIV-1 RNA (p = 0.03. Small ulcers (<50 mm(2, HSV-2 ulcers, first episode HSV-2 ulcers, and ulcers in HIV-1 seropositive individuals responded best but the better effectiveness in South Africa was not explained by differences in these factors. CONCLUSIONS/SIGNIFICANCE: There may be slight benefit in adding acyclovir to syndromic management in settings where most ulcers are genital herpes. The stronger effect among HIV-1 infected individuals suggests that acyclovir may be beneficial for GUD/HIV-1 co-infected patients. The high prevalence in this population highlights that genital ulceration in patients with unknown HIV status provides a potential entry point for provider-initiated HIV testing.

  10. A NEW VALIDATED RP- HPLC METHOD FOR DETERMINATION OF PENCICLOVIR IN HUMAN PLASMA

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    VENKATA KUMAR, ANANTAHAKUMAR, SESHAGIRI RAO

    2013-09-01

    Full Text Available A rapid, selective and sensitive high performance liquid chromatographic method for the estimation of Penciclovir in human plasma has been developed. Chromatography was carried out on a Hypersil BDS C18 column using a mixture of 20mM Potassium dihydrogen phosphate buffer (pH 3.5 + 0.05 and methanol (95:5 v/v as the mobile phase. The eluents were monitored for the drug by UV detection at 254 nm. Acyclovir was used as an internal standard for this study. The retention times for Penciclovir and Acyclovir were found to be 6.2 and 9.2 min respectively. The method was found to be linear in the concentration range of 50.1 ng/mL to 7000.9 ng/mL. The method was validated as per FDA guidelines and was found to be suitable for bioequivalence and pharmacokinetic studies.

  11. Acute Hemorrhagic Leukoencephalitis in Children: A Case Report

    Science.gov (United States)

    Khademi, Gholam Reza; Aelami, Mohammad Hasan

    2016-01-01

    Acute hemorrhagic leukoencephalitis (AHLE) is a rare demyelinating disease characterized by an acute rapidly progressive fulminant inflammation of the white matter. In this case report, we introduce a case of AHLE in children with an interesting and lengthy process and successful treatment. A previously healthy 13-year-old girl was admitted to the hospital because of fever and loss of consciousness. After 4 days, she was referred to our pediatric intensive care unit in Mashhad, Iran. On admission, she had right-sided parotiditis. With a diagnosis of AHLE, our patient was treated with methylprednisolone, intravenous immunoglobulin, acyclovir, and plasmapheresis. AHLE is a rare and severe demyelinating disease, the mortality and morbidity of which can be decreased by early detection and treatment with steroid therapy, intravenous immunoglobulin, acyclovir, and plasmapheresis. PMID:27217610

  12. Acute Hemorrhagic Leukoencephalitis in Children: A Case Report

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    Gholam Reza Khademi

    2016-05-01

    Full Text Available Acute hemorrhagic leukoencephalitis (AHLE is a rare demyelinating disease characterized by an acute rapidly progressive fulminant inflammation of the white matter. In this case report, we introduce a case of AHLE in children with an interesting and lengthy process and successful treatment. A previously healthy 13-year-old girl was admitted to the hospital because of fever and loss of consciousness. After 4 days, she was referred to our pediatric intensive care unit in Mashhad, Iran. On admission, she had right-sided parotiditis. With a diagnosis of AHLE, our patient was treated with methylprednisolone, intravenous immunoglobulin, acyclovir, and plasmapheresis. AHLE is a rare and severe demyelinating disease, the mortality and morbidity of which can be decreased by early detection and treatment with steroid therapy, intravenous immunoglobulin, acyclovir, and plasmapheresis.

  13. Reply to "On the Effect of Common Excipients on the Oral Absorption of Class 3 Drugs".

    Science.gov (United States)

    Vaithianathan, Soundarya; Haidar, Sam H; Zhang, Xinyuan; Jiang, Wenlei; Avon, Christopher; Dowling, Thomas C; Shao, Changxing; Kane, Maureen; Hoag, Stephen W; Flasar, Mark H; Ting, Tricia Y; Polli, James E

    2016-04-01

    We previously concluded that 12 common excipients need not be qualitatively the same and quantitatively very similar to reference for Biopharmaceutics Classification System-based biowaivers. This conclusion for regulatory relief is based upon a series of bioequivalence studies in humans involving cimetidine and acyclovir. Limitations were also discussed. We understand the major concern of García-Arieta et al. is that "results obtained by Vaithianathan et al. should not be extrapolated to other drugs." We understand that individuals conducting their own risk/benefit analysis may reach that conclusion, and we reply to the concerns of García-Arieta et al. We continue to conclude that the 12 common excipients need not be qualitatively the same nor quantitatively very similar to reference, but rather, simply be not more than the quantities studied in our manuscript for cimetidine and acyclovir, and potentially other class 3 drugs with similar properties.

  14. Kyrieleis plaques associated with Herpes Simplex Virus type 1 acute retinal necrosis

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    Neha Goel

    2016-04-01

    Full Text Available We report the case of a 55-year-old immunocompetent male who presented with features typical of acute retinal necrosis (ARN. Polymerase chain reaction of the aqueous tap was positive for Herpes Simplex Virus (HSV – 1. Following therapy with intravenous Acyclovir, followed by oral Acyclovir and steroids, there was marked improvement in the visual acuity and clinical picture. At one week after initiation of treatment, Kyrieleis plaques were observed in the retinal arteries. They became more prominent despite resolution of the vitritis, retinal necrosis and vasculitis and persisted till six weeks of follow-up, when fluorescein angiography was performed. The appearance of this segmental retinal periarteritis also known as Kyrieleis plaques has not been described in ARN due to HSV-1 earlier.

  15. Caulerpin as a potential antiviral drug against herpes simplex virus type 1

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    Nathália Regina Porto Vieira Macedo

    2012-08-01

    Full Text Available About 80% of the human adult population is infected with HSV-1. Although there are many anti-HSV-1 drugs available (acyclovir, ganciclovir, valaciclovir, foscarnet, their continuous use promotes the selection of resistant strains, mainly in ACV patients. In addition to resistance, the drugs also have toxicity, particularly when administration is prolonged. The study of new molecules isolated from green algae with potential antiviral activity represents a good opportunity for the development of antiviral drugs. Caulerpin, the major product from the marine algae Caulerpa Lamouroux (Caulerpales, is known for its biological activities such as antioxidant, antifungal, acetylcholinesterase inhibitor (AChE and antibacterial activity. In this work, we show that caulerpin could be an alternative to acyclovir as an anti-HSV-1 drug that inhibits the alpha and beta phases of the replication cycle.

  16. Development of Treatment Strategies to Combat Ebola and Marburg Viruses

    Science.gov (United States)

    2006-02-02

    HIV, acyclovir for herpes simplex virus and ribavirin for the arenviruses and bunyaviruses. Filoviruses replicate and transcribe their genomes using a...treatment of experimental Ebola virus infections. J. Infect. Dis. 179(Suppl. 1), S224–S234 (1999). • Demonstrates that hyperimmune equine ...Virusol. 40(6), 270–273 (1995). • Reports that hyperimmune equine IgG protected a small cohort of baboons against challenge with a low dose of

  17. Pharmacokinetics of ganciclovir and valganciclovir in the adult horse

    OpenAIRE

    CARMICHAEL, R.J.; Whitfield, C; MAXWELL, L.K.

    2013-01-01

    Equine herpes myeloencephalopathy, resulting from equine herpes virus type 1 (EHV-1) infection, is associated with substantial morbidity and mortality in the horse. As compared to other antiviral drugs, such as acyclovir, ganciclovir has enhanced potency against EHV-1. This study investigated the pharmacokinetics of ganciclovir and its oral prodrug, valganciclovir, in six adult horses in a randomized cross-over design. Ganciclovir sodium was administered intravenously as a slow bolus at a dos...

  18. Herpes simplex reactivation or postinfectious inflammatory response after epilepsy surgery: Case report and review of the literature

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    Anna Lo Presti

    2015-01-01

    Conclusion: HSVE must be suspected in patients with previous history of HSVE and postoperative fever associated with an altered state of consciousness and/or seizures. Considering the high mortality and morbidity rates associated with HSVE, an adequate prophylactic administration of acyclovir should be considered for patients with previous history of HSVE undergoing neurosurgical procedures, especially when surgery involves the site of a previous herpetic lesion.

  19. Polyneuritis cranialis following herpes zoster

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    Radhakrishna H

    2000-01-01

    Full Text Available Herpes zoster is a common clinical condition involving cranial nerves. We encountered 3 cases in which multiple cranial nerves were involved besides the commoner ones. All the three cases were treated with acyclovir and oral steroids. Recovery of motor function was only partial in all three cases when reviewed 2 months after discharge. The clinical details and a brief review of literature are presented.

  20. Antiviral Activity of Hatay Propolis Against Replication of Herpes Simplex Virus Type 1 and Type 2

    OpenAIRE

    Yildirim, Ayse; Duran, Gulay Gulbol; DURAN, Nizami; Jenedi, Kemal; Bolgul, Behiye Sezgin; Miraloglu, Meral; MUZ, Mustafa

    2016-01-01

    Background Propolis is a bee product widely used in folk medicine and possessing many pharmacological properties. In this study we aimed to investigate: i) the antiviral activities of Hatay propolis samples against HSV-1 and HSV-2 in HEp-2 cell line, and ii) the presence of the synergistic effects of propolis with acyclovir against these viruses. Material/Methods All experiments were carried out in HEp-2 cell cultures. Proliferation assays were performed in 24-well flat bottom microplates. We...

  1. Update On Emerging Antivirals For The Management Of Herpes Simplex Virus Infections: A Patenting Perspective

    OpenAIRE

    Vadlapudi, Aswani D.; Vadlapatla, Ramya K.; Mitra, Ashim K.

    2013-01-01

    Herpes simplex virus (HSV) infections can be treated efficiently by the application of antiviral drugs. The herpes family of viruses is responsible for causing a wide variety of diseases in humans. The standard therapy for the management of such infections includes acyclovir (ACV) and penciclovir (PCV) with their respective prodrugs valaciclovir and famciclovir. Though effective, long term prophylaxis with the current drugs leads to development of drug-resistant viral isolates, particularly i...

  2. A rare case of Herpes zoster oticus in an immunocompetent patient

    Directory of Open Access Journals (Sweden)

    Ganesh Prabhakar Dhavalshankh

    2012-10-01

    Full Text Available Herpes zoster oticus in healthy persons is uncommon, though it has been described in immunocompromised patients. We describe a case of disseminated herpes zoster oticus in an elderly man with no apparent immunosuppressive condition. The patient was treated successfully with oral Acyclovir. We suggest that disseminated zoster can occur in an immunocompetent host and should be promptly recognized and treated to prevent serious complications.

  3. Herpes simplex virus type 2-associated recurrent aseptic (Mollaret's meningitis in genitourinary medicine clinic: a case report

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    Abou-Foul AK

    2014-03-01

    Full Text Available Ahmad K Abou-Foul, Thajunisha M Buhary, Sedki L Gayed Department of Genitourinary Medicine, Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust, Blackburn, UK Introduction: Cases of idiopathic recurrent benign aseptic meningitis were first described by Mollaret. Today, herpes simplex virus (HSV is considered the cause of most cases of Mollaret's meningitis. Case report: A 40-year-old male was referred to our genitourinary medicine clinic with recurrent genital herpetic lesions. He had HSV-2-positive genital ulcers 8 years earlier. One year after the first infection, he developed severe recurrent attacks of headache associated with meningitis symptoms. The results of all radiological and biochemical tests were normal, but the patient reported a correlation between his attacks and genital herpes flare-ups. We diagnosed the patient with Mollaret's meningitis and started him on continuous suppressive acyclovir therapy, which resulted in marked clinical improvement. Discussion: Mollaret's meningitis is a rare form of idiopathic recurrent aseptic meningitis that has a sudden onset, short duration, and spontaneous remission with unpredictable recurrence. We believe that the presence of concurrent or recurrent mucocutaneous herpetic lesions can aid its diagnosis, prior to which, affected patients usually have many unnecessary investigations and treatments. Therefore, detailed sexual history should be sought in all patients with aseptic meningitis, and clinicians should also ask about history of recurrent headaches in all patients with recurrent herpetic anogenital lesions. Continuous suppressive acyclovir therapy may reduce the frequency and severity of attacks and can dramatically improve lifestyle. Keywords: HSV-2 virus, acyclovir, Mollaret's meningitis, recurrent aseptic meningitis, HSV-2 virus, viral meningitis, acyclovir

  4. RAMSAY HUNT SYNDROME A CASE REPORT AND REVIEW OF LITERATURE

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    Balasubramanian Thiagarajan

    2013-01-01

    Full Text Available This is a case report of a rather rare disorder i.e. Ramsay Hunt syndrome. This is caused by Varicella zoster infections involving geniculate ganglion of facial nerve. This syndrome is manifested by the presence of blebs in the external auditory canal, ear ache, and lower motor neurone type of facial paralysis. This patient had excellent recovery following administration of oral steroids and acyclovir.

  5. Computed Tomography Perfusion Usefulness in Early Imaging Diagnosis of Herpes Simplex Virus Encephalitis

    Energy Technology Data Exchange (ETDEWEB)

    Marco de Lucas, E.; Mandly, Gonzalez A.; Gutierrez, A.; Sanchez, E.; Arnaiz, J.; Piedra, T.; Rodriguez, E.; Diez, C. [Hospital Univ. Marques de Valdecilla, Santander (Spain). Depts. of Radiology and Neurology

    2006-10-15

    An early diagnosis is crucial in herpes simplex virus encephalitis patients in order to institute acyclovir therapy and reduce mortality rates. Magnetic resonance imaging (MRI) is considered the gold standard for evaluation of these patients, but is frequently not available in the emergency setting. We report the first case of a computed tomography (CT) perfusion study that helped to establish a prompt diagnosis revealing abnormal increase of blood flow in the affected temporoparietal cortex at an early stage.

  6. Newer trends in the management of genital herpes

    Directory of Open Access Journals (Sweden)

    Nath Amiya

    2009-01-01

    Full Text Available Management of genital herpes is complex. Apart from using the standard antivirals, an ideal management protocol also needs to address various aspects of the disease, including the psychological morbidity. Oral acyclovir, valacyclovir or famciclovir are recommended for routine use. Long-term suppressive therapy is effective in reducing the number of recurrences and the risk of transmission to others. Severe or disseminated disease may require intravenous therapy. Resistant cases are managed with foscarnet or cidofovir. Genital herpes in human immunodeficiency virus-infected individuals usually needs a longer duration of antiviral therapy along with continuation of highly active anti retroviral therapy (HAART. Genital herpes in late pregnancy increases the risk of neonatal herpes. Antiviral therapy and/or cesarean delivery are indicated depending on the clinical circumstance. Acyclovir appears to be safe in pregnancy. But, there is limited data regarding the use of valacyclovir and famciclovir in pregnancy. Neonatal herpes requires a higher dose of acyclovir given intravenously for a longer duration. Management of the sex partner, counseling and prevention advice are equally important in appropriate management of genital herpes. Vaccines till date have been marginally effective. Helicase-primase inhibitors, needle-free mucosal vaccine and a new microbicide product named VivaGel may become promising treatment options in the future.

  7. Prevention of ulcerative lesions by episodic treatment of recurrent herpes labialis: A literature review.

    Science.gov (United States)

    Harmenberg, Johan; Oberg, Bo; Spruance, Spotwood

    2010-03-01

    There are substantial difficulties involved in carrying out clinical studies of recurrent herpes labialis, since the disease has a rapid onset, short-lasting viral shedding period and is rapidly self-healing. The aim of this paper was to critically assess published reports of episodic treatment of herpes labialis and to review biological and methodological problems involved in such studies. Limited, but statistically significant, results have been shown with topical antivirals, such as acyclovir and penciclovir, improving healing times by approximately 10%. Orally administrated antivirals, such as valaciclovir and famciclovir, have subsequently found clinical use. However, these two oral medications have different profiles in phase 3 studies. Famciclovir showed additional improvement of efficacy in terms of lesion healing time, but no effect on prevention of ulcerative lesions, while valaciclovir appeared to have similar efficacy to that of acyclovir cream on lesion healing, but some additional efficacy with respect to prevention of ulcerative lesions. A formulation of acyclovir/hydrocortisone showed further improvement in prevention of ulcerative lesions, while retaining efficacy with respect to lesion healing.

  8. Anti-herpes simplex virus activity of polysaccharides from Eucheuma gelatinae.

    Science.gov (United States)

    Jin, Fujun; Zhuo, Cuiqin; He, Zhe; Wang, Huailin; Liu, Wei; Zhang, Rong; Wang, Yifei

    2015-03-01

    Acyclovir is a commonly-used drug for treating herpes simplex virus (HSV) infections, but with its wide clinical application, more and more resistant strains have been found. Therefore, seeking a drug that can act against acyclovir-resistant virus has become an important goal of drug screening and development. In this study, plaque reduction assay, real-time PCR, Western blot, and immunofluorescence technique were used to investigate the antiviral effect of Eucheuma gelatinae polysaccharide (EGP) on HSV and to preliminarily clarify the in vitro anti-HSV mechanism of EGP. EGP was found to significantly inhibit HSV infection in vitro and displayed a good inhibitory effect on acyclovir-resistant strains. More detailed experiments have shown that EGP prevented early HSV-1 infection through directly inactivating HSV-1 particles and impairing virus attachment, but without effect on viral penetration. EGP also inhibited the RNA synthesis of HSV-1 early gene and late gene as well as viral DNA replication; no effect on immediate-early gene synthesis was observed. Besides, through immunofluorescence and western blot, we found that EGP significantly affected the protein synthesis of HSV-1. Taken together, these results demonstrate that EGP exerts its anti-HSV activity mainly through impeding early HSV-1 infection and inhibiting viral RNA and DNA syntheses. The weak cytotoxicity, strong viral inactivation as well as attachment inhibition activity enable EGP to be a virucide candidate for HSV therapy, especially for drug-resistant strains.

  9. Bioequivalence studies of two different film-coated tablet formulations of valacyclovir of two different strengths in healthy volunteers.

    Science.gov (United States)

    Neves, Rita; Almeida, Susana; Filipe, Augusto; Spinola, Ana Cristina Franco; Abolfathi, Zohreh; Lévesque, Ann; Ortuño, Jordi; Torns, Alex

    2010-01-01

    These studies were conducted in order to assess the bioequivalence of two film-coated formulations containing 250 mg and 1000 mg of valacyclovir (INN: valaciclovir; CAS 124832-26-4), which is the L-valyl ester and a pro-drug of the antiviral drug acyclovir (INN: aciclovir). In the study with valacyclovir 250 mg, 36 healthy subjects were enrolled in a randomized, single-dose, open-label, 2-way crossover study, with a washout period of 10 days. In the study with valacyclovir 1000 mg, 46 healthy subjects were enrolled in a randomized, single-dose, open-label, 2-way crossover study, with a washout period of 7 days. Plasma samples were collected up to 36 h postdose for both studies. Valacyclovir levels were determined by liquid chromatography with tandem mass detection (ie, the LC/MS/MS method) (lower limit of quantification: 0.50 ng/ mL for valacyclovir and 9.93 ng/mL for acyclovir for the 250 mg study and 1.00 ng/mL for valacyclovir and 20.00 ng/ mL for acyclovir for the 1000 mg study). Pharmacokinetic parameters used for bioequivalence assessment were the area under the concentration-time curve from time zero to time of last non-zero concentration (AUC(0-t)) and from time zero to infinity (AUC(0-inf) and maximum observed concentration (C(max)). These parameters were determined from the valacyclovir concentration data using non-compartmental analysis. In the tained by analysis of variance (ANOVA) for valacyclovir were 107.54-124.26% for C(max), 95.45-103.46% for AUC(0-Inf) and 95.53-103.63% for AUC(0-t) whereas for acyclovir the 90% confidence intervals obtained were 103.19-117.02% for C(max), 99.61-106.92% for AUC(0-Inf) and 99.58-106.94% for AUC(0-t). In the study with valacyclovir 1000 mg formulations, the 90% confidence intervals obtained for valacyclovir were 93.20-107.35% for C(max), 90.87-96.27% for AUC(0-inf) and 90.87-96.27% for AUC(0-t) whereas for acyclovir the 90% CIs obtained were 95.98-104.94% for C(max), 97.13-103.94% for AUC(0-inf) and 97

  10. Solid dispersions in the form of electrospun core-sheath nanofibers

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    Yu DG

    2011-12-01

    Full Text Available Deng-GuangYu1, Li-Min Zhu2, Christopher J Branford-White3, Jun-He Yang1, Xia Wang1, Ying Li1, Wei Qian11School of Materials Science and Engineering, University of Shanghai for Science and Technology; 2College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, People's Republic of China; 3Faculty of Life Sciences, London Metropolitan University, London, United KingdomBackground: The objective of this investigation was to develop a new type of solid dispersion in the form of core-sheath nanofibers using coaxial electrospinning for poorly water-soluble drugs. Different functional ingredients can be placed in various parts of core-sheath nanofibers to improve synergistically the dissolution and permeation properties of encapsulated drugs and to enable drugs to exert their actions.Methods: Using acyclovir as a model drug, polyvinylpyrrolidone as the hydrophilic filament-forming polymer matrix, sodium dodecyl sulfate as a transmembrane enhancer, and sucralose as a sweetener, core-sheath nanofibers were successfully prepared, with the sheath part consisting of polyvinylpyrrolidone, sodium dodecyl sulfate, and sucralose, and the core part composed of polyvinylpyrrolidone and acyclovir.Results: The core-sheath nanofibers had an average diameter of 410 ± 94 nm with a uniform structure and smooth surface. Differential scanning calorimetry and x-ray diffraction results demonstrated that acyclovir, sodium dodecyl sulfate, and sucralose were well distributed in the polyvinylpyrrolidone matrix in an amorphous state due to favoring of second-order interactions. In vitro dissolution and permeation studies showed that the core-sheath nanofiber solid dispersions could rapidly release acyclovir within one minute, with an over six-fold increased permeation rate across the sublingual mucosa compared with that of crude acyclovir particles.Conclusion: The study reported here provides an example of the systematic design, preparation

  11. Disseminated cutaneous Herpes Simplex Virus-1 in a woman with rheumatoid arthritis receiving Infliximab: A case report

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    Justice Elizabeth

    2008-08-01

    Full Text Available Abstract Introduction We present the case of a 49-year-old woman with a seronegative rheumatoid arthritis who developed pustular psoriasis whilst on etanercept and subsequently developed disseminated herpes simplex on infliximab. Case presentation Our patient presented with an inflammatory arthritis which failed to respond to both methotrexate and leflunomide, and sulphasalazine treatment led to side effects. She was started on etanercept but after 8 months of treatment developed scaly pustular lesions on her palms and soles typical of pustular psoriasis. Following the discontinuation of etanercept, our patient required high doses of oral prednisolone to control her inflammatory arthritis. A second biologic agent, infliximab, was introduced in addition to low-dose methotrexate and 15 mg of oral prednisolone. However, after just 3 infusions of infliximab, she was admitted to hospital with a fever, widespread itchy vesicular rash and worsening inflammatory arthritis. Fluid from skin vesicles examined by polymerase chain reaction showed Herpes Simplex Virus type 1. Blood cultures were negative and her chest X-ray was normal. Her infliximab was discontinued and she was started on acyclovir, 800 mg five times daily for 2 weeks. She made a good recovery with improvement in her skin within 48 hours. She continued for 2 months on a prophylactic dose of 400 mg bd. Her rheumatoid arthritis became increasingly active and a decision was made to introduce adalimumab alongside acyclovir. Acyclovir prophylaxis has been continued but the dose tapered so that she is taking only 200 mg of acyclovir on alternate days. There has been no recurrence of Herpes Simplex Virus lesions despite increasing adalimumab to 40 mg weekly 3 months after starting treatment. Conclusion We believe this to be the first reported case of widespread cutaneous Herpes Simplex Virus type 1 infection following treatment with infliximab. We discuss the clinical manifestations of Herpes

  12. Validação de método de doseamento para aciclovir e aplicação em estudo de equivalência farmacêutica de creme contendo aciclovir

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    Felipe Rebello Lourenço

    2010-06-01

    Full Text Available

    O presente trabalho teve por objetivos validar método para o doseamento de aciclovir em creme por espectrofotometria de absorção no ultravioleta e aplicá-lo em estudo de equivalência farmacêutica entre medicamento de referência, genérico e similar. O método proposto para doseamento de aciclovir em creme por espectrofotometria de absorção no ultravioleta foi validado, mostrando especificidade/ seletividade, linearidade e faixa linear, limite de detecção /quantificação, exatidão e precisão adequados para o uso pretendido. Os medicamentos foram avaliados quanto aos testes de peso médio, limite de guanina por cromatografia em camada delgada, identificação por espectrofotometria de absorção no ultravioleta, contagem microbiana de bactérias e fungos, pesquisa de microrganismos patógenos e doseamento por espectrofotometria de absorção no ultravioleta. Os três medicamentos atenderam as especificações para os testes avaliados e, portanto, podem ser considerados equivalentes farmacêuticos. Palavras-chave: Aciclovir. Validação de método. Equivalência farmacêutica. ABSTRACT Validation of acyclovir assay method and its use to verify pharmaceutical equivalence of creams containing acyclovir The aim of this study was to validate a UV absorption spectrophotometric method to assay acyclovir in cream and to use it to verify the pharmaceutical equivalence of the original brand-name, generic and similar (brand medicines. The method proposed for acyclovir cream was validated, showing adequate specificity/selectivity, linearity and linear range, detection and quantitation limits, accuracy and precision. The medicines were tested for average weight, guanine contents within limits (by thin-layer chromatography, drug identity (by UV spectrophotometry, bacterial and fungal counts and presence of pathogens, and were assayed by UV spectrophotometry. All medicines met the requirements in all these tests and can

  13. Treatment of solitary kidney calculi with minimally invasive percutaneous nephrolithotomy%B超引导微创经皮肾镜取石术治疗孤立肾肾结石

    Institute of Scientific and Technical Information of China (English)

    郭建军; 蔡恒; 梁荣兴; 袁鹏飞; 邹谨; 廖继红; 杨英刚

    2011-01-01

    Objective To investigate the histological features, clinical manifestations, treatment options and prognosis of Acyclovir-induced acute renal failure. Methods The clinical, pathological and prognosis of 1 case of Acyclovir-induced acute renal failure were reviewed respectively, and the related literature was reviewed. ResultS A middle-aged man suffering from cutaneous herpes zoster was given Acyclovir by intravenous drip and per os, when he developed acute abdominal pain and general malaise. Renal examin on showed, his serum creatinine (CRE) and blood urea nitrogen (BUN) concentrations rose to560.3 ymol/L and 20. 7 mmol/L, respectively. The pathology of kidney exhibited acute renal tubular necrosis acompanied with slight glomerular sclerosis. Renal impairment was restored afrer discontinuation of Acyclovir, hemodialysis and symptomatic treatment. Conclusion Acute abdominal pain and nausea are the most common symptoms of Acyclovir-induced acute renal failure. The pathology revealed acute renal tubular necrosis. Hemodialysis, symptomatic treatment and discontinuation of Acyclovir are the effective treatment.%目的 探讨B超引导下微创经皮肾镜取石术(MPCNL)治疗孤立肾肾结石的安全性和疗效.方法 回顾性分析2005年12月~2010年1月在B超引导下行MPCNL治疗孤立肾肾结石27例患者的临床资料.其中21例I期穿刺碎石取石,并发肾积脓的4例和肾功能衰竭的2例患者先行经皮肾穿刺造瘘引流,在感染控制和肾功能好转后行Ⅱ期MPCNL.结果 27例患者中,经单通道取石22例,双通道取石5例.一次取尽结石21例,需2次取尽结石3例,总结石清除率88.89%(余3例联合体外冲击波碎石治疗结石排尽).随访3~12月,肾功能不全的9例患者中,5例恢复正常,3例明显改善,1例因尿毒症需血液透析治疗,无其他重大并发症发生.结论 B超引导MPCNL治疗孤立肾肾结石安全、有效,创伤小、恢复快、并发症少.

  14. Varicella-zoster virus infections in immunocompromised patients - a single centre 6-years analysis

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    Liese Johannes

    2011-05-01

    Full Text Available Abstract Background Infection with varicella-zoster virus (VZV contemporaneously with malignant disease or immunosuppression represents a particular challenge and requires individualized decisions and treatment. Although the increasing use of varicella-vaccines in the general population and rapid initiation of VZV-immunoglobulins and acyclovir in case of exposure has been beneficial for some patients, immunocompromised individuals are still at risk for unfavourable courses. Methods In this single center, 6-year analysis we review incidence, hospitalization and complication rates of VZV-infections in our center and compare them to published data. Furthermore, we report three instructive cases. Results Hospitalization rate of referred children with VZV-infections was 45%, among these 17% with malignancies and 9% under immunosuppressive therapy. Rate of complications was not elevated in these two high-risk cohorts, but one ALL-patient died due to VZV-related complications. We report one 4-year old boy with initial diagnosis of acute lymphoblastic leukemia who showed a rapidly fatal outcome of his simultaneous varicella-infection, one 1.8-year old boy with an identical situation but a mild course of his disease, and an 8.5-year old boy with a steroid-dependent nephrotic syndrome. This boy developed severe hepatic involvement during his varicella-infection but responded to immediate withdrawl of steroids and administration of acyclovir plus single-dose cidofovir after nonresponse to acyclovir after 48 h. Conclusion Our data show that patients with malignant diseases or immunosuppressive therapy should be hospitalized and treated immediately with antiviral agents. Despite these measures the course of VZV-infections can be highly variable in these patients. We discuss aids to individual decision-making for these difficult situations.

  15. The dynamics of neopterin level in patients with herpes zoster

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    A. L. Yakubenko

    2015-01-01

    Full Text Available Neopterin is a specific marker of cellular immunity and monocytes/macrophages activation. Correlation between serum neopterin levels and clinical features of herpes zoster is unknown.The objective of the study was to determine the concentration of serum neopterin in patients with herpes zoster.Methods: 55 patients with herpes zoster (30 HIV-positive and 25 HIV-negative were included. Serum neopterin levels were measured three times during the observation period (before onset of treatment with acyclovir, on the 3rd day of treatment and after healing of skin lesions. The clinical course and dynamics of laboratory data were also evaluated.Results: The study showed that elevated serum neopterin levels were found in all patients with herpes zoster. Neopterin concentrations were significantly reduced during acyclovir treatment (from 30 (17; 32 to 12 (11; 27 nmol/L (p = 0,0000001, but remained above the upper limit of normal by the time skin lesions were healed in most patients. Neopterin levels before and after treatment weren’t associated with HIV-status. Neopterin concentration was slightly higher in patients with HIV infection on the third day of observation only, that could reflect the abnormal immunoreactivity of this host. Neopterin levels in patients with varicella zoster viremia were higher compared to patients without viremia on the third day of treatment with acyclovir (23.5 (12,7; 30,0 and 12 (4,2, 24,5 nmol/L, respectively, p = 0,037.Conclusions: These results suggest that the dynamics of serum neopterin could be a marker of effectiveness of immune response in herpes zoster.

  16. Impact of Herpes simplex virus load and red blood cells in cerebrospinal fluid upon herpes simplex meningo-encephalitis outcome

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    Poissy Julien

    2012-12-01

    Full Text Available Abstract Background Herpes simplex encephalitis (HSE often leads to severe disability or death. Factors usually associated with outcome include Simplified Acute Physiology Score, age and delay of initiation of acyclovir treatment. Our aim was to determine the impact of Herpes simplex virus (HSV load in cerebrospinal fluid (CSF upon HSE outcome. Methods We retrospectively determined HSV load in the CSF of 43 patients with confirmed HSE, hospitalized in northern France from 1998 to 2005, using CSF samples collected the day of hospital admission and stored at −20°C. We analyzed the association between HSV load and mortality/morbidity by the Glasgow Outcome Scale. Fisher’s exact test and Wilcoxon’s test were used for statistical analysis. Results The M/F sex ratio was 1.7 and median patient age was 61 years. Median HSV load in CSF was 2.0 log copies/μL (IQR 25-75=1.2-2.6. The mortality rate was 32.6% six months after HSE diagnosis. Higher age was associated with mortality (p=0.03. Longer delay in acyclovir initiation tended to be associated with higher mortality but did not reach statistical significance (p=0.08. Severe disability and death due to HSV were associated with a higher Knaus score (p=0.004, later acyclovir initiation (p=0.006, older age (p=0.04 and presence of red blood cells in CSF (p=0.05. HSV load in CSF was neither associated with mortality (p=1.00 nor with morbidity (p=0.90. Conclusion In this study, HSV load in CSF was not found to be associated with poor outcome in patients with HSE. These data do not support measurement of HSV load at admission in patients with HSE.

  17. Evaluation of USP apparatus 3 for dissolution testing of immediate-release products.

    Science.gov (United States)

    Yu, Lawrence X; Wang, Jin T; Hussain, Ajaz S

    2002-01-01

    We sought to evaluate whether U.S. Pharmacopeia (USP) apparatus 3 can be used as an alternative to USP apparatus 2 for dissolution testing of immediate-release (IR) dosage forms. Highly soluble drugs, metoprolol and ranitidine, and poorly soluble drugs, acyclovir and furosemide, were chosen as model drugs. The dissolution profiles of both innovator and generic IR products were determined using USP apparatus 2 at 50 rpm and apparatus 3 at 5, 15, and 25 dips per minute (dpm). The dissolution profiles from USP apparatus 3 were compared to those from USP apparatus 2 using the f(2) similarity test. The dissolution profile from USP apparatus 3 generally depends on the agitation rate, with a faster agitation rate producing a faster dissolution rate. It was found that USP apparatus 3 at the extreme low end of the possible agitation range, such as 5 dpm, gave hydrodynamic conditions equivalent to USP apparatus 2 at 50 rpm. With appropriate agitation rate, USP apparatus 3 can produce similar dissolution profiles to USP apparatus 2 or distinguish dissolution characteristics for the IR products of metoprolol, ranitidine, and acyclovir. Incomplete dissolution was observed for the furosemide tablets using USP apparatus 3. Although it is primarily designed for the release testing of extended-release products, USP apparatus 3 may be used for the dissolution testing of IR products of highly soluble drugs, such as metoprolol and ranitidine, and some IR products of poorly soluble drugs, such as acyclovir. USP apparatus 3 offers the advantages of avoiding cone formation and mimicking the changes in physiochemical conditions and mechanical forces experienced by products in the gastrointestinal tract.

  18. Varicella-zoster virus encephalitis in an AIDS patient

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    P.V. Toledo

    2004-06-01

    Full Text Available A 37-year-old man with a three-year history of Acquired Immunodeficiency Syndrome was admitted with impaired consciousness, seizures and fever. He was on highly active antiretroviral therapy and on neurotoxoplasmosis secondary prophylaxis. Laboratory exams from two months before showed a CD4 cell count of 37/µL and a viral load of 230,000 copies/mL. Three months before admission he developed herpetic skin rash in the right trunk and acyclovir was added to his treatment regimen. On physical exam he was drowsy and had motor and sensory aphasia. The patient had elevated protein levels and normal pressure in the cerebrospinal fluid (CSF. Contrast enhanced computed tomography scan of the brain showed a hypodense lesion in the left parietal lobe, with poorly defined margins and no contrast enhancement. The magnetic resonance scan (MRI showed multiple hyperintensities in T2-weighted image in white and grey matters and hypointense products of hemorrhage in both hemispheres and in the cerebellum. He was empirically treated with intravenous acyclovir and prednisone. Viral DNA of Varicella-zoster virus (VZV was detected in the CSF by means of polymerase chain reaction (PCR analysis. Acyclovir was continued for 10 days and the patient became well, with improvement of aphasia.We present a case of VZV encephalitis, confirmed by nested PCR, in a patient with suggestive MRI findings, who succeeded with treatment. VZV encephalitis is a rare opportunistic infection, occurring in 0.1 to 4% of AIDS patients with neurological disease; it is related to severe immunodeficiency and has a high mortality.

  19. In vitro anti-herpes simplex virus-2 activity of Salvia desoleana Atzei & V. Picci essential oil

    Science.gov (United States)

    Sanna, Cinzia; Cagliero, Cecilia; Ballero, Mauro; Civra, Andrea; Donalisio, Manuela; Bicchi, Carlo; Lembo, David

    2017-01-01

    Salvia desoleana Atzei & V. Picci is an indigenous species in Sardinia island used in folk medicine to treat menstrual, digestive and central nervous system diseases. Nowadays, it is widely cultivated for the pleasant smell of its essential oil (EO), whose antimicrobial and antifungal activities have already been screened. This study evaluated the in vitro anti-Herpes Simplex Virus-2 (HSV-2) activity of S. desoleana EO, fractions and main components: linalyl acetate, alpha terpinyl acetate, and germacrene D. Phytochemical composition of S. desoleana EO was studied by GC-FID/MS analysis and the active fraction(s) and/or compounds in S. desoleana EO were identified with a bioassay-guided fractionation procedure through in vitro assays on cell viability and HSV-2 and RSV inhibition. S. desoleana EO inhibits both acyclovir sensitive and acyclovir resistant HSV-2 strains with EC50 values of 23.72 μg/ml for the former and 28.57 μg/ml for the latter. Moreover, a significant suppression of HSV-2 replication was observed with an EC50 value of 33.01 μg/ml (95% CI: 26.26 to 41.49) when the EO was added post-infection. Among the fractions resulting from flash column chromatography on silica gel, the one containing 54% of germacrene D showed a similar spectrum of activity of S. desoleana EO with a stronger suppression in post-infection stage. These results indicated that S. desoleana EO can be of interest to develop new and alternative anti-HSV-2 products active also against acyclovir-resistant HSV-2 strains. PMID:28207861

  20. Antioxidant and antiviral properties of Pseudopiptadenia contorta (Leguminosae and of quebracho (Schinopsis sp. extracts

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    Davyson de L. Moreira

    2005-06-01

    Full Text Available Proanthocyanidins from P. contorta leaves and from a commercial quebracho extract were isolated and characterized. Flavonoids, catechins and gallic acid were also identified in the extracts of P. contorta. Compounds were evaluated for their antioxidant properties and for their antiviral activity against an acyclovir-resistant herpes simplex virus type 1 strain. The low molecular weight phenolic derivatives and the proanthocyanidins from P. contorta showed the highest antioxidant activity. Purified proanthocyanidins from both P. contorta and quebracho showed the same maximum non toxic concentrations (25 µg/mL, with 82.2% and 100% of virus inhibition, respectively.

  1. Herpetic keratitis with iritis after corneal crosslinking with riboflavin and ultraviolet A for keratoconus.

    Science.gov (United States)

    Kymionis, George D; Portaliou, Dimitra M; Bouzoukis, Dimitrios I; Suh, Leejee H; Pallikaris, Aristofanis I; Markomanolakis, Marinos; Yoo, Sonia H

    2007-11-01

    A 21-year-old woman had crosslinking for keratoconus in the right eye; the left eye was scheduled for penetrating keratoplasty. Five days postoperatively, she presented with geographic epithelial keratitis and iritis. Analysis of tear samples by polymerase chain reaction confirmed the diagnosis. The patient was treated with oral steroids and acyclovir, with significant improvement. Two months postoperatively, the visual acuity was improved and there was no evidence of herpetic disease recurrence. Crosslinking can induce herpetic keratitis with iritis even in patients with no history of herpetic disease. Early diagnosis and proper treatment are essential for a favorable outcome.

  2. Corticosteroid and antiviral therapy for Bell's palsy: A network meta-analysis

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    Attia John

    2011-01-01

    Full Text Available Abstract Background Previous meta-analyses of treatments for Bell's palsy are still inconclusive due to different comparators, insufficient data, and lack of power. We therefore conducted a network meta-analysis combining direct and indirect comparisons for assessing efficacy of steroids and antiviral treatment (AVT at 3 and 6 months. Methods We searched Medline and EMBASE until September 2010 using PubMed and Elsviere search engines. A network meta-analysis was performed to assess disease recovery using a mixed effects hierarchical model. Goodness of fit of the model was assessed, and the pooled odds ratio (OR and 95% confidence interval (CI were estimated. Results Six studies (total n = 1805were eligible and contributed to the network meta-analysis. The pooled ORs for resolution at 3 months were 1.24 (95% CI: 0.79 - 1.94 for Acyclovir plus Prednisolone and 1.02 (95% CI: 0.73 - 1.42 for Valacyclovir plus Prednisolone, versus Prednisolone alone. Either Acyclovir or Valacyclovir singly had significantly lower efficacy than Prednisolone alone, i.e., ORs were 0·44 (95% CI: 0·28 - 0·68 and 0·60 (95% CI: 0·42 - 0·87, respectively. Neither of the antiviral agents was significantly different compared with placebo, with a pooled OR of 1·25 (95% CI: 0·78 - 1·98 for Acyclovir and 0·91 (95% CI: 0·63 - 1·31 for Valacyclovir. Overall, Prednisolone-based treatment increased the chance of recovery 2-fold (95% CI: 1·55 - 2·42 compared to non-Prednisolone-based treatment. To gain 1 extra recovery, 6 and 26 patients need to be treated with Acyclovir and prednisolone compared to placebo and prednisolone alone, respectively. Conclusions Our evidence suggests that the current practice of treating Bell's palsy with AVT plus corticosteroid may lead to slightly higher recovery rates compared to treating with prednisone alone but this does not quite reach statistical significance; prednisone remains the best evidence-based treatment.

  3. Cutaneous neonatal herpes simplex virus infection type 2: a case report*

    Science.gov (United States)

    Bittencourt, Maraya de Jesus Semblano; Freitas, Lívia Karlla Marinho; Drago, Marion Guimarães; Carvalho, Alessandra Haber; do Nascimento, Bianca Angelina Macêdo

    2016-01-01

    Neonatal herpes is a serious condition. Newborns can be contaminated in utero via transplacental hematogenic transmission, upon delivery (the most frequent route), or during the postnatal period (indirect transmission). Optimal management requires prompt and accurate recognition, particularly in newborns, in order to prevent complications. Acyclovir is the treatment of choice, but its implementation is often delayed while awaiting test results, such as PCR and serology. Cytology for diagnostic purposes is rarely used in dermatology, despite the quick and reliable results. We report a case of neonatal herpes caused by type 2 herpes simplex virus diagnosed by cytology. PMID:27192523

  4. Evaluation of USP apparatus 3 for dissolution testing of immediate-release products

    OpenAIRE

    Yu, Lawrence X.; Wang, Jin T.; Hussain, Ajaz S.

    2002-01-01

    We sought to evaluate whether U.S. Pharmacopeia (USP) apparatus 3 can be used as an alternative to USP apparatus 2 for dissolution testing of immediate-release (IR) dosage forms. Highly soluble drugs, metoprolol and ranitidine, and poorly soluble drugs, acyclovir and furosemide, were chosen as model drugs. The dissolution profiles of both innovator and generic IR products were determined using USP apparatus 2 at 50 rpm and apparatus 3 at 5, 15, and 25 dips per minute (dpm). The dissolution pr...

  5. Susac's syndrome as HIV-associated immune reconstitution inflammatory syndrome.

    Science.gov (United States)

    Ferretti, Francesca; Gerevini, Simonetta; Colombo, Bruno; Testa, Manuela; Guffanti, Monica; Franciotta, Diego; Bernardi, Gaetano; Lazzarin, Adriano; Cinque, Paola

    2013-09-03

    Susac's Syndrome (SS) is an autoimmune endotheliopathy of cerebral, retinal and cochlear arterioles. We report of an HIV-infected woman who developed a first SS episode following a spontaneous reduction of plasma viral load and several relapses six years later, following initiation of combined antiretroviral therapy (cART). Corticosteroids and intravenous immunoglobulins alone did not control the disease, which improved after combined treatment with acyclovir and ganciclovir. SS onset in HIV infection and relapses during cART-induced immune reconstitution are consistent with the dysimmune nature of the disease. The response to anti-herpes drugs suggests a viral contribute in this case of SS.

  6. Rapid quantification of the metabolite of valacyclovir hydrochloride in human plasma by liquid chromatography-tandem mass spectrometry

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Objective To establish a rapid,sensitive and selective liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination of acyclovir (the metabolite of valacyclovir hydrochloride) in human plasma. Methods After addition of ganciclovir as internal standard (IS),plasma samples were prepared by one-step protein precipitation using acetonitrile as precipitant,followed by an isocratic elution with 0.1% formic acid solution-methanol (95∶5,v/v) on an Agilent ZORBAX SB-C18 (150mm×2.1mm i.d.,3....

  7. Herpes simplex virus keratitis: an update of the pathogenesis and current treatment with oral and topical antiviral agents.

    Science.gov (United States)

    Tsatsos, Michael; MacGregor, Cheryl; Athanasiadis, Ioannis; Moschos, Marilita M; Hossain, Parwez; Anderson, David

    2016-12-01

    Ophthalmic herpes simplex viral keratitis is responsible for a range of ocular manifestations from superficial epithelial disease to stromal keratitis and endotheliitis. The Herpetic Eye Disease Study has guided the management of herpetic eye disease for almost twenty years, but newer medications such as valacyclovir are now available and are considered to have better bioavailability than acyclovir. In this review, we examine the existing evidence on the pathogenesis of different ophthalmic herpes simplex viral keratitis disease modalities and the role of oral and topically administered antiviral drugs in the treatment of herpes simplex viral keratitis.

  8. Kaposi′s varicelliform eruption

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    Shenoy Manjunath

    2007-01-01

    Full Text Available Kaposi′s varicelliform eruption (eczema herpeticum is the name given to a distinct cutaneous eruption caused by herpes simplex and certain other viruses that infect persons with preexisting dermatosis. Most commonly it is associated with atopic dermatitis. We report a case of a three-year-old atopic child who presented with extensive vesicular eruption suggestive of Kaposi′s varicelliform eruption. There was history of fever, malaise and extensive vesicular eruptions. Diagnosis was made based on clinical features and Tzanck smear examination. Patient responded adequately to oral acyclovir therapy.

  9. Herpes simplex Virus Esophagitis in an Immunocompetent Patient with Ebstein-Barr Virus Infection

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    M. Tzouvala

    2008-11-01

    Full Text Available Epstein-Barr virus infectious mononucleosis can cause transient immune deficiency which may predispose to reactivation of latent herpes simplex virus (HSV infection in the immunocompetent host. We report the case of a 15-year-old male who presented with severe odynophagia and herpes labialis during the course of Epstein-Barr virus infectious mononucleosis that had been diagnosed ten days before. Esophagoscopy revealed extensive ulcerations with distinct borders and whitish exudates at the mid and distal esophagus. Polymerase chain reaction detected HSV-1 DNA in the biopsy specimens. The patient was treated with intravenous acyclovir. The symptoms resolved rapidly within 3 days, in accordance with improved endoscopic findings.

  10. Intercalation of Amido Cationic Drug with Montmorillonite

    Institute of Scientific and Technical Information of China (English)

    ZHENG Junping; WANG Hongyan; ZHUANG Hong; XI Lifei; YAO Kangde

    2007-01-01

    The intercalation of drug molecules with montmorillonit (MMT) using Acyclovir (ACV) as the model drug was focused on. The optimum conditions were studied based on orthogonal design, such as intercalation time and temperature. The intercalation composites were characterized by X-ray diffraction (XRD), Fourier transformed infrared (FT-IR), and thermogravimetric analysis (TGA). The experimental results reveal that ACV is successfully intercalated into the interlayers of MMT. The in vitro release experiments reveal that ACV is released from MMT steadily and pH dependent

  11. 更昔洛韦治疗水痘98例疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈红梅; 向稚丹

    2003-01-01

    @@ 更昔洛韦(ganciclovir,GCV)又名丙氧鸟苷,属新型开环类核苷药物,具有较广谱的强效抗病毒作用,对单纯疱疹病毒、水痘-带状疱疹病毒的作用优于阿昔洛韦(acyclovir,ACV).我科采用GCV治疗水痘患者,观察其疗效、不良反应并与ACV比较.现将结果报道如下.

  12. Herpes simplex type 2 encephalitis and methotrexate medication: a fortuitous or causative association in a patient with spondyloarthritis?

    Science.gov (United States)

    Lupo, Julien; Dos Santos, Ophélie; Germi, Raphaele; Baccard-Longère, Monique; Stahl, Jean-Paul; Epaulard, Olivier; Morand, Patrice

    2016-11-23

    It is unclear whether immunosuppression is a risk factor for herpes encephalitis. Herein, we describe a rare case of herpes simplex virus (HSV) type 2 encephalitis in a patient treated with low-dose methotrexate for HLA-B27-associated spondyloarthritis. The patient was successfully treated with acyclovir but presented sequelae of encephalitis. Here we discuss the possible role of low-dose MTX therapy as a risk factor of neurological herpes reactivation and severe disease. The host-related and viral risk factors are also addressed.

  13. Evaluation needle length and density of microneedle arrays in the pretreatment of skin for transdermal drug delivery.

    Science.gov (United States)

    Yan, Guang; Warner, Kevin S; Zhang, Jie; Sharma, Sanjay; Gale, Bruce K

    2010-05-31

    Solid silicon microneedle arrays with different needle lengths (ranging from 100 to 1100 microm) and needle densities (ranging from 400 to 11,900 needles/cm(2)) were used to penetrate epidermal membrane of human cadaver skin. After this pretreatment, the electrical resistance of the skin and the flux of acyclovir across the skin were monitored. A linear correlation between the acyclovir flux and the inverse of the skin electric resistance was observed. Microneedle arrays with longer needles (>600 microm) were more effective in creating pathways across skin and enhancing drug flux, and microneedle arrays with lower needle densities (microneedles with long enough needle length (>600 microm). In addition, the microneedle arrays were used to penetrate hairless rat skin in vivo, and the trans-epidermal water loss (TEWL) of the rat skin was measured before and after the pretreatment. Treating rat skin with microneedle arrays of lower needle density and longer needle length was more effective in increasing TEWL. Integrity of the stratum corneum barrier of the penetrated rat skin as measured by TEWL recovered back to its base line level within 24h after the microneedle pretreatment.

  14. Pharmacokinetics of valacyclovir in the adult horse.

    Science.gov (United States)

    Maxwell, L K; Bentz, B G; Bourne, D W A; Erkert, R S

    2008-08-01

    Recent outbreaks of equine herpes virus type-1 infections have stimulated renewed interest in the use of effective antiherpetic drugs in horses. The purpose of this study was to investigate the pharmacokinetics of valacyclovir (VCV), the prodrug of acyclovir (ACV), in horses. Six adult horses were used in a randomized cross-over design. Treatments consisted of 10 mg/kg ACV infused intravenously, 5 g (7.7-11.7 mg/kg) VCV delivered intragastrically (IG) and 15 g (22.7-34.1 mg/kg) VCV administered IG. Serum samples were obtained at predetermined times for acyclovir assay using high-performance liquid chromatography. Following the administration of 5 g VCV, the mean observed maximum serum ACV concentration (C(max)) was 1.45 +/- 0.38 (SD) microg/mL, at 0.74 +/- 0.43 h. At a dose of 15 g VCV, the mean C(max) was 5.26 +/- 2.82 microg/mL, at 1 +/- 0.27 h. The mean bioavailability of ACV from oral VCV was 60 +/- 12% after 5 g of VCV and 48 +/- 12% after 15 g VCV, and did not differ significantly between dose rates (P > 0.05). Superposition suggested that a loading dose of 27 mg/kg VCV every 8 h for 2 days, followed by a maintenance dose of 18 mg/kg every 12 h, will maintain effective serum ACV concentrations.

  15. Anti-HSV1 activity of brown algal polysaccharides and possible relevance to the treatment of Alzheimer's disease.

    Science.gov (United States)

    Wozniak, Matthew; Bell, Tracey; Dénes, Ádám; Falshaw, Ruth; Itzhaki, Ruth

    2015-03-01

    Herpes simplex virus type 1 (HSV1) induces the formation of the characteristic abnormal molecules of Alzheimer's disease (AD) brains, beta-amyloid, and abnormally phosphorylated, AD-like tau (P-tau). Formation of these molecules is inhibited by treatment with the antiviral agent acyclovir (ACV), which prevents viral DNA replication. A totally different mechanism of antiviral action against herpes simplex viruses is shown by sulfated fucans. The antiviral activity of sulfated fucans from five brown algae (Scytothamnus australis, Marginariella boryana, Papenfussiella lutea, Splachnidium rugosum and Undaria pinnatifida) was investigated in relation to the HSV1-induced formation of beta-amyloid, and AD-like tau. Antiviral activity was also related to specific structural features of these polysaccharides. Four sulfated fucan extracts each prevented the accumulation of HSV1-induced beta-amyloid and AD-like tau in HSV1-infected Vero cells. The structures of these extracts had some similarities but also key differences, indicating that a number of structural features can cause antiviral activity. The most active sulfated fucan combined with acyclovir was particularly effective, so may be particularly suitable for further experimental testing in order to develop treatment protocols for AD patients, with the aim of slowing or stopping disease progression.

  16. A Spotty Liver of Pregnancy

    Directory of Open Access Journals (Sweden)

    Meagan Gray MD

    2014-09-01

    Full Text Available Herpes simplex virus (HSV hepatitis by definition constitutes disseminated herpes simplex infection; it is rare, with only approximately 130 cases reported in the literature. Although HSV hepatitis typically occurs in immunocompromised hosts, pregnancy—especially the third trimester, has been identified as a risk factor for its development. This is likely because of the fact that humoral and cell-mediated immunity decrease throughout pregnancy and nadir in the third trimester with decreased T-cell counts and altered B/T lymphocyte ratios. Here, we report on a patient with HSV 2 hepatitis in a previously healthy 27-year-old woman in her 23rd week of pregnancy. She initially presented with nausea, vomiting, and abdominal pain and was found to have acute hepatocellular liver injury and a systemic inflammatory response syndrome. Broad-spectrum antibiotics and acyclovir were promptly initiated. Liver biopsy, serum DNA polymerase chain reaction (PCR as well as a labial ulcer culture and PCR were all positive for HSV 2. The patient recovered completely; however, her fetus did not survive. Review of the literature emphasizes that presentation with disseminated HSV infection typically occurs in the third trimester of pregnancy. This report emphasizes that abdominal pain combined with fever and hepatic dysfunction in pregnancy should prompt immediate consideration of the diagnosis of HSV hepatitis. Furthermore, given the high mortality rate and effective treatment, empiric treatment with acyclovir should be considered early in all potential cases.

  17. Herpes zoster oticus: A rare clinical entity

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    Shailesh Gondivkar

    2010-01-01

    Full Text Available Herpes zoster oticus also known as Ramsay Hunt syndrome is a rare complication of herpes zoster in which reactivation of latent varicella zoster virus infection in the geniculate ganglion causes otalgia, auricular vesicles, and peripheral facial paralysis. Ramsay Hunt syndrome is rare in children and affects both sexes equally. Incidence and clinical severity increases when host immunity is compromised. Because these symptoms do not always present at the onset, this syndrome can be misdiagnosed. Although secondary to Bell′s palsy in terms of the cause of acute atraumatic peripheral facial paralysis, Ramsay Hunt syndrome, with incidence ranged from 0.3 to 18%, has a worse prognosis. Herpes zoster oticus accounts for about 12% cases of facial palsy, which is usually unilateral and complete and full recovery occurs in only about 20% of untreated patients. The most advisable method to treat Ramsay Hunt syndrome is the combination therapy with acyclovir and prednisone but still not promising, and several prerequisites are required for better results. We present a case of 32-year-old man suffering from Ramsay Hunt syndrome with grade V facial palsy treated effectively with rehabilitation program, after the termination of the combination therapy of acyclovir and prednisone.

  18. Bilateral Ramsay Hunt syndrome in a diabetic patient

    Directory of Open Access Journals (Sweden)

    Goyal Amit

    2004-12-01

    Full Text Available Abstract Background Herpes zoster oticus accounts for about 10% cases of facial palsy, which is usually unilateral and complete and full recovery occurs in only about 20% of untreated patients. Bilateral herpes zoster oticus can sometime occur in immunocompromised patients, though incidence is very rare. Case presentation Diabetic male, 57 year old presented to us with bilateral facial palsy due to herpes zoster oticus. Patient was having bilateral mild to moderate sensorineural hearing loss. Patient was treated with appropriate metabolic control, anti-inflammatory drugs and intravenous acyclovir. Due to uncontrolled diabetes, glucocorticoids were not used in this patient. Significant improvement in hearing status and facial nerve functions were seen in this patient. Conclusions Herpes zoster causes severe infections in diabetic patients and can be a cause of bilateral facial palsy and bilateral Ramsay Hunt syndrome. Herpes zoster in diabetic patients should be treated with appropriate metabolic control, NSAIDS and intravenous acyclovir, which we feel should be started at the earliest. Glucocorticoids should be avoided in diabetic patients.

  19. Fulminant bilateral acute retinal necrosis syndrome associated with viral encephalitis: A case report

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    Zhou, Chunkui; Zhu, Lijun; Fang, Shaokuan

    2016-01-01

    Herpes simplex virus (HSV) is the most common cause of acute viral encephalitis. Acute retinal necrosis (ARN) is a rapidly progressing and potentially blinding eye disease that may be induced by HSV. The present case study reports the very rare case of a patient with herpes simplex encephalitis (HSE) combined with acute retinal necrosis (ARN). A 47-year-old woman was admitted to hospital with persistent high fever and somnolence for 5 days. Magnetic resonance imaging showed abnormal signals in the right medial temporal lobes, and HSV-1 was identified in the serum and cerebrospinal fluid. Five days later, despite treatment with intravenous acyclovir and partial improvement in consciousness, the patient suddenly developed blurred vision and bilateral visual pain. Fundus fluorescence angiography revealed bilateral vessel obstruction and flaky reduced fluorescence. ARN was diagnosed clinically. Dexamethasone was administered as an anti-inflammatory adjunct to intravenous acyclovir therapy. The visual acuity of the patient was reduced to mere light perception a further 4 days later. The present case indicates that HSE may be complicated with ARN, causing a reduction in visual acuity to mere light perception within a very short time. PMID:27698716

  20. Management of ramsay hunt syndrome in an acute palliative care setting

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    Shrenik Ostwal

    2015-01-01

    Full Text Available Introduction: The Ramsay Hunt syndrome is characterized by combination of herpes infection and lower motor neuron type of facial nerve palsy. The disease is caused by a reactivation of Varicella Zoster virus and can be unrepresentative since the herpetic lesions may not be always be present (zoster sine herpete and might mimic other severe neurological illnesses. Case Report: A 63-year-old man known case of carcinoma of gall bladder with liver metastases, post surgery and chemotherapy with no scope for further disease modifying treatment, was referred to palliative care unit for best supportive care. He was on regular analgesics and other supportive treatment. He presented to Palliative Medicine outpatient with 3 days history of ipsilateral facial pain of neuropathic character, otalgia, diffuse vesciculo-papular rash over ophthalmic and maxillary divisions of left trigeminal nerve distribution of face and ear, and was associated with secondary bacterial infection and unilateral facial edema. He was clinically diagnosed to have Herpes Zoster with superadded bacterial infection. He was treated with tablet Valacyclovir 500 mg four times a day, Acyclovir cream for local application, Acyclovir eye ointment for prophylactic treatment of Herpetic Keratitis, low dose of Prednisolone, oral Amoxicillin and Clindamycin for 7 days, and Pregabalin 150 mg per day. After 7 days of treatment, the rash and vesicles had completely resolved and good improvement of pain and other symptoms were noted. Conclusion: Management of acute infections and its associated complications in an acute palliative care setting improves both quality and length of life.

  1. A systematic review on recurrent respiratory papillomatosis: clinical effect and duration of benefit of different treatment modalities

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    Elina Kiverniti

    2011-12-01

    Full Text Available The aim of this study is to compare different modalities used for the treatment of recurrent respiratory papillomatosis (RRP in adults and children in terms of their clinical effect and the duration of benefit. Systematic review of papers was written in the English language and published between 1977 and 2007. Outcomes are number of patients with a clinical response and length of time the response lasted for. We found 28 useful studies. There were 1,045 subjects, 416 children and 339 adults who underwent different treatments for RRP between 1976 and 2007. The methods used consisted of cidofovir, interferon, surgical excision, indole-3-carbinol, acyclovir, mumps vaccine, and photodynamic therapy. 62.5% of patients had a complete response on cidofovir (11 studies, 45.14% on interferon (8 studies, 33.33% on I3C (2 studies, 44.36% after surgery (5 studies, 77.55% after the mumps vaccine (1 study, 100% on acyclovir (1 study, and 9.09% after photodynamic therapy (1 study. The effect of different modalities lasted between 9 and 27 months. In conclusion, it is impossible to reach any reliable conclusions as to which method is the most durable and effective. There is a great need for randomised control multicentre trials on the treatment of RRP, so that reliable results can be produced.

  2. Facial herpes zoster infection precipitated by surgical manipulation of the trigeminal nerve during exploration of the posterior fossa: a case report

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    Mansour Nassir

    2009-09-01

    Full Text Available Abstract Introduction We present a case of herpes zoster infection (shingles precipitated by surgical manipulation of the trigeminal nerve root during an attempted microvascular decompression procedure. The pathogenesis of this phenomenon, as well as the importance and role of prophylactic acyclovir in its management, are discussed. Case presentation A 54-year-old Caucasian man with a classical long-standing left-sided V2 and V3 division primary trigeminal neuralgia refractory to medical management, underwent posterior fossa exploration for microvascular decompression via a standard retromastoid craniectomy. The patient had immediate and complete relief from pain. Three days after the operation, he developed severely painful vesicles with V2 and V3 dermatomal distribution. Rather than the classical paroxysmal, lancinating type of trigeminal neuralgia, the pain experienced by the patient was of a constant burning nature. A clinical diagnosis of herpes zoster (shingles was made after smear confirmation from microbiological testing. The patient was commenced on antiviral treatment with acyclovir. His vesicular rash and pain gradually subsided over the next two weeks. He remains asymptomatic one year later. Conclusions Postoperative shingles precipitated by trigeminal nerve manipulation during surgery for trigeminal neuralgia can be a distressing and demoralizing experience for the patient. A careful preoperative history, early recognition, and prompt antiviral therapy is necessary.

  3. A rare complication of Ramsey Hunt Syndrome: Sınus vein thrombosis

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    Ramiz Ahmedov

    2011-03-01

    Full Text Available Ramsay-Hunt Syndrome (RHS is a rare affection characterized by peripheral facial paralysis (PFP, skin eruption in the auricular canal and cochleovestibular symptoms. It is produced by varicella-zoster virus(VZV reactivation at the geniculate ganglia. In elderly and immunocompromised individuals, the virus may reactivate to produce shingles (zoster. After zoster resolves, many elderly patients experience postherpetic neuralgia. Uncommonly, VZV can spread to large cerebral arteries to cause a spectrum of large-vessel vascular damage, ranging from vasculopathy to vasculitis, with stroke. In immunocompromised individuals, especially those with cancer or acquired immunodeficiency syndrome, deeper tissue penetration of the virus may occur (as compared with immunocompetent individuals, with resultant myelitis, small-vessel vasculopathy, ventriculitis, and meningoencephalitis. The polymerase chain reaction (PCR analysis of cerebrospinal fluid remains the mainstay for diagnosing the neurologic complications of VZV during life. We report a case of Ramsay Hunt syndrome complicated with cerebral venous thrombosis. Patient received treatment with acyclovir and anticoagulation. Early treatment with acyclovir therapy and anticoagulation could improve the recovery rate of facial nerve palsy and sinus vein thrombosis.

  4. Antitumor action of temozolomide, ritonavir and aprepitant against human glioma cells.

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    Kast, Richard E; Ramiro, Susana; Lladó, Sandra; Toro, Salvador; Coveñas, Rafael; Muñoz, Miguel

    2016-02-01

    In the effort to find better treatments for glioblastoma we tested several currently marketed non-chemotherapy drugs for their ability to enhance the standard cytotoxic drug currently used to treat glioblastoma- temozolomide. We tested four antiviral drugs- acyclovir, cidofovir, maraviroc, ritonavir, and an anti-emetic, aprepitant. We found no cytotoxicity of cidofovir and discussed possible reasons for discrepancy from previous findings of others. We also found no cytotoxicity from acyclovir or maraviroc also in contradistinction to predictions. Cytotoxicity to glioma cell line GAMG for temozolomide alone was 14%, aprepitant alone 7%, ritonavir alone 14%, while temozolomide + aprepitant was 19%, temozolomide + ritonavir 34%, ritonavir + aprepitant 64 %, and all three, temozolomide + ritonavir + aprepitant 78%. We conclude that a remarkable synergy exists between aprepitant and ritonavir. Given the long clinical experience with these two well-tolerated drugs in treating non-cancer conditions, and the current median survival of glioblastoma of 2 years, a trial is warranted of adding these two simple drugs to current standard treatment with temozolomide.

  5. Co-occurrence of Photochemical and Microbiological Transformation Processes in Open-Water Unit Process Wetlands.

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    Prasse, Carsten; Wenk, Jannis; Jasper, Justin T; Ternes, Thomas A; Sedlak, David L

    2015-12-15

    The fate of anthropogenic trace organic contaminants in surface waters can be complex due to the occurrence of multiple parallel and consecutive transformation processes. In this study, the removal of five antiviral drugs (abacavir, acyclovir, emtricitabine, lamivudine and zidovudine) via both bio- and phototransformation processes, was investigated in laboratory microcosm experiments simulating an open-water unit process wetland receiving municipal wastewater effluent. Phototransformation was the main removal mechanism for abacavir, zidovudine, and emtricitabine, with half-lives (t1/2,photo) in wetland water of 1.6, 7.6, and 25 h, respectively. In contrast, removal of acyclovir and lamivudine was mainly attributable to slower microbial processes (t1/2,bio = 74 and 120 h, respectively). Identification of transformation products revealed that bio- and phototransformation reactions took place at different moieties. For abacavir and zidovudine, rapid transformation was attributable to high reactivity of the cyclopropylamine and azido moieties, respectively. Despite substantial differences in kinetics of different antiviral drugs, biotransformation reactions mainly involved oxidation of hydroxyl groups to the corresponding carboxylic acids. Phototransformation rates of parent antiviral drugs and their biotransformation products were similar, indicating that prior exposure to microorganisms (e.g., in a wastewater treatment plant or a vegetated wetland) would not affect the rate of transformation of the part of the molecule susceptible to phototransformation. However, phototransformation strongly affected the rates of biotransformation of the hydroxyl groups, which in some cases resulted in greater persistence of phototransformation products.

  6. Houttuynia cordata targets the beginning stage of herpes simplex virus infection.

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    Pei-Yun Hung

    Full Text Available Herpes simplex virus (HSV, a common latent virus in humans, causes certain severe diseases. Extensive use of acyclovir (ACV results in the development of drug-resistant HSV strains, hence, there is an urgent need to develop new drugs to treat HSV infection. Houttuynia cordata (H. cordata, a natural herbal medicine, has been reported to exhibit anti-HSV effects which is partly NF-κB-dependent. However, the molecular mechanisms by which H. cordata inhibits HSV infection are not elucidated thoroughly. Here, we report that H. cordata water extracts (HCWEs inhibit the infection of HSV-1, HSV-2, and acyclovir-resistant HSV-1 mainly via blocking viral binding and penetration in the beginning of infection. HCWEs also suppress HSV replication. Furthermore, HCWEs attenuate the first-wave of NF-κB activation, which is essential for viral gene expressions. Further analysis of six compounds in HCWEs revealed that quercetin and isoquercitrin inhibit NF-κB activation and additionally, quercetin also has an inhibitory effect on viral entry. These results indicate that HCWEs can inhibit HSV infection through multiple mechanisms and could be a potential lead for development of new drugs for treating HSV.

  7. Treatment and Prognosis of Facial Palsy on Ramsay Hunt Syndrome: Results Based on a Review of the Literature

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    Monsanto, Rafael da Costa

    2016-05-01

    Full Text Available Introduction Ramsay Hunt syndrome is the second most common cause of facial palsy. Early and correct treatment should be performed to avoid complications, such as permanent facial nerve dysfunction. Objective The objective of this study is to review the prognosis of the facial palsy on Ramsay Hunt syndrome, considering the different treatments proposed in the literature. Data Synthesis We read the abstract of 78 studies; we selected 31 studies and read them in full. We selected 19 studies for appraisal. Among the 882 selected patients, 621 (70.4% achieved a House-Brackmann score of I or II; 68% of the patients treated only with steroids achieved HB I or II, versus 70.5% when treated with steroids plus antiviral agents. Among patients with complete facial palsy (grades V or VI, 51.4% recovered to grades I or II. The rate of complete recovery varied considering the steroid associated with acyclovir: 81.3% for methylprednisolone, 69.2% for prednisone; 61.4% for prednisolone; and 76.3% for hydrocortisone. Conclusions Patients with Ramsay-hunt syndrome, when early diagnosed and treated, achieve high rates of complete recovery. The association of steroids and acyclovir is better than steroids used in monotherapy.

  8. Treatment and Prognosis of Facial Palsy on Ramsay Hunt Syndrome: Results Based on a Review of the Literature.

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    Monsanto, Rafael da Costa; Bittencourt, Aline Gomes; Bobato Neto, Natal José; Beilke, Silvia Carolina Almeida; Lorenzetti, Fabio Tadeu Moura; Salomone, Raquel

    2016-10-01

    Introduction Ramsay Hunt syndrome is the second most common cause of facial palsy. Early and correct treatment should be performed to avoid complications, such as permanent facial nerve dysfunction. Objective The objective of this study is to review the prognosis of the facial palsy on Ramsay Hunt syndrome, considering the different treatments proposed in the literature. Data Synthesis We read the abstract of 78 studies; we selected 31 studies and read them in full. We selected 19 studies for appraisal. Among the 882 selected patients, 621 (70.4%) achieved a House-Brackmann score of I or II; 68% of the patients treated only with steroids achieved HB I or II, versus 70.5% when treated with steroids plus antiviral agents. Among patients with complete facial palsy (grades V or VI), 51.4% recovered to grades I or II. The rate of complete recovery varied considering the steroid associated with acyclovir: 81.3% for methylprednisolone, 69.2% for prednisone; 61.4% for prednisolone; and 76.3% for hydrocortisone. Conclusions Patients with Ramsay-hunt syndrome, when early diagnosed and treated, achieve high rates of complete recovery. The association of steroids and acyclovir is better than steroids used in monotherapy.

  9. Bilateral herpetic keratitis presenting with unilateral neurotrophic keratitis in pemphigus foliaceus: a case report

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    Yang Hee K

    2011-07-01

    Full Text Available Abstract Introduction We report a case of bilateral herpetic keratitis developing after rapid oral corticosteroid tapering in a patient with pemphigus foliaceus, which was followed by unilateral neurotrophic keratitis that was treated with amniotic membrane transplantation. Case presentation A 71-year-old Korean man developed bilateral herpetic keratitis one week after rapid tapering of systemic corticosteroid. He had been on high-dose oral corticosteroid and azathioprine therapy for six months for treatment of pemphigus foliaceus. Topical acyclovir ointment was prescribed. A week later, our patient's right eye had healed, but his left eye showed increased stromal edema with enlarged epithelial defects. He was prescribed oral acyclovir with topical broad-spectrum antibiotics applied to his left eye. The stromal edema cleared within a week but the epithelial defect remained unchanged. An amniotic membrane transplantation was performed on our patient's left eye, and his epithelial defect had totally healed three weeks later. Conclusions Patients with autoimmune disease or who are on immunosuppressive therapy have a higher chance of developing bilateral herpetic keratitis. Although rare, the condition may be followed by unilateral neurotrophic keratitis. Rapid corticosteroid tapering may act as a triggering factor for viral infection or reactivation of herpes.

  10. Novel composite efficacy measure to demonstrate the rationale and efficacy of combination antiviral-anti-inflammatory treatment for recurrent herpes simplex labialis.

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    Hull, Christopher M; Levin, Myron J; Tyring, Stephen K; Spruance, Spotswood L

    2014-01-01

    Historically, the primary target for research and treatment of recurrent herpes simplex labialis (HSL) has been limited to inhibiting herpes simplex virus (HSV) replication. Antiviral monotherapy, however, has proven only marginally effective in curtailing the duration and severity of recurrent lesions. Recently, the role of inflammation in the progression and resolution of recurrences has been identified as an additional target. This was evaluated in a randomized study comparing combination topical 5% acyclovir-1% hydrocortisone cream (AHC) with 5% acyclovir alone (AC; in the AHC vehicle) and the vehicle. The efficacy of each topical therapy was evaluated for cumulative lesion size--a novel composite efficacy endpoint incorporating episode duration, lesion area, and proportion of nonulcerative lesions. In that study, cumulative lesion area was significantly decreased with AHC compared with AC (25% decrease; P<0.05) and the vehicle (50% decrease; P<0.0001). As research continues in this arena, cumulative lesion area should be included as a measure of efficacy in clinical trials of recurrent HSL therapies.

  11. Successful Treatment of Corticosteroid with Antiviral Therapy for a Neonatal Liver Failure with Disseminated Herpes Simplex Virus Infection.

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    Maeba, Shinji; Hasegawa, Shunji; Shimomura, Maiko; Ichimura, Takuya; Takahashi, Kazumasa; Motoyama, Masashi; Fukunaga, Shinnosuke; Ito, Yoshinori; Ichiyama, Takashi; Ohga, Shouichi

    2015-10-01

    Background Herpes simplex virus (HSV) infection carries one of the poorest outcomes of neonatal liver failure (NLF). Neonates with disseminated HSV infection can develop hemophagocytic lymphohistiocytosis (HLH), and occasionally need orthotopic liver transplantation. Early interventions may be critical for the cure of NLF. Case Report We describe herewith a 6-day-old neonate with fulminant hepatic failure due to disseminated HSV-1 infection, who successfully responded to high-dose corticosteroid therapy 72 hours after the onset of disease. Preceding acyclovir, gamma globulin, and exchange blood transfusion therapies failed to control the disease. Methylprednisolone pulse therapy led to a drastic improvement of liver function and cytokine storms, and prevented the disease progression to HLH. Sustained levels of plasma and cerebrospinal fluid HSV DNA declined after prolonged acyclovir therapy. Bilateral lesions of the periventricular white matter areas, assessed by magnetic resonance imaging, disappeared at 3 months of age. The infant showed normal growth and development at 4 years of age. Conclusion Early anti-hypercytokinemia therapy using corticosteroid, and prolonged antiviral therapy might only provide the transplantation-free cure of NLF with HSV dissemination.

  12. Successful Treatment of Corticosteroid with Antiviral Therapy for a Neonatal Liver Failure with Disseminated Herpes Simplex Virus Infection

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    Shinji Maeba

    2015-10-01

    Full Text Available Background - Herpes simplex virus (HSV infection carries one of the poorest outcomes of neonatal liver failure (NLF. Neonates with disseminated HSV infection can develop hemophagocytic lymphohistiocytosis (HLH, and occasionally need orthotopic liver transplantation. Early interventions may be critical for the cure of NLF. Case Report - We describe herewith a 6-day-old neonate with fulminant hepatic failure due to disseminated HSV-1 infection, who successfully responded to high-dose corticosteroid therapy 72 hours after the onset of disease. Preceding acyclovir, gamma globulin, and exchange blood transfusion therapies failed to control the disease. Methylprednisolone pulse therapy led to a drastic improvement of liver function and cytokine storms, and prevented the disease progression to HLH. Sustained levels of plasma and cerebrospinal fluid HSV DNA declined after prolonged acyclovir therapy. Bilateral lesions of the periventricular white matter areas, assessed by magnetic resonance imaging, disappeared at 3 months of age. The infant showed normal growth and development at 4 years of age. Conclusion - Early anti-hypercytokinemia therapy using corticosteroid, and prolonged antiviral therapy might only provide the transplantation-free cure of NLF with HSV dissemination.

  13. Herpes zoster as a cause of viral meningitis in immunocompetent patients.

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    Kangath, Raghesh Varot; Lindeman, Tracey Einem; Brust, Karen

    2013-01-09

    A 30-year-old Caucasian woman, without significant medical history or immunosuppression, presented with a 7-day history of severe headache and neck pain. The patient was presumed to have tension headache versus migraine, but was admitted because her symptoms did not resolve. A lumbar puncture was performed showing lymphocytic pleocytosis suggestive of aseptic meningitis and the patient was started on broad-spectrum antibiotics and acyclovir. After admission, a rash was discovered on her left lumbar region with vesicles on top of an erythematous base. Varicella PCR was conducted on the patient's cerebrospinal fluid which was positive. Upon further history, patient was found to have previous varicella infection as a child, but no prior episodes of dermatomal zoster. Therefore, this patient was found to have aseptic meningitis and cutaneous manifestation of disseminated varicella-zoster despite immunocompetence. Antibacterial treatment was discontinued and she was continued on acyclovir for 7 days with transition to valacyclovir for 2 additional weeks with good treatment response and symptom resolution.

  14. Bilateral acute retinal necrosis after herpetic meningitis

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    Katsura T

    2012-04-01

    Full Text Available Keisho Hirota1,2, Masayuki Akimoto1,3, Toshiaki Katsura21Department of Ophthalmology, Kyoto Medical Center, National Hospital Organization, 2Internal Medicine, Kyoto Medical Center, 3Clinical Research Center, Kyoto Medical Center, Kyoto, JapanPurpose: The report of a case of bilateral acute retinal necrosis after herpetic meningitis.Case report: A 47-year-old man was admitted with the chief complaint of persistent high fever and transient loss of consciousness. Although his general condition improved after intravenous acyclovir administration, the patient presented with visual loss in both eyes 4 days after admission. Visual acuity in his right eye was 20/200 and his left eye had light perception alone. Both eyes showed panretinal arteritis diagnosed as acute retinal necrosis. Panretinal photocoagulation was performed for both eyes. Progression of retinal detachment was prevented in both eyes; however, visual acuity of the left eye was totally lost because of neovascular glaucoma. Visual acuity of the right eye recovered to 20/20.Conclusion: Although cases of bilateral acute retinal necrosis have been reported after herpetic encephalitis, this condition is rare after herpetic meningitis. Prophylactic acyclovir therapy and early panretinal photocoagulation may prevent retinal detachment and improve the prognosis. Neurologists and ophthalmologists should be aware that not only herpetic encephalitis but also herpetic meningitis can lead to acute retinal necrosis within a very short interval.Keywords: acute retinal necrosis, herpetic meningitis, herpes simplex, varicella zoster virus

  15. Outcome of patients presenting with idiopathic facial nerve paralysis (Bell's palsy) in a tertiary centre--a five year experience.

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    Tang, I P; Lee, S C; Shashinder, S; Raman, R

    2009-06-01

    This is a retrospective study. The objective of this study is to review the factors influencing the outcome of treatment for the patients presented with idiopathic facial nerve paralysis. The demographic data, clinical presentation and management of 84 patients with idiopathic facial nerve paralysis (Bell's palsy) were collected from the medical record office, reviewed and analyzed from 2000 to 2005. Thirty-four (72.3%) out of 47 patients who were treated with oral prednisolone alone, fully recovered from Bell's palsy meanwhile 36 (97%) out of 37 patients who were treated with combination of oral prednisolone and acyclovir fully recovered. The difference was statistically significant. 42 (93.3%) out of 45 patients who presented within three days to our clinic, fully recovered while 28 (71.8%) out of 39 patients presented later then three days had full recovery from Bell's palsy. The difference was statistically significant. The outcome of full recovery is better with the patients treated with combined acyclovir and prednisolone compared with prednisolone alone. The patients who were treated after three days of clinical presentation, who were more than 50 years of age, who had concurrent chronic medical illness and facial nerve paralysis HB Grade IV to VI during initial presentation have reduced chance of full recovery of facial nerve paralysis.

  16. Cultured Vestibular Ganglion Neurons Demonstrate Latent HSV1 Reactivation

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    Roehm, Pamela C.; Camarena, Vladimir; Nayak, Shruti; Gardner, James B.; Wilson, Angus; Mohr, Ian; Chao, Moses V.

    2013-01-01

    Objectives/Hypothesis Vestibular neuritis is a common cause of both acute and chronic vestibular dysfunction. Multiple pathologies have been hypothesized to be the causative agent of vestibular neuritis; however, whether herpes simplex type I (HSV1) reactivation occurs within the vestibular ganglion has not been demonstrated previously by experimental evidence. We developed an in vitro system to study HSV1 infection of vestibular ganglion neurons (VGNs) using a cell culture model system. Study design basic science study. Results Lytic infection of cultured rat VGNs was observed following low viral multiplicity of infection (MOI). Inclusion of acyclovir suppressed lytic replication and allowed latency to be established. Upon removal of acyclovir, latent infection was confirmed with reverse-transcription polymerase chain reaction and by RNA fluorescent in situ hybridization for the latency-associated transcript (LAT). 29% cells in latently infected cultures were LAT positive. The lytic IPC27 transcript was not detected by reverse-transcription polymerase chain reaction (RT-PCR). Reactivation of HSV1 occurred at a high frequency in latently infected cultures following treatment with trichostatin A (TSA), a histone deactylase inhibitor. Conclusions VGNs can be both lytically and latently infected with HSV1. Furthermore, latently infected VGNs can be induced to reactivate using TSA. This demonstrates that reactivation of latent HSV1 infection in the vestibular ganglion can occur in a cell culture model, and suggests that reactivation of HSV1 infection a plausible etiologic mechanism of vestibular neuritis. PMID:21898423

  17. Kinetics of drug release from ointments: Role of transient-boundary layer.

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    Xu, Xiaoming; Al-Ghabeish, Manar; Krishnaiah, Yellela S R; Rahman, Ziyaur; Khan, Mansoor A

    2015-10-15

    In the current work, an in vitro release testing method suitable for ointment formulations was developed using acyclovir as a model drug. Release studies were carried out using enhancer cells on acyclovir ointments prepared with oleaginous, absorption, and water-soluble bases. Kinetics and mechanism of drug release was found to be highly dependent on the type of ointment bases. In oleaginous bases, drug release followed a unique logarithmic-time dependent profile; in both absorption and water-soluble bases, drug release exhibited linearity with respect to square root of time (Higuchi model) albeit differences in the overall release profile. To help understand the underlying cause of logarithmic-time dependency of drug release, a novel transient-boundary hypothesis was proposed, verified, and compared to Higuchi theory. Furthermore, impact of drug solubility (under various pH conditions) and temperature on drug release were assessed. Additionally, conditions under which deviations from logarithmic-time drug release kinetics occur were determined using in situ UV fiber-optics. Overall, the results suggest that for oleaginous ointments containing dispersed drug particles, kinetics and mechanism of drug release is controlled by expansion of transient boundary layer, and drug release increases linearly with respect to logarithmic time.

  18. Antiviral activity of the Lippia graveolens (Mexican oregano essential oil and its main compound carvacrol against human and animal viruses

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    Marciele Ribas Pilau

    2011-12-01

    Full Text Available Mexican oregano (Lippia graveolens is a plant found in Mexico and Central America that is traditionally used as a medicinal herb. In the present study, we investigated the antiviral activity of the essential oil of Mexican oregano and its major component, carvacrol, against different human and animal viruses. The MTT test (3-4,5-dimethythiazol-2yl-2,5-diphenyl tetrazolium bromide was conducted to determine the selectivity index (SI of the essential oil, which was equal to 13.1, 7.4, 10.8, 9.7, and 7.2 for acyclovir-resistant herpes simplex virus type 1 (ACVR-HHV-1, acyclovir-sensitive HHV-1, human respiratory syncytial virus (HRSV, bovine herpesvirus type 2 (BoHV-2, and bovine viral diarrhoea virus (BVDV, respectively. The human rotavirus (RV and BoHV-1 and 5 were not inhibited by the essential oil. Carvacrol alone exhibited high antiviral activity against RV with a SI of 33, but it was less efficient than the oil for the other viruses. Thus, Mexican oregano oil and its main component, carvacrol, are able to inhibit different human and animal viruses in vitro. Specifically, the antiviral effects of Mexican oregano oil on ACVR-HHV-1 and HRSV and of carvacrol on RV justify more detailed studies.

  19. Ellagitannins as synergists of ACV on the replication of ACV-resistant strains of HSV 1 and 2.

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    Vilhelmova-Ilieva, N; Jacquet, R; Quideau, S; Galabov, A S

    2014-10-01

    The plant-derived polyphenolic compounds castalagin, vescalagin and grandinin (C-glucosidic ellagitannins containing nonahydroxyterphenoyl) manifested a strong inhibitory effect on the replication of acyclovir-resistant strains of herpes simplex viruses (HSV) type 1 and 2 in MDBK cells in focus forming units (i.e., microscopically registered microplaques) reduction assay and in two variants of cytopathic effect inhibition test. The effect on the acyclovir (ACV)-resistant herpes simplex virus type 1 (HSV-1) strain was markedly higher compared to that on the ACV-resistant herpes simplex virus type 2 (HSV-2). The three compounds showed comparable levels of antiviral activity against ACV-resistant HSV strains, in contrast with previous results where castalagin exerted the highest degree of activity against wild type HSV strains (Vilhelmova et al., 2011). Combinations of ellagitannins and ACV were tested on the ACV-resistant strains of both HSV-1 and 2 and produced synergistic effects that were revealed by applying the three-dimensional approach of Prichard and Shipman (1990). The ellagitannin(s)-ACV combination applied against ACV-resistant HSV-1 produced a much stronger synergistic effect compared to the effect observed against ACV-resistant HSV-2. The study of the effects of the combination ellagitannin(s)-ACF on intact cell monolayers did not show any toxicity resulting from interaction between the two substances. Altogether, the results obtained in this study demonstrate the highly promising potential of these plant polyphenols as antiherpetic agents.

  20. Effect of immunoglobulin on T cell subsets and inflammatory cytokines of patients with viral meningoencephalitis

    Institute of Scientific and Technical Information of China (English)

    Zhi-Cheng Bao; Xue-Long Xia; Ya-Ping Wu; Dan Liu

    2016-01-01

    Objective:To observe the effect of immunoglobulin in the adjuvant therapy of viral meningoencephalitis (VM).Methods: A total of 78 cases of VN in our hospital from September 2011 to April 2016 were chosen. According to the admission order, they were randomly divided into two groups, the control group and observation group, and 39 cases in each group. The control group was treated with acyclovir conventional therapy, and the observation group was supplemented by immunoglobulins. The differences of serum and cerebrospinal fluid levels of T cell subsets and inflammatory cytokines between the two groups before and after treatment were compared.Results:The total effective rate of the observation group was significantly higher than that in the control group (P<0.05). The serum and cerebrospinal fluid levels of T cell subsets CD3+, CD4+ and CD4+/CD8+ were significantly higher than those in the control group, while the CD8+ was lower than that in the control group (P<0.05). The serum and cerebrospinal fluid levels of inflammatory cytokines PCT, INF-γ, IL-6 and TNF-α were all significantly lower than those in the control group (P<0.05).Conclusions:Immunoglobulin can effectively improve the level of CD3+, CD4+ and VM in CD8 patients, and adjust the CD4/CD8 balance, inhibit synthesis and secretion of Th1cytokines, so to play the assistant effects of acyclovir in the treatment of VM.

  1. Antiviral and antimicrobial activities of three sesquiterpene lactones from Centaurea solstitialis L. ssp. solstitialis.

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    Ozçelik, Berrin; Gürbüz, Ilhan; Karaoglu, Taner; Yeşilada, Erdem

    2009-01-01

    Three sesquiterpene lactones (centaurepensin = chlorohyssopifolin A, chlorojanerin and 13-acetyl solstitialin A) isolated from the aerial parts of Centaurea solstitialis L. ssp. solstitialis (Asteraceae) were investigated for antimicrobial and antiviral activities. For the antimicrobial activity assessment, both standard and isolated strains of Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecalis, Staphylococcus aureus, Candida albicans and C. parapsilosis were employed by the microdilution method. Herpes simplex type-1, a DNA virus, and Parainfluenza, an RNA virus, were employed for the determination of the antiviral activity of these three sesquiterpene lactones using Vero cell lines. Ampicilline, ofloxocine, ketoconazole, fluconazole, acyclovir and oseltamivir were used as the reference drugs. 13-Acetyl solstitialin A displayed remarkable antibacterial activity against isolated strains of E. faecalis at 1 microg/ml concentration, which was close to the effective concentrations of ampicillin. The same compound also showed significant activity against the DNA virus, being as potent as the reference compound acyclovir at maximum and minimum concentrations of 16-<0.00006 microg/ml. This is the first report showing that 13-acetyl solstitialin A possesses significant antiviral activity.

  2. Unidentified angular recurrent ulceration responsive to antiviral therapy

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    Rahmi Amtha

    2013-03-01

    Full Text Available Background: Recurrent ulcer on angular area is usually called stomatitis angularis. It is caused by many factors such as vertical dimension reduce, vitamin B12, and immune system deficiency, C. albicans and staphylococcus involvement. Clinically is characterized by painful fissure with erythematous base without fever. Purpose: to describe an unidentified angular ulcer proceeded by recurrent ulcers with no response of topical therapy. Case: An 18-years old male came to Oral Medicine clinic in RSCM who complained of angular recurrent ulcers since 3 years ago which developed on skin and bleed easily on mouth opening. Patient had fever before the onset of ulcers. Large, painful, irregular ulcers covered by red crustae on angular area bilaterally. Patient has been treated with various drugs without improvement and lead to mouth opening limitation. Intra oral shows herpetiformtype of ulcer and swollen of gingival. Case management: Provisional diagnosis was established as viral infection thus acyclovir 200 mg five times daily for two weeks and topical anti inflammation gel were administered. Blood test for IgG/IgM of HSV1 and HSV2 were non reactive, however ulceration showed a remarkable improvement. The ulcers healed completely after next 2 weeks with acyclovir. Conclusion: The angular ulceration on above patient failed to fulfill the criteria of stomatitis angularis or herpes labialis lesion. However it showed a good response to antiviral. Therefore, unidentified angular ulceration was appointed, as the lesion might be triggered by other type of human herpes virus or types of virus that response to acyclovir.Latar belakang: ulser rekuren pada sudut mulut biasanya disebut stomatitis angularis. Kelainan ini disebabkan oleh banyak faktor seperti berkurangnya dimensi vertikal, defisiensi vitamin B12 dan sistem kekebalan tubuh, infeksi C. albicans serta staphylococcus. Secara klinis kelainan ini ditandai dengan fisur sakit pada sudut mulut dengan dasar

  3. Elimination of micropollutants and transformation products from a wastewater treatment plant effluent through pilot scale ozonation followed by various activated carbon and biological filters.

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    Knopp, Gregor; Prasse, Carsten; Ternes, Thomas A; Cornel, Peter

    2016-09-01

    Conventional wastewater treatment plants are ineffective in removing a broad range of micropollutants, resulting in the release of these compounds into the aquatic environment, including natural drinking water resources. Ozonation is a suitable treatment process for micropollutant removal, although, currently, little is known about the formation, behavior, and removal of transformation products (TP) formed during ozonation. We investigated the elimination of 30 selected micropollutants (pharmaceuticals, X-ray contrast media, industrial chemicals, and TP) by biological treatment coupled with ozonation and, subsequently, in parallel with two biological filters (BF) or granular activated carbon (GAC) filters. The selected micropollutants were removed to very different extents during the conventional biological wastewater treatment process. Ozonation (specific ozone consumption: 0.87 ± 0.29 gO3 gDOC(-1), hydraulic retention time: 17 ± 3 min) eliminated a large number of the investigated micropollutants. Although 11 micropollutants could still be detected after ozonation, most of these were eliminated in subsequent GAC filtration at bed volumes (BV) of approximately 25,000 m(3) m(-3). In contrast, no additional removal of micropollutants was achieved in the BF. Ozonation of the analgesic tramadol led to the formation of tramadol-N-oxide that is effectively eliminated by GAC filters, but not by BF. For the antiviral drug acyclovir, the formation of carboxy-acyclovir was observed during activated sludge treatment, with an average concentration of 3.4 ± 1.4 μg L(-1) detected in effluent samples. Subsequent ozonation resulted in the complete elimination of carboxy-acyclovir and led to the formation of N-(4-carbamoyl-2-imino-5-oxo imidazolidin)-formamido-N-methoxyacetetic acid (COFA; average concentration: 2.6 ± 1.0 μg L(-1)). Neither the BF nor the GAC filters were able to remove COFA. These results highlight the importance of considering TP in the

  4. Primoinfección por virus del herpes simp le tipo 1. Manejo farmacológico y caracteristicas clínicas

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    Hernan Francisco Sariego Santana

    2013-10-01

    Full Text Available ResumenEl presente artículo reporta un caso clínico de gingivoestomatitis herpética primaria y una breve revisión de los medicamentos usados para tratar la infección por virus del herpes simple (HSV. Se presenta un paciente con múltiples ulceraciones confluentes tanto en la cara ventral como en la dorsal de la lengua y en los labios, compatible con gingivoestomatitis herpética primaria. Esta forma de presentarse las ulceraciones y la edad del paciente son frecuentes en pacientes VIH positivo (Virus de la inmunodeficiencia humana, esto no pudo ser comprobado en el caso ya que el paciente dejo de asistir a consulta luego de recibido el tratamiento. El tratamiento instaurado fue aciclovir tabletas 200 mg cada 6 horas vía oral por 10 días. Cabe mencionar que los tratamientos para el virus del herpes simple con aciclovir no están aprobados por la Administración de Alimentos y Drogas de los Estados Unidos (FDA siglas en inglés pero si son aceptados por el Centro de Control de Enfermedades (CDC siglas en ingles, también se utilizó gel de polivinilpirrolidona, hialuronato de sodio para facilitar la deglución del paciente. (DUAZARY 2011 No. 2, 199 - 205AbstractThis article reports a case of primary herpetic gingivostomatitis and a brief review of drugs used to treat infection with herpes simplex virus (HSV. We present a patient with multiple confluent ulcers in both the ventral and the dorsal tongue and lips, compatible with primary herpetic gingivostomatitis. This way of presenting ulceration and patient age are common in HIV positive patients (human immunodeficiency virus, this could not be found in the case because the patient stopped coming to see after the treatment. Acyclovir treatment was introduced 200 mg tablets orally every 6 hours for 10 days. It is noteworthy that the treatments for herpes simplex virus with acyclovir are not approved by the Food and Drug Administration (FDA but if accepted by the Center for Disease Control

  5. Herpes Simplex Virus Type II Infection of Ileum Mesothelium: A Case Report and Review of the Literature

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    SAC Medlicott

    2005-01-01

    Full Text Available Disseminated herpes simplex virus (HSV infection usually manifests in the immunocompromised. However, anecdotal examples of visceral HSV disease and viremia have complicated type I diabetes. A case of a 53-year-old type I diabetic patient with bowel obstruction one week subsequent to bronchitis is reported. At laparotomy, a perforated segment of ileum was associated with an adhesive peritoneal band. HSV cytopathic atypia and HSV immunohistochemical staining were confined to fibrocytes and mesothelial cells without involvement of the epithelium. Dissemination of symptomatic HSV pneumonia was verified by histology, immunohistochemistry, in situ hybridization, polymerase chain reaction and direct fluorescence antibody. Intravenous acyclovir resolved symptoms. This is a novel documentation of HSV complicating ileal adhesive band disease. Furthermore, this case indicates that the HSV cytopathic effect is not unique to the epithelium. Disseminated infection can manifest in myofibrocytes and mesothelium, distinguishing it from standard epithelial atypia of localized HSV infection.

  6. Varicella Vaccination of Children With Leukemia Without Interruption of Maintenance Therapy

    DEFF Research Database (Denmark)

    Smedegaard, Lotte Møller; Poulsen, Anja; Kristensen, Ines Ackerl

    2016-01-01

    of vaccination and (5) receiving maintenance therapy. Results: Forty-five children were vaccinated. No child died or experienced serious adverse events due to VZV vaccination. Nine children developed late chickenpox despite vaccination. Long-term protection was found in 86% of children not receiving acyclovir......, a vaccine-induced rash reduced the risk of late chickenpox [hazard ratio = 0.08 (0.01, 0.66), P = 0.02]. No child had interruption of maintenance therapy at the time of vaccination, but 33% experienced discontinuation of therapy due to vaccine-induced rash. Dexamethasone was associated with an increased...... risk of vaccine-induced rash [hazard ratio = 2.9 (1.21, 6.90), P = 0.02]. Conclusions: This analysis indicates that VZV vaccination is feasible and justified in seronegative children with ALL, in countries where VZV vaccination is not part of the national vaccination program....

  7. Herpes Zoster in a 3-month-old infant

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    Duarte Malveiro

    2015-12-01

    Full Text Available Introduction: Herpes Zoster (HZ is rare in infancy and results from reactivation of varicella-zoster virus, latent in the dorsal root ganglia of sensory or cranial nerves after primary infection (chickenpox. Case Report: We describe the case of an healthy infant, three months old, without previous clinical symptoms of chickenpox, in spite of having contacted with the disease at two weeks of life. She was hospitalized for vesicular-papular rash involving unilaterally dermatomes L4 and L5 and was treated with acyclovir with good clinical outcome. Conclusion: The immaturity of the immune system and the interference of maternal antibodies contribute to the manifestation of HZ in the first year of life. In a previously healthy child it is not recommended the exclusion of underlying immunodeficiency or malignant disease.

  8. [Herpes zoster and postherpetic neuralgia].

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    Wollina, U; Machetanz, J

    2016-08-01

    Herpes zoster develops by endogenous reactivation of varizella zoster virus (VZV). Incidence increases with age. Females are more frequently affected than males. The reactivation rate in seropositive individuals is about 20 %. After a short prodromal stage, herpetiform-grouped vesicles appear in segmental arrangement. Pain and paresthesia are typical zoster symptoms. Complications like bacterial superinfections, vasculopathy, paresis, and oculopathy may occur. During pregnancy herpes zoster is a threat for mother and child. Among elderly patients, cardiovascular risk is increased during the first week of herpes zoster infection. Postherpetic neuropathy is feared. Diagnosis can be made clinically and by the use of polymerase chain reaction. First-line treatment is systemic antiviral drug therapy with either acyclovir or brivudine. Adjuvant therapies consist of pain management and topical treatment.

  9. Herpes Zoster-Induced Ogilvie’s Syndrome

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    Irfan Masood

    2015-01-01

    Full Text Available Ogilvie’s syndrome due to herpes zoster infection is a rare manifestation of VZV reactivation. The onset of rash of herpes zoster and the symptoms of intestinal obstruction can occur at different time intervals posing a significant diagnostic challenge resulting in avoidable surgical interventions. Herein, we describe a case of 35-year-old male who presented with 6-day history of constipation and colicky abdominal pain along with an exquisitely tender and vesicular skin eruption involving the T8–T11 dermatome. Abdominal X-ray and ultrasound revealed generalized gaseous distention of the large intestine with air up to the rectum consistent with paralytic ileus. Colonoscopy did not show any obstructing lesion. A diagnosis of Ogilvie’s syndrome associated with herpes zoster was made. He was conservatively managed with nasogastric decompression, IV fluids, and acyclovir. The patient had an uneventful recovery and was later discharged.

  10. Herpes Simplex Virus-2 Esophagitis in a Young Immunocompetent Adult

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    Deepak K. Kadayakkara

    2016-01-01

    Full Text Available Herpes simplex esophagitis (HSE is commonly identified in immunosuppressed patients. It is rare among immunocompetent patients and almost all of the reported cases are due to HSV-1 infection. HSV-2 esophagitis is extremely rare. We report the case of a young immunocompetent male who presented with dysphagia, odynophagia, and epigastric pain. Endoscopy showed multitudes of white nummular lesions in the distal esophagus initially suspected to be candida esophagitis. However, classic histopathological findings of multinucleated giant cells with eosinophilic intranuclear inclusions and positive HSV-2 IgM confirmed the diagnosis of HSV-2 esophagitis. The patient rapidly responded to acyclovir treatment. Although HSV-2 is predominantly associated with genital herpes, it can cause infections in other parts of the body previously attributed to only HSV-1 infection.

  11. In vitro susceptibility of sea lion poxvirus to cidofovir.

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    Nollens, Hendrik H; Gulland, Frances M D; Jacobson, Elliott R; Hernandez, Jorge A; Klein, Paul A; Walsh, Michael T; Condit, Richard C

    2008-10-01

    Parapoxviruses of seals and sea lions are commonly encountered pathogens with zoonotic potential. The antiviral activity of the antiviral compounds isatin-beta-thiosemicarbazone, rifampicin, acyclovir, cidofovir and phosphonoacetic acid against a parapoxvirus (SLPV-1) isolated from a Californian sea lions (Zalophus californianus) was evaluated. Cidofovir was able to reduce virus-induced cytopathic effect of SLPV-1 in confluent monolayers when used in concentrations greater than 2microg/ml. A decreasing virus yield was observed in the presence of increasing concentrations of cidofovir, which confirmed the ability of cidofovir to inhibit SLPV-1 replication. The in vitro efficacy of cidofovir against SLPV-1 indicates the therapeutic potential of cidofovir for the treatment of infections of humans and pinnipeds with parapoxviruses of seals and sea lions. This study confirms the previously proposed therapeutic potential of cidofovir for the treatment of parapoxvirus infections.

  12. Milestones in the discovery of antiviral agents: nucleosides and nucleotides

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    Erik de Clercq

    2012-12-01

    Full Text Available In this review article, a number of milestones in the antiviral research field on nucleosides and nucleotides are reviewed in which the author played a significant part, especially in the initial stages of their development. Highlighted are the amino acyl esters of acyclovir, particularly valacyclovir (VACV, brivudin (BVDU and the valine ester of Cf1743 (FV-100, the 2′,3′-dideoxynucleosides (nucleoside reverse transcriptase inhibitors, NRTIs, the acyclic nucleoside phosphonates (S-HPMPA, (S-HPMPC (cidofovir and alkoxyalkyl esters thereof (HDP-, ODE-CDV, adefovir and adefovir dipivoxil, tenofovir and tenofovir disoproxil fumarate (TDF, combinations containing TDF and emtricitabine, i.e., Truvada®, Atripla®, Complera®/Eviplera® and the Quad pill, and the phosphonoamidate derivatives GS-7340, GS-9131, GS-9191 and GS-9219.

  13. Progressive multifocal leucoencephalopathy in an immunocompetent patient with favourable outcome. A case report

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    Mørk Sverre J

    2010-05-01

    Full Text Available Abstract Background To report the clinical course of PML in an apparently immunocompetent patient treated with cidofovir. Case Presentation A 35-year-old immunocompetent man who developed progressive hemianopsia, aphasia, and limb weakness underwent repeated MRI scans of the brain, spinal fluid analyses, and brain biopsy. Before diagnosis was established based on brain biopsy, he was consecutively treated with methylprednisolone, acyclovir, ceftriaxone and plasmapheresis, but he deteriorated rapidly suggestive of the immune reconstitution inflammatory syndrome (IRIS. He started to recover two weeks after the initiation of treatment with cidofovir and has had no relapse at 3 1/2 years of follow-up. MRI has shown marked improvement. Conclusions PML should be considered in immunocompetent patients with a typical clinical course and MRI findings compatible with PML. Treatment with cidofovir should be considered as early as possible in the disease course.

  14. [Efficacy of plant products against herpetic infections].

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    Schnitzler, P; Reichling, J

    2011-12-01

    Essential oils from various aromatic medicinal plants are highly active against some viral infections, e.g. labial herpes caused by herpes simplex virus type 1. Balm oil, tea tree oil and peppermint oil demonstrate in vitro a significant antiherpetic activity, mainly related to a direct drug-virus particle interaction, some essential oils also act directly virucidal. Interestingly, these essential oils are also highly active against acyclovir-resistant herpes simplex virus strains. In clinical studies, tea tree oil has been shown to possess antiherpetic, anti-inflammatory and pain-relieving properties, as well as to accelerate the healing process of herpes labialis. Applying diluted essential oils three to four times daily for the antiherpetic treatment of affected areas is recommended. Some companies have marketed plant products, e.g. from Melissa, for the treatment of recurrent herpetic infections.

  15. Epstein-Barr Virus Encephalitis in an Immunocompetent Child: A Case Report and Management of Epstein-Barr Virus Encephalitis

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    Gulsen Akkoc

    2016-01-01

    Full Text Available Epstein-Barr virus (EBV usually causes mild, asymptomatic, and self-limited infections in children and adults; however, it may occasionally lead to severe conditions such as neurological diseases, malignant diseases, hepatic failure, and myocarditis. Epstein-Barr virus-related neurological disorders include meningitis, encephalitis, and cranial or peripheral neuritis, which are mostly seen in immunocompromised patients. The therapeutic modalities for EBV-related severe organ damage including central nervous system manifestations are still uncertain. Herein, we describe a seven-year-old boy with EBV encephalitis who presented with prolonged fever, exudative pharyngitis, reduced consciousness, and neck stiffness. Cranial magnetic resonance imaging showed contrast enhancement in the bilateral insular cortex and the right hypothalamus. The diagnosis was made by EBV-DNA amplification in both the blood and cerebrospinal fluid samples. He was discharged with acyclovir therapy without any sequelae.

  16. Ramsay Hunt Syndrome Associated with Central Nervous System Involvement in an Adult

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    Tommy L. H. Chan

    2016-01-01

    Full Text Available Ramsay Hunt syndrome associated with varicella zoster virus reactivation affecting the central nervous system is rare. We describe a 55-year-old diabetic female who presented with gait ataxia, right peripheral facial palsy, and painful vesicular lesions involving her right ear. Later, she developed dysmetria, fluctuating diplopia, and dysarthria. Varicella zoster virus was detected in the cerebrospinal fluid by polymerase chain reaction. She was diagnosed with Ramsay Hunt syndrome associated with spread to the central nervous system. Her facial palsy completely resolved within 48 hours of treatment with intravenous acyclovir 10 mg/kg every 8 hours. However, cerebellar symptoms did not improve until a tapering course of steroid therapy was initiated.

  17. Oesophagobronchial fistula caused by varicella zoster virus in a patient with AIDS: a unique case

    Science.gov (United States)

    Moretti, F; Uberti-Foppa, C; Quiros-Roldan, E; Fanti, L; Lillo, F; Lazzarin, A

    2002-01-01

    Human herpesvirus oesophagitis in human immunodeficiency virus positive patients is caused by cytomegalovirus and herpes simplex virus; no cases of oesophagitis and oesophagobrochial fistula as a result of varicella zoster virus (VZV) have been reported to date. This report describes the case of a patient with a 2–3 mm deep oesophageal ulcer whose viral culture was positive for VZV. The patient was treated with acyclovir with resolution of the symptomatology. After the end of the induction treatment, because of the onset of fever and fits of coughing during eating, the patient underwent oesophagography, which showed an ulcer with an oesophagobronchial fistula in the middle and lower third of the oesophagus. This case report stresses the role of VZV infection as a possible cause of oesophagobronchial fistula, a rare but benign condition in patients with AIDS. PMID:11986352

  18. New strategies against drug resistance to herpes simplex virus

    Institute of Scientific and Technical Information of China (English)

    Yu-Chen Jiang; Hui Feng; Yu-Chun Lin; Xiu-Rong Guo

    2016-01-01

    Herpes simplex virus (HSV), a member of the Herpesviridae family, is a significant human pathogen that results in mucocutaneous lesions in the oral cavity or genital infections. Acyclovir (ACV) and related nucleoside analogues can successfully treat HSV infections, but the emergence of drug resistance to ACV has created a barrier for the treatment of HSV infections, especially in immunocompromised patients. There is an urgent need to explore new and effective tactics to circumvent drug resistance to HSV. This review summarises the current strategies in the development of new targets (the DNA helicase/primase (H/P) complex), new types of molecules (nature products) and new antiviral mechanisms (lethal mutagenesis of Janus-type nucleosides) to fight the drug resistance of HSV.

  19. Long-Term Isoflurane Therapy for Refractory Bronchospasm Associated with Herpes Simplex Pneumonia in a Heart Transplant Patient

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    C. Hornuss

    2010-01-01

    Full Text Available A 47-year-old man with a history of heart transplant was admitted after severe traumatic brain injury and seizures. During mechanical ventilation, the patient developed bronchospasm that severely compromised respiratory function that led to cardiac arrest. After resuscitation, application of isoflurane through the Anaesthetic Conserving Device (AnaConDa in the ICU successfully treated bronchospasm, provided adequate sedation, and enabled appropriate ventilation and diagnostic bronchoscopy. A subsequent bronchoalveolar lavage revealed a high amount of Herpes simplex DNA. Herpes simplex pneumonia was diagnosed and treated with acyclovir. Isoflurane treatment was applied for twelve days total without side effects on renal and cerebral function. The patient recovered quickly after the termination of sedation. At discharge, he was fully awake without focal neurological deficiency and his long-term outcome was excellent. This case demonstrates that isoflurane is a treatment option in life-threatening cases of bronchospasm and a safe option for long-term sedation.

  20. Varicella gastritis in an immunocompetent child.

    Science.gov (United States)

    Ugras, Meltem; Vitrinel, Ayca; Yilmaz, Gulden; Midilli, Kenan; Ozkan, Ferda

    2013-02-01

    The varicella zoster virus (VZV) is a very rare cause of gastritis. Gastritis caused by VZV can be presented as abdominal pain, vomiting. Most of the cases reported with varicella gastritis in the literature are immunocompromised patients with various kinds of malignancy, and most of these patients are adults. Here we report an adolescent girl with acute abdominal pain. The girl was immunocompetent. Her endoscopically taken biopsy material revealed varicella, and her gastritis was healed with acyclovir therapy. This is a very rare condition and not frequently reported in the literature. The authors want to drive attention to the fact that varicella gastritis can be seen in immunocompetent children, the presentation can be nausea, vomiting and/or (severe) abdominal pain. Serological studies may be less helpful than tissue studies, so interventional procedures should be done.

  1. SELECTED ASPECTS OF TERAHERTZ SPECTROSCOPY IN PHARMACEUTICAL SCIENCES.

    Science.gov (United States)

    Nowak, Kacper; Pliński, Edward F; Karolewicz, Bożena; Jarząb, Przemysław P; Plińska, Stanisława; Fuglewicz, Bogusław; Walczakowski, Michał J; Augustyn, Łukasz; Sterczewsk, Łukasz A; Grzelczak, Michał P; Hruszowiec, Mariusz; Beziuk, Grzegorz; Mikulic, Martin; Pałka, Norbert; Szustakowskip, Mieczysław

    2015-01-01

    THz-TDS techniques are applied to investigate selected pharmaceutical samples. Investigations were performed on selected pharmaceutical samples with active pharmaceutical ingredients (API)--famotidine, ranitidine, fenofibrate, lovastatin, simvastatin, aspirin, ketoconazole, acyclovir (hydrated and non-hydrated), on excipients--lactose, glucose (hydrated and non-hydrated), Pluronic 127, and on mixtures of selected compounds. Pseudo-polymorphism effects are considered as well. Examples of the terahertz imaging technique are also given. APIs and excipients can be easily recognized in the terahertz band by their specific "fingerprints" as individual components and in mixtures. The hydration process as a variety of polymorphism can also be easily monitored using the THz technique. Moreover, terahertz light can be useful for the penetration of tablets, giving clear pictures of possible defects in tablet coatings.

  2. A case of atypical progressive outer retinal necrosis after highly active antiretroviral therapy.

    Science.gov (United States)

    Woo, Se Joon; Yu, Hyeong Gon; Chung, Hum

    2004-06-01

    This is a report of an atypical case of progressive outer retinal necrosis (PORN) and the effect of highly active antiretroviral therapy (HAART) on the clinical course of viral retinitis in an acquired immunodeficiency syndrome (AIDS) patient. A 22-year-old male patient infected with human immunodeficiency virus (HIV) presented with unilaterally reduced visual acuity and a dense cataract. After cataract extraction, retinal lesions involving the peripheral and macular areas were found with perivascular sparing and the mud-cracked, characteristic appearance of PORN. He was diagnosed as having PORN based on clinical features and was given combined antiviral treatment. With concurrent HAART, the retinal lesions regressed, with the regression being accelerated by further treatment with intravenous acyclovir and ganciclovir. This case suggests that HAART may change the clinical course of PORN in AIDS patients by improving host immunity. PORN should be included in the differential diagnosis of acute unilateral cataract in AIDS patients.

  3. Acute meningoencephalomyelitis due to varicella-zoster virus in an AIDS patient: report of a case and review of the literature

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    Marcelo Corti

    2011-12-01

    Full Text Available Varicella-zoster virus (VZV meningoencephalomyelitis is a rare but severe neurological complication of VZV reactivation in immunocompromised patients. We report the case of an HIV-infected individual who developed an acute and severe meningoencephalomyelitis accompanied by a disseminated cutaneous eruption due to VZV. The presence of VZV DNA in cerebrospinal fluid was confirmed by polymerase chain reaction (PCR technique. The patient started undergoing an intravenous acyclovir therapy with a mild recovery of neurological manifestations. Varicella-zoster virus should be included as a cause of acute meningoencephalomyelitis in patients with AIDS. Early diagnosis followed by specific therapy should modify the rapid and fulminant course for this kind of patients.

  4. Evolução branda de recidiva de infecção por varicela zoster após tratamento com fingolimode em paciente com esclerose múltipla: relato de casoBenign evolution of shingles with fingolimod in a patient with multiple sclerosis: case report

    Directory of Open Access Journals (Sweden)

    Antonio Arlindo Morais

    2016-03-01

    Full Text Available Objetivo: Relatar o caso de um paciente com recidiva de herpes-zoster (HZ e evolução benigna mesmo diante de imunomodulação para esclerose múltipla (EM. Descrição de caso: Mulher de 48 anos com história de EM durante seis anos, previamente tratada com interferon1b, iniciou tratamento com fingolimode, desenvolvendo HZ após 10 meses de tratamento. Mesmo sem tratamento com acyclovir, a paciente desenvolveu um curso brando, sem posterior desenvolvimento de neuralgia pós-herpética. Conclusões: As novas terapias para EM podem estar associadas a novos tipos de eventos adversos. Apesar da potencial gravidade, nem todos os pacientes com HZ em uso das novas terapias para EM têm curso desfavorável, sendo necessários estudos para identificar fatores de risco para as formas graves.

  5. The recurrent true umbilical cord knots: a case report

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    I Naghi

    2012-11-01

    Full Text Available Background: True umbilical cord knot is one of the abnormalities of the umbilical cord. Active fetal movements create cord knotting. True umbilical cord knots are rare but may be associated with fetal distress and stillbirth. True umbilical cord knots are capable of impeding blood flow to the fetus.Case presentation: A 26-year old primigravid woman was first treated for genital herpes simplex virus (HSV type 2 at 36 weeks of gestational age. She received oral acyclovir (400 mg three times daily for 10 days. At the gestational age of 38 weeks and 5 days, fetal activity decreased and NST was nonreactive. She was delivered by cesarean section and a true umbilical cord knot was found. Four years later, in her second pregnancy, another true knot was seen.Conclusion: Excessively long umbilical cords are more likely to be associated with true knots. Genetics has an important role in determining cord length and occurrence of true knots.

  6. Recurrent herpes zoster in a child with SLE

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    Jain C

    1995-01-01

    Full Text Available A 12-year-old girl had systemic lupus erythematosus (SLE and type IV lupus nephritis since three-and-a-half years. She was treated with prednisolone and cyclophosphamide. She had first attack of herpes zoster (HZ involving eighth and ninth thoracic segments on right side at the age of nine years. Second attack occurred on the same segments on same side at the age of twelve years. The second attack of herpes zoster was treated with oral acyclovir 400 mg five times a day for seven days plus analgesics and multi-vitamins. Most probably this is the first case of recurrent herpes zoster (RHZ in a child in Indian literature.

  7. Superior orbital fissure syndrome in herpes zoster ophthalmicus.

    LENUS (Irish Health Repository)

    Kirwan, R P

    2012-02-01

    AIM: To report a case of superior orbital fissure syndrome (SOFS) in a patient with herpes zoster ophthalmicus (HZO). MATERIALS AND METHODS: A case report. RESULTS: A 71-year-old male with HZO presented acutely to accident and emergency complaining of right vision loss, double vision and drowsiness. The right visual acuity was counting fingers. There was no relative afferent pupillary defect. He had interstitial keratitis, ptosis, proptosis and total ophthalmoplaegia. The signs indicated HZO complicated by SOFS. Brain imaging and lumbar puncture confirmed the diagnosis of varicella zoster encephalitis. Systemic acyclovir and prednisolone led to recovery of visual acuity and ocular motility in addition to resolution of his proptosis and ptosis. CONCLUSION: SOFS is a rare complication of herpes zoster infection. With the appropriate treatment and follow-up, patients may be reassured that recovery of their visual acuity and ocular motility will occur.

  8. Pediatric Ramsay Hunt Syndrome: Analysis of Three Cases

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    İmran Aydoğdu

    2015-01-01

    Full Text Available Ramsay Hunt syndrome (RHS is a disorder characterized by herpetic eruptions on the auricle, facial paralysis, and vestibulocochlear dysfunction and is attributed to varicella zoster virus (VZV infection in the geniculate ganglion. Although it is a common cause of acute peripheral facial paralysis, children are not usually affected. The diagnosis is based on history and physical findings. Treatment of RHS uses a combination of high-dose corticosteroids and acyclovir. This paper presents three cases diagnosed as RHS in the pediatric age group in association with the literature review. The aim of this paper is to emphasize the importance of careful examination and early initiation of therapy in suspected cases of RHS.

  9. A case report of herpetic and candidal esophagitis in an immunocompetent adult

    Institute of Scientific and Technical Information of China (English)

    Vishwanath Sathyanarayanan; Abdul Razak; M Mukhyprana Prabhu; Kavitha Saravu; Ganesh Pai C; Anuradha K Rao

    2011-01-01

    Reports of combined candidal and herpetic esophagitis in immunocompetent states are rare and sporadic. A 44-year-old previously healthy lady presented with a one week history of progressive dysphagia, odynophagia and fever. Esophagogastroduodenoscopy (EGD) showed extensive desquamation of the entire esophagus except for distal 4 cm. Histopathological examination revealed ulcerated and inflamed squamous epithelium with the margin of ulcer showing a few overhanging squamous cells with dense eosinophilic cytoplasm, multinucleated and faceted nuclei with glassy chromatin, and an occasional Cowdry type A intranuclear inclusion bodies. Few candidal spores were seen in the underlying stroma. Intravenous acyclovir, fluconazole and pantoprazole were initiated. Oral analgesics were given for pain relief. She was treated for a total of 14 days. She showed significant improvement and was tolerating oral intake after discharge. The patient was asymptomatic with no evidence of recurrence at a 2-month follow-up.

  10. Unilateral facial paralysis caused by Ramsay Hunt syndrome.

    Science.gov (United States)

    Pereira, Flávia P; Guskuma, Marcos H; Luvizuto, Eloá R; Faco, Eduardo F S; Magro-Filho, Osvaldo; Hochuli-Vieira, Eduardo

    2011-09-01

    The Ramsay Hunt syndrome is a rare disease caused by an infection of the geniculate ganglion by the varicella-zoster virus. The main clinical features of the syndrome are as follows: Bell palsy unilateral or bilateral, vesicular eruptions on the ears, ear pain, dizziness, preauricular swelling, tingling, tearing, loss of taste sensation, and nystagmus. We describe a 23-year-old white woman, who presented with facial paralysis on the left side of the face, pain, fever, ear pain, and swelling in the neck and auricular region on the left side. She received appropriate treatment with acyclovir, vitamin B complex, and CMP nucleus. After 30 days after presentation, the patient did not show any signs or symptoms of the syndrome. At follow-up at 1 year, she showed no relapse of the syndrome.

  11. 阿昔洛韦与头孢噻肟钠配伍稳定性的考察

    Institute of Scientific and Technical Information of China (English)

    李景庄; 丁玮; 地力拜尔·乌斯满江

    2002-01-01

    @@阿昔洛韦(acyclovir)为一临床常用抗病毒药,主用于治疗单纯疱疹病毒Ⅰ、Ⅱ型感染和带状疱疹病毒感染。头孢噻肟钠(cefotaxime sodium)是半合成的第三代头孢菌素,为临床抗感染治疗的常规药物。两药配伍用于病毒与细菌混合感染性疾病的治疗有临床意义,但尚未见有两药配伍稳定性的实验报告。为给临床合理用药提供参考,本文考察了两药的配伍稳定性,现报道如下。……

  12. Vaccine-strain herpes zoster found in the trigeminal nerve area in a healthy child: A case report.

    Science.gov (United States)

    Iwasaki, Sayaka; Motokura, Kouji; Honda, Yoshitaka; Mikami, Masamitsu; Hata, Daisuke; Hata, Atsuko

    2016-12-01

    A previously healthy 2-year-old girl, vaccinated for varicella at 17 months, was admitted because of left-sided facial herpes zoster caused by vaccine-strain varicella-zoster virus (VZV). She recovered fully with no complication after intravenous treatment using acyclovir. Earlier reports have described that herpes zoster (HZ) rashes caused by vaccine-strain VZV tend to occur on the dermis corresponding to the skin area where the varicella vaccine was received. However, rashes appeared on this girl only in the trigeminal nerve area, which is unrelated to the vaccinated site. Results underscore the importance of distinguishing vaccine-strain VZV from wild-type VZV whenever encountering HZ cases after vaccination, even in immunocompetent children, irrespective of the skin lesion site. Monitoring vaccine-strain HZ incidence rates is expected to elucidate many aspects of varicella vaccine safety.

  13. 027.无环鸟苷新型脂质载体制剂治疗复发性疱疹性唇炎的临床评价

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@  [英]/Horwitz E…∥Oral Surg Oral Med Oral Patho1.-1999,87(6).-700~ 705   环鸟苷(acyclovir,ACV)是一种有效的治疗复发性疱疹性唇炎(recurrent herpes labialis,RHL)的药物,与口服药相比,有许多优点.常用剂型有5%、10%ACV软膏和5%ACV霜剂,但临床报道其渗透效果均不理想,影响疗效发挥.本研究目的是评价一种无环鸟苷新型脂质载体ethosome治疗RHL的临床效果.    出版日期:2001年3月20日 请看PDF全文

  14. 盐酸万乃洛韦、阿昔洛韦治疗带状泡疹临床疗效观察%Clinical Observation of Effectiveness of Valacicloir and Aciclovir Hydrochloride in the treatment of Herpes Zoster

    Institute of Scientific and Technical Information of China (English)

    黄捷

    2002-01-01

    目的:观察盐酸万乃洛韦(Valaciclovir Hydrochloride)与阿昔洛韦(Acyclovir,ACV)治疗带状疱疹临床疗效.方法:应用万乃洛韦口服治疗带状疱疹42例,并与ACV口服治疗带状疱疹40例相比较.结果:万乃洛韦组总有效率90.48%,ACV组总有效率67.5%,两组间疗效相比差异有显著性.结论:Valaciclovir Hydrodoride治疗带状疱疹疗效优于ACV.

  15. New strategies against drug resistance to herpes simplex virus

    Science.gov (United States)

    Jiang, Yu-Chen; Feng, Hui; Lin, Yu-Chun; Guo, Xiu-Rong

    2016-01-01

    Herpes simplex virus (HSV), a member of the Herpesviridae family, is a significant human pathogen that results in mucocutaneous lesions in the oral cavity or genital infections. Acyclovir (ACV) and related nucleoside analogues can successfully treat HSV infections, but the emergence of drug resistance to ACV has created a barrier for the treatment of HSV infections, especially in immunocompromised patients. There is an urgent need to explore new and effective tactics to circumvent drug resistance to HSV. This review summarises the current strategies in the development of new targets (the DNA helicase/primase (H/P) complex), new types of molecules (nature products) and new antiviral mechanisms (lethal mutagenesis of Janus-type nucleosides) to fight the drug resistance of HSV. PMID:27025259

  16. Fabrication and application of porous silicon multilayered microparticles in sustained drug delivery

    Science.gov (United States)

    Maniya, Nalin H.; Patel, Sanjaykumar R.; Murthy, Z. V. P.

    2015-09-01

    In the present study, the ability of porous silicon (PSi) based distributed Bragg reflector (DBR) microparticles for sustained and observable delivery of the antiviral agent acyclovir (ACV) is demonstrated. DBR was fabricated by electrochemical etching of single crystal silicon wafers and ultrasonic fractured to prepare microparticles. The hydrogen-terminated native surface of DBR microparticles was modified by thermal oxidation and thermal hydrosilylation. Particles were loaded with ACV and drug release experiments were conducted in phosphate buffered saline. Drug loading and surface chemistry of particles were characterized by scanning electron microscopy and Fourier transform infrared spectroscopy. Drug release profiles from PSi DBR particles show sustained release behavior from all three studied surface chemistries. Drug release from particles was also monitored from change in color of particles.

  17. Floating microspheres of valacyclovir HCl: Formulation, optimization, characterization, in vitro and in vivo floatability studies

    Directory of Open Access Journals (Sweden)

    Nilamgiri Goswami

    2012-01-01

    Full Text Available Floating microspheres are multiple unit Gastroretentive drug delivery systems. Valacyclovir hydrochloride (VCH is L-valyl ester prodrug of acyclovir. VCH degrades in intestinal fluid. The objective was to develop floating microspheres of VCH to localise the drug at upper part of GIT, for improved absorption. Floating microspheres were prepared by W/O emulsification solvent evaporation method using Ethylcellulose (EC as polymer. Particle size and % EE were 550.021±0.241 μm, 79.88±2.236% respectively. in vitro and in vivo floatability studies confirmed floating behaviour of microspheres. VCH loaded floating microspheres can be a suitable alternative to the conventional formulation, by localizing the drug at upper GIT.

  18. Studies on the Antiviral Activities in vitro of Polysaccharide from Eucheuma striatum

    Institute of Scientific and Technical Information of China (English)

    CEN,Ying-Zhou; KHOO,Gaik-Ming; YE,Shao-Ming; RUI,Wen

    2004-01-01

    @@ To assay the antiviral activities on HSV-1 and CVB3 in vitro of the polysaccharide from Eucheuma striatum, its antiviral mechanism was explored. Vero cells were infected by HSV-1 and CVB3, and they were cultured with serial dilutions of polysaccharide. The cells cytotoxicity of Polysaccharide was evaluated by the MTT method. The inhibitory effects were evaluated by the cytopathic effect (CPE). Its antiviral mechanism was researched by the method of giving samples in different time. The polysaccharide could inhibit the CPE of cells infected by HSV-1 and CVB3. It showed low cytotoxicity on vero cells. Its antiviral activities were better than those of acyclovir and ribavirin which were run in parallel as the positive control samples. The polysaccharide from Eucheuma striatum has potent antiviral activities. Its antiviral mechanism is that it can prevent the virus from absorbing to the cell surface.

  19. A rare case of cytomegalovirus papillitis in patient with immunodeficiency

    Directory of Open Access Journals (Sweden)

    Dinda A. Devona

    2016-10-01

    Full Text Available A 26-year-old male diagnosed with AIDS came with sudden blurred vision and central sco-toma in left eye since 2 weeks before admission. His visual acuity was counting finger at 5 meters with normal IOP and anterior segment. The posterior segment revealed edematous optic nerve covered by exudates and hemorrhages. Due to low CD4+ count and serological test result, we considered a HIV-related opportunistic ocular infection, specifically HSV infection. As visual acuity worsened during treatment with acyclovir, we performed PCR ex-amination from aqueous tap which revealed positive CMV DNA. Unfortunately, the visual acuity had worsened to no light perception before he received any specific anti-CMV agent. CMV papillitis is an unusual presentation of CMV retinitis. PCR examination from aqueous or vitreous tap should be performed while waiting for serological test result, especially in doubtful cases. Therefore, appropriate diagnosis and management can be established early to prevent irreversible visual loss.

  20. Ultrasound for critical care physicians: neutropenic patient with fever snd shortness of breath

    Directory of Open Access Journals (Sweden)

    Kraai E

    2014-06-01

    Full Text Available No abstract available. Article truncated after first page. A 63 year old female with a history of acute myelogenous leukemia presents with shortness of breath, fever and hypotension to the ICU. She is in septic shock on norepinephrine, and has been treated on the oncology unit with vancomycin, cefepime, acyclovir and voriconazole. She has been neutropenic for 1 month. The patient develops a progressive right lower chest opacity. This opacity has progressed in spite of antibiotics and antifungals. The portable AP chest radiograph is presented below (Figure 1. An ultrasound of the right chest was performed for further evaluation of the opacity (figure 2. Question: What pathology does the ultrasound reveal in the right hemithorax? 1. Air filled cavity; 2. Chest wall abscess; 3. Fractured ribs; 4. Pleural effusion and suspected empyema; 5. Simple consolidation ...

  1. Herpetic Esophagitis in Immunocompetent Medical Student

    Directory of Open Access Journals (Sweden)

    Andréia Vidica Marinho

    2014-01-01

    Full Text Available Esophagitis caused by herpes simplex virus (HSV is often documented during periods of immunosuppression in patients infected with human immunodeficiency virus (HIV; it is rare in immunocompetent diagnosed patients. Case reports of herpetic esophagitis in students of health sciences are extremely rare. The disease presents with a clinical picture characterized by acute odynophagia and retrosternal pain without obvious causes and ulcers, evidenced endoscopically in the middistal esophagus. Diagnosis depends on endoscopy, biopsies for pathology studies, and immunohistochemistry techniques. The disease course is often benign; however, treatment with acyclovir speeds the disappearance of symptoms and limits the severity of infection. In this report, we present a case of herpetic esophagitis in an immunocompetent medical student, with reference to its clinical features, diagnosis, and treatment. The disease may have manifested as a result of emotional stress experienced by the patient.

  2. MANAGEMENT OF IDIOPATHIC SUDDEN SENSORINEURAL HEARING LOSS: OUR EXPERIENCE

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    Surya Prakash

    2015-12-01

    Full Text Available Sudden Sensorineural Hearing Loss (SSHL is dreaded condition affecting many individuals around the world due to its sudden appearance and inconspicuous nature of disease. More than 50% recover spontaneously, but timely identification of cause and treatment can help the patient immensely. METHODS In our study, we prospectively analyzed twenty patients presenting with idiopathic sudden hearing loss of 30 db or more between 2010 and 2015. RESULTS Two out of 20 patients (60% showed complete improvement and 10 patients out of 13 (77% who presented with 7 days showed complete recovery. Hence, time of presentation and drugs used directly affect the outcome of the patient. CONCLUSION It can be safely concluded that early diagnosis and management is key in treatment of SSHL. Intratympanic dexamethasone with intravenous dexamethasone or oral deflazacort is used in all patients with supportive measures has helped most of our patients. Oral acyclovir was used in only one patient.

  3. Antiviral Activity of Obtained Extracts from Different Parts of Cupressus sempervirens against Herpes Simplex Virus Type 1

    Directory of Open Access Journals (Sweden)

    Mehrangiz Khajeh Karamadini

    2009-09-01

    Full Text Available Objective(sThe aim of this study was to search for new antiviral agents from herbal medicines. Ethanol extracts of C. semipervirens, C. semipervirens var. horizontalis and C. semipervirens cv. Cereiformis were used in experiments to test their influence on herpes viruses (HSV-1. Materials and MethodsHeLa cells monolayers were infected with herpes viruses (HSV-1. Antiviral activity of the plant extracts assessed using Hematoxylin & Eosin method and observed under a light microscope. All tests were compared with a positive control, acyclovir.ResultsResults showed that all three plants have antiviral activity against HSV-1 virus. The most active extract was the obtained extract from C. semipervirens. Among the different parts of this medicinal plant tested, the fruit’s extract appeared to possess the strongest anti- HSV activity.ConclusionIn conclusion, of the extracts tested in this survey all showed significant antiviral potency.

  4. Development history of herpes simplex encephalitis

    Directory of Open Access Journals (Sweden)

    Jia-wei WANG

    2014-08-01

    Full Text Available Herpes simplex encephalitis (HSE is an acute central nervous system infection caused by herpes simplex virus (HSV. Early clinical manifestations mainly include fever, headache and unconsciousness; when progressing, psychiatric symptoms can occur. Death or serious neurological sequelae will happen if not treated. With the development of laboratory tests and imaging techniques, the early diagnosis of HSE is possible. Even though imaging with temporal lobe abnormal signal has the implication to HSE, the application of polymerase chain reaction (PCR in detecting HSV DNA in cerebrospinal fluid is currently the "gold standard" to diagnose HSE. Once diagnosed, acyclovir must be given as soon as possible, as delayed treatment will result in a poor outcome. doi: 10.3969/j.issn.1672-6731.2014.08.003

  5. Acute anterior necrotizing scleritis:A case report

    Institute of Scientific and Technical Information of China (English)

    Yuen Keat Gan; Syed Shoeb Ahmad; Sheena Mary Alexander; Amir Samsudin

    2016-01-01

    Necrotizing scleritis is an uncommon but potential disastrous infection to the eye. It is commonly caused by vaso-occlusive autoimmune diseases such as rheumatoid arthritis or surgically-induced, and rarely due to infections. In this article, we presented a rare case of necrotizing scleritis caused by herpes infection in an immunocompromised patient. A 49 years old, retroviral positive gentleman presented to our clinic with a painful, red right eye associated with watering, photophobia and blurring of vision. His right eye rapidly deteriorated leading to an impending perforation of the sclera despite intensive antimicrobial therapy. The patient was started on acyclovir ointment and subsequently improved remarkably salvaging the eye from the need of an evis-ceration. Although the visual prognosis was poor, structural integrity of the eye was achieved.

  6. Parameterization of small intestinal water volume using PBPK modeling.

    Science.gov (United States)

    Maharaj, Anil; Fotaki, Nikoletta; Edginton, Andrea

    2015-01-25

    To facilitate accurate predictions of oral drug disposition, mechanistic absorption models require optimal parameterization. Furthermore, parameters should maintain a biological basis to establish confidence in model predictions. This study will serve to calculate an optimal parameter value for small intestinal water volume (SIWV) using a model-based approach. To evaluate physiologic fidelity, derived volume estimates will be compared to experimentally-based SIWV determinations. A compartmental absorption and transit (CAT) model, created in Matlab-Simulink®, was integrated with a whole-body PBPK model, developed in PK-SIM 5.2®, to provide predictions of systemic drug disposition. SIWV within the CAT model was varied between 52.5mL and 420mL. Simulations incorporating specific SIWV values were compared to pharmacokinetic data from compounds exhibiting solubility induced non-proportional changes in absorption using absolute average fold-error. Correspondingly, data pertaining to oral administration of acyclovir and chlorothiazide were utilized to derive estimates of SIWV. At 400mg, a SIWV of 116mL provided the best estimates of acyclovir plasma concentrations. A similar SIWV was found to best depict the urinary excretion pattern of chlorothiazide at a dose of 100mg. In comparison, experimentally-based estimates of SIWV within adults denote a central tendency between 86 and 167mL. The derived SIWV (116mL) represents the optimal parameter value within the context of the developed CAT model. This result demonstrates the biological basis of the widely utilized CAT model as in vivo SIWV determinations correspond with model-based estimates.

  7. Herpes simplex virus 1 immediate-early and early gene expression during reactivation from latency under conditions that prevent infectious virus production.

    Science.gov (United States)

    Pesola, Jean M; Zhu, Jia; Knipe, David M; Coen, Donald M

    2005-12-01

    The program of gene expression exhibited by herpes simplex virus during productive infection of cultured cells is well established; however, less is known about the regulatory controls governing reactivation from latency in neurons. One difficulty in examining gene regulation during reactivation lies in distinguishing between events occurring in initial reactivating cells versus events occurring in secondarily infected cells. Thus, two inhibitors were employed to block production of infectious virus: acyclovir, which inhibits viral DNA synthesis, and WAY-150138, which permits viral DNA synthesis but inhibits viral DNA encapsidation. Latently infected murine ganglia were explanted in the presence of either inhibitor, and then amounts of RNA, DNA, or infectious virus were quantified. In ganglia explanted for 48 h, the levels of five immediate-early and early RNAs did not exhibit meaningful differences between acyclovir and WAY-150138 treatments when analyzed by in situ hybridization or quantitative reverse transcription-PCR. However, comparative increases in viral DNA and RNA content in untreated ganglia suggested that virus was produced before 48 h postexplant. This was confirmed by the detection of infectious virus as early as 14 h postexplant. Together, these results suggest that high levels of viral gene expression at 48 h postexplant are due largely to the production of infectious virus and subsequent spread through the tissue. These results lead to a reinterpretation of previous results indicating a role for DNA replication in immediate-early and early viral gene expression; however, it remains possible that viral gene expression is regulated differently in neurons than in cultured cells.

  8. A method for evaluating antiviral drug susceptibility of Epstein-Barr virus

    Directory of Open Access Journals (Sweden)

    Charlotte A Romain

    2010-01-01

    Full Text Available Charlotte A Romain1, Henry H Balfour Jr1,2, Heather E Vezina1,3, Carol J Holman11Department of Laboratory Medicine and Pathology, 2Department of Pediatrics, 3Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN, USAAbstract: We developed an in vitro Epstein-Barr virus (EBV drug susceptibility assay using P3HR1 cells or lymphoblastoid cells from subjects with infectious mononucleosis, which were grown in the presence of various concentrations of acyclovir (ACV, ganciclovir (GCV or R-9-[4-hydroxy-2-(hydroxymethylbutyl]guanine (H2G and 12-O-tetradecanoyl-phorbol-13-acetate (TPA. On day 7, total cellular DNA was extracted and EBV DNA was detected using an in-house quantitative real-time polymerase chain reaction (PCR method. All three drugs had in vitro activity against EBV in both the laboratory standard producer cell line P3HR1 and in subject-derived lymphoblastoid cell lines. The median 50% inhibitory concentrations (IC50s in P3HR1 cells were: ACV, 3.4 μM; GCV, 2.6 μM; and H2G, 2.7 μM and in 3 subject-derived cells were: ACV, 2.5 μM; GCV, 1.7 μM; and H2G, 1.9 μM. Our assay can be used to screen candidate anti-EBV drugs. Because we can measure the IC50 of patients’ strains of EBV, this assay may also be useful for monitoring viral resistance especially in immunocompomised hosts receiving antiviral drugs for prevention or treatment of EBV diseases.Keywords: Epstein-Barr virus, ganciclovir, acyclovir, valomaciclovir, H2G, antivirals

  9. The antiviral drug valacyclovir successfully suppresses salivary gland hypertrophy virus (SGHV in laboratory colonies of Glossina pallidipes.

    Directory of Open Access Journals (Sweden)

    Adly M M Abd-Alla

    Full Text Available Many species of tsetse flies are infected with a virus that causes salivary gland hypertrophy (SGH symptoms associated with a reduced fecundity and fertility. A high prevalence of SGH has been correlated with the collapse of two laboratory colonies of Glossina pallidipes and colony maintenance problems in a mass rearing facility in Ethiopia. Mass-production of G. pallidipes is crucial for programs of tsetse control including the sterile insect technique (SIT, and therefore requires a management strategy for this virus. Based on the homology of DNA polymerase between salivary gland hypertrophy virus and herpes viruses at the amino acid level, two antiviral drugs, valacyclovir and acyclovir, classically used against herpes viruses were selected and tested for their toxicity on tsetse flies and their impact on virus replication. While long term per os administration of acyclovir resulted in a significant reduction of productivity of the colonies, no negative effect was observed in colonies fed with valacyclovir-treated blood. Furthermore, treatment of a tsetse colony with valacyclovir for 83 weeks resulted in a significant reduction of viral loads and consequently suppression of SGH symptoms. The combination of initial selection of SGHV-negative flies by non-destructive PCR, a clean feeding system, and valacyclovir treatment resulted in a colony that was free of SGH syndromes in 33 weeks. This is the first report of the use of a drug to control a viral infection in an insect and of the demonstration that valacyclovir can be used to suppress SGH in colonies of G. pallidipes.

  10. Characteristics of HIV-1 discordant couples enrolled in a trial of HSV-2 suppression to reduce HIV-1 transmission: the partners study.

    Directory of Open Access Journals (Sweden)

    Jairam R Lingappa

    Full Text Available BACKGROUND: The Partners HSV-2/HIV-1 Transmission Study (Partners Study is a phase III, placebo-controlled trial of daily acyclovir for genital herpes (HSV-2 suppression among HIV-1/HSV-2 co-infected persons to reduce HIV-1 transmission to their HIV-1 susceptible partners, which requires recruitment of HIV-1 serodiscordant heterosexual couples. We describe the baseline characteristics of this cohort. METHODS: HIV-1 serodiscordant heterosexual couples, in which the HIV-1 infected partner was HSV-2 seropositive, had a CD4 count >or=250 cells/mcL and was not on antiretroviral therapy, were enrolled at 14 sites in East and Southern Africa. Demographic, behavioral, clinical and laboratory characteristics were assessed. RESULTS: Of the 3408 HIV-1 serodiscordant couples enrolled, 67% of the HIV-1 infected partners were women. Couples had cohabitated for a median of 5 years (range 2-9 with 28% reporting unprotected sex in the month prior to enrollment. Among HIV-1 susceptible participants, 86% of women and 59% of men were HSV-2 seropositive. Other laboratory-diagnosed sexually transmitted infections were uncommon (500 relative to <350, respectively, p<0.001. CONCLUSIONS: The Partners Study successfully enrolled a cohort of 3408 heterosexual HIV-1 serodiscordant couples in Africa at high risk for HIV-1 transmission. Follow-up of this cohort will evaluate the efficacy of acyclovir for HSV-2 suppression in preventing HIV-1 transmission and provide insights into biological and behavioral factors determining heterosexual HIV-1 transmission. TRIAL REGISTRATION: ClinicalTrials.gov NCT00194519.

  11. Efficacy of an aqueous Pelargonium sidoides extract against herpesvirus.

    Science.gov (United States)

    Schnitzler, P; Schneider, S; Stintzing, F C; Carle, R; Reichling, J

    2008-12-01

    The compounds of an aqueous root extract of the African medicinal plant Pelargonium sidoides were analysed by LC-MS spectroscopy and the antiviral effect of this extract against herpes simplex virus was examined in cell culture. Besides predominant coumarins, simple phenolic structures as well as flavonoid and catechin derivatives were identified as major constituents in the Pelargonium extract. The inhibitory activity of this extract against herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) was tested in vitro on RC-37 cells using a plaque reduction assay and exhibited high antiviral activity against both herpesviruses in viral suspension tests. The 50% inhibitory concentration (IC(50)) of the aqueous Pelargonium sidoides extract for herpes simplex virus plaque formation was determined at 0.00006% and 0.000005% for HSV-1 and HSV-2, respectively. At maximum noncytotoxic concentrations of the extract, plaque formation was significantly reduced by more than 99.9% for HSV-1 and HSV-2 and a clear concentration-dependent antiviral activity against HSV could be demonstrated for this extract. In order to determine the mode of antiviral action, the extract was added at different times to the cells or viruses during the infection cycle. Both herpesviruses were significantly inhibited when pretreated with the plant extract or when the extract was added during the adsorption phase, whereas acyclovir demonstrated antiviral activity only intracellularly during replication of HSV. These results indicate that P. sidoides extract affected the virus before penetration into the host cell and reveals a different mode of action when compared to the classical drug acyclovir. Hence this extract is capable of exerting an antiviral effect on herpes simplex virus and might be suitable for topical therapeutic use as antiviral drug both in labial and genital herpes infection.

  12. Infections in cancer patients: some controversial issues.

    Science.gov (United States)

    Schimpff, S C; Scott, D A; Wade, J C

    1994-03-01

    Despite more than two decades of clinical research into the management of infections in the neutropenic cancer patient, many patients still develop serious morbidity from infection and all too many still die. A number of controversies surround (a) the use of combination versus monotherapy for initial empiric administration; (b) the use of vancomycin as part of the initial regimen; (c) the origin of Staphylococcus epidermidis infections (i.e., mostly from vascular catheters or mostly from the alimentary canal); (d) the use of acyclovir for herpes simplex prophylaxis during remission induction for acute leukemia patients not undergoing bone marrow transplantation; (e) the use of alimentary canal microbial suppression or reverse isolation in a room with laminar air flow, or both, as infection prevention techniques. Current recommendations and observations include the following. (a) Monotherapy with ceftazidime or imipenem is effective and appropriate for patients with moderate granulocytopenia at limited risk for infection with a resistant organism. Combination therapy is recommended for patients with profound, persistent granulocytopenia who are at high risk for gram-negative bacteremia; such bacteremic patients have a better prognosis with combined-modality therapy. (b) Vancomycin need not be included in the initial regimen although some centers may choose to do so because of the high prevalence of gram-positive bacteremias. (c) Despite the ubiquitous presence of indwelling vascular catheters, most S. epidermidis infections among neutropenic patients originate from along the alimentary canal. (d) Herpes simplex infection is much more common following standard remission induction chemotherapy than previously recognized. Acyclovir will reduce these infections and concurrently probably reduce the likelihood of resultant bacterial/fungal co-infections and superinfections. (e) Selective microbial suppression is appropriate for patients expected to experience prolonged

  13. Preparation and targeted delivery of hepatotropic antiviral drug Lac-P LL-ACV%肝靶向抗病毒药Lac-PLL-ACV的制备及其趋肝性研究

    Institute of Scientific and Technical Information of China (English)

    项贵明; 周世文; 汤建林; 徐颖; 黄永平

    2002-01-01

    目的减少抗病毒药阿昔洛韦(Acyclovir, ACV)在治疗乙型肝炎中的肝外毒副作用,获得肝靶向ACV偶联物.方法多聚赖氨酸(Poly-L-lysine, PLL)在氰硼酸钠的催化作用下与乳糖反应生成乳糖化多聚赖氨酸 ,乳糖化多聚赖氨酸与咪唑化阿昔洛韦在37 ℃ pH9.5的条件下反应合成偶联物乳糖化多聚赖氨酸-阿昔洛韦(Lactosaminated poly-L-lysine-acyclovir,Lac-PLL-ACV).偶联物经尾静脉注射进入小鼠体内后,收集小鼠血浆及肝脏样品,用高效液相色谱法测定药物浓度,研究偶联物的体内分布和药代动力学.结果 HPLC检测证实Lac-PLL-ACV在血浆中十分稳定,不易解离出ACV.偶联物的肝最大摄取率约为60%,是ACV组的1 0倍以上,偶联物肝中的T1/2,AUC, CL 分别为ACV的4.2倍,56.6倍和1/57,具有明显的肝靶向性.结论乳糖化多聚赖氨酸作为肝去唾液酸糖蛋白受体(Asialogl ycoprotein receptor,ASGPR)介导的一种药物载体,能使抗病毒药ACV获得较满意的肝靶向性.

  14. Evaluation of Viral Meningoencephalitis Cases

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    Handan Ilhan

    2012-08-01

    Full Text Available AIM: To evaluate retrospectively adult cases of viral encephalitis. METHOD: Fifteen patients described viral encephalitis hospitalized between the years 2006-2011 follow-up and treatment at the infectious diseases clinic were analyzed retrospectively. RESULTS: Most of the patients (%60 had applied in the spring. Fever (87%, confusion (73%, neck stiffness (73%, headache (73%, nausea-vomiting (33%, loss of consciousness (33%, amnesia (33%, agitation (20%, convulsion (%20, focal neurological signs (13%, Brudzinski-sign (13% were most frequently encountered findings. Electroencephalography test was applied to 13 of 14 patients, and pathological findings compatible with encephalitis have been found. Radiological imaging methods such as CT and MRI were performed in 9 of the 14 patients, and findings consistent with encephalitis were reported. All of initial cerebrospinal fluid (CSF samples were abnormal. The domination of the first examples was lymphocytes in 14 patients; only one patient had an increase in neutrophilic cells have been found. CSF protein level was high in nine patients, and low glucose level was detected in two patients. Herpes simplex virus polymerized chain reaction (PCR analyze was performed to fourteen patients CSF. Only two of them (14% were found positive. One of the patients sample selectively examined was found to be Parvovirus B19 (+, the other patient urine sample Jacobs-creutzfeld virus PCR was found to be positively. Empiric acyclovir therapy was given to all patients. Neuropsychiatric squeal developed at the one patient. CONCLUSION: The cases in the forefront of change in mental status viral meningoencephalitis should be considered and empirical treatment with acyclovir should be started. [TAF Prev Med Bull 2012; 11(4.000: 447-452

  15. In vitro comparison of antiviral drugs against feline herpesvirus 1

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    Garré B

    2006-04-01

    Full Text Available Abstract Background Feline herpesvirus 1 (FHV-1 is a common cause of respiratory and ocular disease in cats. Especially in young kittens that have not yet reached the age of vaccination, but already lost maternal immunity, severe disease may occur. Therefore, there is a need for an effective antiviral treatment. In the present study, the efficacy of six antiviral drugs, i.e. acyclovir, ganciclovir, cidofovir, foscarnet, adefovir and 9-(2-phosphonylmethoxyethyl-2, 6-diaminopurine (PMEDAP, against FHV-1 was compared in Crandell-Rees feline kidney (CRFK cells using reduction in plaque number and plaque size as parameters. Results The capacity to reduce the number of plaques was most pronounced for ganciclovir, PMEDAP and cidofovir. IC50 (NUMBER values were 3.2 μg/ml (12.5 μM, 4.8 μg/ml (14.3 μM and 6 μg/ml (21.5 μM, respectively. Adefovir and foscarnet were intermediately efficient with an IC50 (NUMBER of 20 μg/ml (73.2 μM and 27 μg/ml (140.6 μM, respectively. Acyclovir was least efficient (IC50 (NUMBER of 56 μg/ml or 248.7 μM. All antiviral drugs were able to significantly reduce plaque size when compared with the untreated control. As observed for the reduction in plaque number, ganciclovir, PMEDAP and cidofovir were most potent in reducing plaque size. IC50 (SIZE values were 0.4 μg/ml (1.7 μM, 0.9 μg/ml (2.7 μM and 0.2 μg/ml (0.7 μM, respectively. Adefovir and foscarnet were intermediately potent, with an IC50 (SIZE of 4 μg/ml (14.6 μM and 7 μg/ml (36.4 μM, respectively. Acyclovir was least potent (IC50 (SIZE of 15 μg/ml or 66.6 μM. The results demonstrate that the IC50 (SIZE values were notably lower than the IC50 (NUMBER values. The most remarkable effect was observed for cidofovir and ganciclovir. None of the products were toxic for CRFK cells at antiviral concentrations. Conclusion In conclusion, measuring reduction in plaque number and plaque size are two valuable and complementary means of assessing the efficacy of

  16. Herpes zoster em pacientes com lúpus eritematoso sistêmico juvenil Herpes zoster in patients with juvenile systemic lupus erythematosus

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    Paula da Silva Neves

    2007-04-01

    VZV. In these patients, the mean age was 16 years and 5 months and the mean duration of the JSLE until the first infection was 4 years. All of these VZV infections were associated with disease activity. All patients presented vesicles and blister lesions along a nerve. The thorax and limbs regions were the most frequently affected. All of the patients received prednisone and 4 cyclophosphamide IV. All patients received acyclovir IV from 7 to 10 days. None of the patients had post-herpetic neuralgia, secondary bacterial infection or died. One patient that was receiving acyclovir had acute blindness by bilateral retinal necrosis vasculitis associated to the VZV, needed two applications of intra-vitreous gancyclovir and immunoglobulin (2 g/kg/dose IV and her vision partially improved. VZV infection in patients with JSLE was rarely observed and was usually associated with disease activity and steroid use. Infection was controlled with acyclovir without serious adverse complications.

  17. Targeted lipid based drug conjugates: a novel strategy for drug delivery.

    Science.gov (United States)

    Vadlapudi, Aswani Dutt; Vadlapatla, Ramya Krishna; Kwatra, Deep; Earla, Ravinder; Samanta, Swapan K; Pal, Dhananjay; Mitra, Ashim K

    2012-09-15

    A majority of studies involving prodrugs are directed to overcome low bioavailability of the parent drug. The aim of this study is to increase the bioavailability of acyclovir (ACV) by designing a novel prodrug delivery system which is more lipophilic, and at the same time site specific. In this study, a lipid raft has been conjugated to the parent drug molecule to impart lipophilicity. Simultaneously a targeting moiety that can be recognized by a specific transporter/receptor in the cell membrane has also been tethered to the other terminal of lipid raft. Targeted lipid prodrugs i.e., biotin-ricinoleicacid-acyclovir (B-R-ACV) and biotin-12hydroxystearicacid-acyclovir (B-12HS-ACV) were synthesized with ricinoleicacid and 12hydroxystearicacid as the lipophilic rafts and biotin as the targeting moiety. Biotin-ACV (B-ACV), ricinoleicacid-ACV (R-ACV) and 12hydroxystearicacid-ACV (12HS-ACV) were also synthesized to delineate the individual effects of the targeting and the lipid moieties. Cellular accumulation studies were performed in confluent MDCK-MDR1 and Caco-2 cells. The targeted lipid prodrugs B-R-ACV and B-12HS-ACV exhibited much higher cellular accumulation than B-ACV, R-ACV and 12HS-ACV in both cell lines. This result indicates that both the targeting and the lipid moiety act synergistically toward cellular uptake. The biotin conjugated prodrugs caused a decrease in the uptake of [(3)H] biotin suggesting the role of sodium dependent multivitamin transporter (SMVT) in uptake. The affinity of these targeted lipid prodrugs toward SMVT was studied in MDCK-MDR1 cells. Both the targeted lipid prodrugs B-R-ACV (20.25 ± 1.74 μM) and B-12HS-ACV (23.99 ± 3.20 μM) demonstrated higher affinity towards SMVT than B-ACV (30.90 ± 4.19 μM). Further, dose dependent studies revealed a concentration dependent inhibitory effect on [(3)H] biotin uptake in the presence of biotinylated prodrugs. Transepithelial transport studies showed lowering of [(3)H] biotin permeability in

  18. In vitro cytotoxic, antioxidant and antiviral effects of Pterocaulon alopecuroides and Bidens segetum extracts Efeitos citotóxico, antioxidante e antiviral in vitro de extratos de Pterocaulon alopecuroides e Bidens segetum

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    Cristiane Silva Silveira

    2009-06-01

    Full Text Available Pterocaulon alopecuroides (Lamark De Candolle and Bidens segetum Mart. ex Colla are two species belonging to the Asteraceae family. Extracts from those two species were evaluated to their cytotoxic, antioxidant and antiviral activities. All the extracts assayed have shown a very high cytotoxity against RBL-2H3 cell line. The antioxidant assay pointed out a really high activity of the ethyl acetate extracts for B. segetum and P. alopecuroides. This can be partially explained due to the high content of coumarins, at least for P. alopecuroides. None of the total ethanol extracts from B. segetum showed significant activity against the two strains of Herpes simplex virus (Types 1 and 2 resistant to acyclovir. P. alopecuroides ethanol extract was also inactive against the Herpes simplex virus type 1 resistant to acyclovir. However, this extract presented inhibitory activity against the Herpes simplex virus type 2 resistant to acyclovir. From the ethanol crude extract of P. alopecuroides, it was possible to isolate 7-(2',3'-dihidroxy-3'-methylbutyloxy-6-methoxycoumarin, which was tested in the same conditions, showing a viral inhibitory rate almost twice bigger than the P. alopecuroides sample for HSV-2-ACVr. The coumarin was also active against HSV-1-ACVr. Those results provide further evidence of the importance of Pterocaulon alopecuroides and Bidens segetum as medicinal plants.Pterocaulon alopecuroides (Lamark De Candolle e Bidens segetum Mart. ex Colla são duas espécies pertencentes à família Asteraceae. Os extratos dessas duas espécies foram avaliados quanto às suas atividades citotóxica, antioxidante e antiviral. Todos os extratos analisados apresentaram citotoxidade muito alta contra linhagens de células RBL-2H3. O ensaio de atividade antioxidante demonstrou uma alta atividade das frações em acetato de etila de B. segetum e P. alopecuroides. Isso pode ser parcialmente explicado pelo alto conteúdo de cumarinas, ao menos para P

  19. Flow-injection electrochemiluminescence analysis of aciclovir based on the enzymatic reaction%基于酶促反应的阿昔洛韦流动注射电化学发光分析法

    Institute of Scientific and Technical Information of China (English)

    赵常志; 梁俊钰

    2014-01-01

    We report a new flow-injection electrochemiluminescence (ECL ) analytical method for the determination of aciclovir based on the enzymatic reaction of aciclovir by xanthine oxidase immobi-lized in a micro-column .When the sample flow s through the enzyme reactor ,the xanthine oxidase cat-alyzes aciclovir to produce hydrogen peroxide (H2 O2 ) .Followed by ECL reaction of H2 O2 with lumi-nol ,the acyclovir was determined in the sample .In the paper ,effects of the mobile phase ,electrolyte pH ,excitation potential ,and luminol concentration on the ECL intensity were investigated and opti-mized .The linear response of aciclovir concentrations ranged from 0 .56 to 22 .5 mg/L was obtained with a detection limit of 0 .32 mg/L .This method was successfully applied to detect the active ingre-dient of acyclovir in pharmaceutical preparations .The relative standard deviation was less than 1 .80% (n=9) and the recovery was in the range of 95 .5% ~108% for the determination of actual samples .%基于阿昔洛韦与酶柱中的黄嘌呤氧化酶反应生成过氧化氢,继而与鲁米诺发生电化学发光反应的原理,建立了流动注射电化学发光测定阿昔洛韦的新方法,并将其应用于实际药品的检测.在pH为9.0的0.05mol/L的硼砂介质、激发电位为0.65V、鲁米诺浓度为5.00×10-4 mol/L、流速为1.90 mL/min的优化条件下,测定阿昔洛韦的线性范围为0.56~22.5mg/L,线性相关系数为0.9995,检出限为0.32mg/L,测定实际药品的相对标准偏差小于1.80%(n=9),加标回收率为95.5%~108%.

  20. Infrared Spectrum Analysis of the Unknown Floss of in Inosine Glucose Injection%2例肌苷葡萄糖注射液配药后不明絮状物的红外光谱分析

    Institute of Scientific and Technical Information of China (English)

    李湘晖; 田甜; 许世伟; 杜智敏

    2011-01-01

    目的:分析临床配药过程中出现的2例与肌苷葡萄糖注射液有关的絮状物的成分.方法:将临床配药过程中肌苷葡萄糖注射液与阿昔洛韦注射液混合及肌苷葡萄糖注射液与还原型谷胱甘肽混合时出现的不明絮状物分离出,低温干燥后进行红外光谱扫描,扫描结果通过与SDBS(Spectral Data Base System)谱图数据库中各组分红外图谱峰位、峰形及相对强度进行对比,确定是否为单一物质,分析原因.结果:该絮状物既不是肌苷,也不是阿昔洛韦或还原型谷胱甘肽,为茵类污染的可能性极大.结论:对于肌苷葡萄糖注射液类生物药品,临床使用时应先仔细观察外观后再行配药.%OBJECTIVE: To analyze the unknown floss of Inosine glucose injection in 2 cases during drug dispensing. METHODS: The unknown floss was isolated from mixture of lnosine glucose injection with Acyclovir injection and mixture of Inosine glucose injection with reduced glutathione. Isolated unknown floss was analyzed by infrared spectroscopy (IR) after cold drying. Results of IR were compared with SDBS (Spectral Data Base System) in terms of IR peak, peak shape and relative peak density to confirm whether the unknown floss was homogenous material or not and analyze its reason. RESULTS: The floss was not inosine or reduced glutathione or acyclovir. It was most likely a kind of bacteria. CONCLUSION: For such biological drugs of Inosine glucose injection, appearance should be observed carefully before clinical utilization.

  1. 不同pH值条件下蒙脱石散对配伍药物体外吸附作用的影响%Adsorption effects of montmorillonite powder on its compatible drugs at different pH values in vitro

    Institute of Scientific and Technical Information of China (English)

    陈爱瑛; 叶小弟; 程敏; 缪云萍; 方颖颖; 郑高利

    2011-01-01

    AIM To investigate the adsorption of montmorillonite powder interacting with its commonly used compatible drugs including norfloxacin, ofloxacin, Yulian tablets, ranitidine, famotidine, acyclovir and ribavirin in artificial gastric and intestinal fluid at different pH values in vitro. METHODS The artificial gastric and intestinal fluid at different pH values were used to dissolve the drugs, then montmorillonite powder was added into the drug solutions. The drug contents were determined by HPLC method, and the adsorption rates were calculated. RESULTS The adsorption rate of montmorillonite powder to palmatine and berberine in Yulian tablets were both higher than 95% , to norfloxacin and ofloxacin were about 80% , to acyclovir and ribavirin were lower than 10%. Ranitidine and famotidine decreased with the increase of PH value. CONCLUSION The adsorption effects of montmorillonite powder on these drugs are different. The dosing interval should be considered when the drugs with high adsorption rate were administered.%目的 研究在不同pH值人工胃液和人工肠液中蒙脱石散对常与其配伍药物诺氟沙星、氧氟沙星、萸连片、雷尼替丁、法莫替丁、阿昔洛韦、利巴韦林的体外吸附作用.方法 取蒙脱石散分别加入到用不同pH人工胃液和人工肠液溶解的上述药物溶液中,用高效液相色谱法测定药物含量,计算吸附率.结果 蒙脱石对萸连片中巴马汀、小檗碱的吸附率达95%以上;对诺氟沙星、氧氟沙星吸附率达80%左右;对阿昔洛韦、利巴韦林吸附率比较小,在10%以下;对法莫替丁和雷尼替丁的吸附率随着pH值的增加而降低.结论 蒙脱石散对上述药物有不同的吸附作用,吸附率大的药物配伍应用时注意服药间隔时间.

  2. Perphenazine-induced hyperprolactinemia%奋乃静致高催乳素血症

    Institute of Scientific and Technical Information of China (English)

    张艳; 宿英英

    2012-01-01

    A 22-year-old woman was hospitalized with viral encephalitis accompanied by symptomatic epilepsy and received an IV infusion of acyclovir 0. 5 g in 0. 9% sodium chloride 250 ml every eight hours, oral perphenazine 4 mg every eight hours, oral olanzapine 2. 5 mg every morning and 5 mg every night, and oral valproate sodium 0. 5 g every twelve hours. Before admission, she had been prescribed oral perphenazine 4 mg every eight hours and olanzapine 5 mg every night for 7 days because of viral encephalitis. On day 5 after admission, she developed galactorrhea and , on day 6, her prolactin (PRL) level was 5.93 nmol/L. Then the dose of perphenazine was reduced by 2 mg each day and, until twelve days after admission, perphenazine was stopped. However, acyclovir, olanzapine, and valproate sodium were continued. On the day of drug withdrawal, her PRL level was 4. 11 nmol/L. On day 8 of perphenazine discontinuation , her symptom of galactorrhea vanished and the PRL level returned to normal range (1.28 nmol/L).%1例22岁女性患者,因病毒性脑炎伴症状性癫痫入院,予阿昔洛韦0.5 g加入0.9%氯化钠注射液250 ml静脉滴注,1次/8 h;奋乃静4 mg,1次/8 h口服;奥氮平每早2.5 mg、每晚5 mg口服;丙戊酸钠0.5 g,1次/12 h口服.入院前曾因病毒性脑炎,已连续口服奋乃静(4 mg,1次/8 h)和奥氮平(5 mg,每晚1次)7 d.入院第5天患者出现泌乳,第6天催乳激素(PRL)水平为5.93 nmol/L,当日开始逐日递减奋乃静2 mg,至入院第12天停用,阿昔洛韦、奥氮平和丙戊酸钠继续应用.停药当日PRL为4.11 nmol/L.停用奋乃静第8天患者泌乳症状消失,PRL水平恢复正常(1.28 nmol/L).

  3. Charles Bonnet syndrome after herpes simplex encephalitis.

    Science.gov (United States)

    Aydin, Ömer Faruk; Ince, Hülya; Taşdemir, Haydar Ali; Özyürek, Hamit

    2012-04-01

    Visual impairment associated with Charles Bonnet syndrome is rarely reported in childhood. We describe a child who presented with visual hallucinations and postinfectious bilateral retrobulbar optic neuritis. The patient had undergone acyclovir therapy for 3 weeks because of herpes encephalitis. Four days after therapy was completed, he experienced visual impairment in both eyes. He manifested a bilateral decrease in visual acuity, with normal funduscopic findings. The patient experienced visual hallucinations for about 1 week, and then experienced total loss of vision. During his hallucinations, the patient did not exhibit behavioral changes or cognitive impairment. The visual hallucinations included unfamiliar children hiding under his bed, and he spoke to someone whom he did not know. Magnetic resonance imaging indicated bilateral optic nerve hyperintensity on T(2)-weighted and contrast-enhanced images. The patient received corticosteroid therapy for his retrobulbar optic neuritis, and his vision returned to normal after 1 month. Although rare, visual impairment can be associated with complex visual hallucinations indicative of Charles Bonnet syndrome.

  4. Herpes Simplex Viral Encephalitis Masquerading as a Classic Left MCA Stroke

    Directory of Open Access Journals (Sweden)

    Peter A. Abdelmalik

    2015-01-01

    Full Text Available Objective. Stroke is a clinical diagnosis, with a history and physical examination significant for acute onset focal neurological symptoms and signs, often occurring in patients with known vascular risk factors and is frequently confirmed radiographically. Case Report. A 79-year-old right-handed woman, with a past medical history of hypertension, hyperlipidemia, and prior transient ischemic attack (TIA, presented with acute onset global aphasia and right hemiparesis, in the absence of fever or prodrome. This was initially diagnosed as a proximal left middle cerebral artery (MCA stroke. However, CT perfusion failed to show evidence of reduced blood volume, and CT angiogram did not show evidence of a proximal vessel occlusion. Furthermore, MRI brain did not demonstrate any areas of restricted diffusion. EEG demonstrated left temporal periodic lateralized epileptiform discharges (PLEDs. The patient was empirically loaded with a bolus valproic acid and started on acyclovir, both intravenously. CSF examination demonstrated a pleocytosis and PCR confirmed the diagnosis of herpes simplex viral encephalitis (HSVE. Conclusions. HSVE classically presents in a nonspecific fashion with fever, headache, and altered mental status. However, acute focal neurological signs, mimicking stroke, are possible. A high degree of suspicion is required to institute appropriate therapy and decrease morbidity and mortality associated with HSVE.

  5. Pharmacokinetics of ganciclovir and valganciclovir in the adult horse.

    Science.gov (United States)

    Carmichael, R J; Whitfield, C; Maxwell, L K

    2013-10-01

    Equine herpes myeloencephalopathy, resulting from equine herpes virus type 1 (EHV-1) infection, is associated with substantial morbidity and mortality in the horse. As compared to other antiviral drugs, such as acyclovir, ganciclovir has enhanced potency against EHV-1. This study investigated the pharmacokinetics of ganciclovir and its oral prodrug, valganciclovir, in six adult horses in a randomized cross-over design. Ganciclovir sodium was administered intravenously as a slow bolus at a dose of 2.5 mg/kg, and valganciclovir was administered orally at a dose of 1800 mg per horse. Intravenously administered ganciclovir disposition was best described by a three-compartment model with a prolonged terminal half-life of 72 ± 9 h. Following the oral administration of valganciclovir, the mean observed maximum serum ganciclovir concentration was 0.58 ± 0.37 μg/mL, and bioavailability of ganciclovir from oral valganciclovir was 41 ± 20%. Superposition predicted that oral dosing of 1800-mg valganciclovir two times daily would fail to produce and maintain effective plasma concentrations of ganciclovir. However, superposition suggested that i.v. administration of ganciclovir at 2.5 mg/kg every 8 h for 24 h followed by maintenance dosing of 2.5 mg/kg every 12 h would maintain effective ganciclovir serum concentrations in most horses throughout the dosing interval.

  6. The equine herpes virus 4 thymidine kinase is a better suicide gene than the human herpes virus 1 thymidine kinase.

    Science.gov (United States)

    Loubière, L; Tiraby, M; Cazaux, C; Brisson, E; Grisoni, M; Zhao-Emonet, J; Tiraby, G; Klatzmann, D

    1999-09-01

    The herpes simplex virus type 1 thymidine kinase suicide gene (HSV1tk) together with ganciclovir (GCV) have been successfully used for in vivo treatment of various experimental tumors, and many clinical trials using this system have been launched. With the aim to improve this therapeutic system, we compared the potential efficacy of different herpes virus derived thymidine kinases (HSV1, varicella-zoster virus, equine herpes virus type-4 and Epstein-Barr virus) as suicide genes in association with the nucleoside analogs acyclovir, ganciclovir and bromovinyldeoxyur- idine. Using various murine and human cell lines expressing these viral tk, we show that HSV1- and EHV4tk are the more efficient suicide genes for the different nucleoside analogs tested. Moreover, EHV4tk expressing murine and human cells were three- to 12-fold more sensitive to GCV than HSV1tk expressing cells. This was correlated with the presence of five-fold higher amounts of the toxic triphosphated-GCV in EHV4- versus HSV1tk expressing cells. Altogether, these experiments underline the potential advantages of the EHV4tk as a suicide gene.

  7. Quantitative Prediction of Human Renal Clearance and Drug-Drug Interactions of Organic Anion Transporter Substrates Using In Vitro Transport Data: A Relative Activity Factor Approach.

    Science.gov (United States)

    Mathialagan, Sumathy; Piotrowski, Mary A; Tess, David A; Feng, Bo; Litchfield, John; Varma, Manthena V

    2017-04-01

    Organic anion transporters (OATs) are important in the renal secretion, and thus, the clearance, of many drugs; and their functional change can result in pharmacokinetic variability. In this study, we applied transport rates measured in vitro using OAT-transfected human embryonic kidney cells to predict human renal secretory and total renal clearance of 31 diverse drugs. Selective substrates to OAT1 (tenofovir), OAT2 (acyclovir and ganciclovir), and OAT3 (benzylpenicillin, oseltamivir acid) were used to obtain relative activity factors (RAFs) for these individual transporters by relating in vitro transport clearance (after physiologic scaling) to in vivo secretory clearance. Using the estimated RAFs (0.64, 7.3, and 4.1, respectively, for OAT1, OAT2, and OAT3, respectively) and the in vitro active clearances, renal secretory clearance and total renal clearance were predicted with average fold errors (AFEs) of 1.89 and 1.40, respectively. The results show that OAT3-mediated transport play a predominant role in renal secretion for 22 of the 31 drugs evaluated. This mechanistic static approach was further applied to quantitatively predict renal drug-drug interactions (AFE ∼1.6) of the substrate drugs with probenecid, a clinical probe OAT inhibitor. In conclusion, the proposed in vitro-in vivo extrapolation approach is the first comprehensive attempt toward mechanistic modeling of renal secretory clearance based on routinely employed in vitro cell models.

  8. Nucleic acid related compounds. 65. New syntheses of 1-(beta-D-arabinofuranosyl)-5(E)-(2-iodovinyl)uracil (IVAraU) from vinylsilane precursors. Radioiodine uptake as a marker for thymidine kinase positive herpes viral infections

    Energy Technology Data Exchange (ETDEWEB)

    Robins, M.J.; Manfredini, S.; Wood, S.G.; Wanklin, R.J.; Rennie, B.A.; Sacks, S.L. (Department of Chemistry, Brigham Young University, Provo, UT (USA))

    1991-07-01

    (Trimethylsilyl)acetylene was coupled with 1-(2,3,5-tri-O-acetyl-beta-D- arabinofuranosyl)-5-iodouracil to give 1- (2,3,5-tri-O-acetyl-beta-D-arabinofuranosyl)-5-(2-(trimethylsilyl)eth yny l) uracil. Lindlar hydrogenation of 4 gave 1-(2,3,4-tri-O-acetyl-beta-D-arabinofuranosyl)-5(Z)-(2- (trimethylsilyl)vinyl)uracil. Treatment of 5 with iodine monochloride (or sodium iodide/phenyliodine(III) dichloride) in benzene gave 1-(2,3,5-tri-O-acetyl-beta-D-arabinofuranosyl)-5(E)-(2-iodovinyl)uracil (7), whereas polar solvents favored the (Z)-iodovinyl isomer 8. Deacetylation of 7 gave 1-(beta-D-arabinofuranosyl)-5(E)-(2-iodovinyl)uracil (IVAraU, 9). A microscale in situ synthesis with Na{asterisk}I gave ({asterisk}I)IVAraU. Treatment of HSV-infected cells with (125I)IVAraU resulted in virus-dependent uptake associated with nucleoside phosphorylation by wild type or acyclovir-resistant DNA polymerase mutants (but not with TK-HSV-1 mutants). Uptake was virus-inoculum dependent and was detectable within 4 h postinfection. The process was not completely reversible. Virus-specified uptake of (125I)IVAraU may allow automated in vitro detection of HSV isolates.

  9. Fulminant Staphylococcus lugdunensis septicaemia following a pelvic varicella-zoster virus infection in an immune-deficient patient: a case report

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    Woznowski M

    2010-09-01

    Full Text Available Abstract Introduction The deadly threat of systemic infections with coagulase negative Staphylococcus lugdunensis despite an appropriate antibiotic therapy has only recently been recognized. The predominant infectious focus observed so far is left-sided native heart valve endocarditis, but bone and soft tissue infections, septicaemia and vascular catheter-related bloodstream infections have also been reported. We present a patient with a fatal Staphylococcus lugdunensis septicaemia following zoster bacterial superinfection of the pelvic region. Case presentation A 71-year old male diagnosed with IgG kappa plasmocytoma presented with a conspicuous weight loss, a hypercalcaemic crisis and acute renal failure. After initiation of haemodialysis treatment his condition improved rapidly. However, he developed a varicella-zoster virus infection of the twelfth thoracic dermatome requiring intravenous acyclovir treatment. Four days later the patient presented with a fulminant septicaemia. Despite an early intravenous antibiotic therapy with ciprofloxacin, piperacillin/combactam and vancomycin the patient died within 48 hours, shortly before the infective isolate was identified as Staphylococcus lugdunensis by polymerase chain reaction. Conclusion Despite S. lugdunensis belonging to the family of coagulase-negative staphylococci with an usually low virulence, infections with S. lugdunensis may be associated with an aggressive course and high mortality. This is the first report on a Staphylococcus lugdunensis septicaemia following a zoster bacterial superinfection of the pelvic region.

  10. Acute retinal necrosis results in low vision in a young patient with a history of herpes simplex virus encephalitis.

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    Shahi, Sanjeet K

    2016-08-31

    Acute retinal necrosis (ARN), secondary to herpes simplex encephalitis, is a rare syndrome that can present in healthy individuals, as well as immuno-compromised patients. Most cases are caused by a secondary infection from the herpes virus family, with varicella zoster virus being the leading cause of this syndrome. Potential symptoms include blurry vision, floaters, ocular pain and photophobia. Ocular findings may consist of severe uveitis, retinal vasculitis, retinal necrosis, papillitis and retinal detachment. Clinical manifestations of this disease may include increased intraocular pressure, optic disc oedema, optic neuropathy and sheathed retinal arterioles. A complete work up is essential to rule out cytomegalovirus retinitis, herpes simplex encephalitis, herpes virus, syphilis, posterior uveitis and other conditions. Depending on the severity of the disease, the treatment options consist of anticoagulation therapy, cycloplegia, intravenous acyclovir, systemic steroids, prophylactic laser photocoagulation and pars plana vitrectomy with silicon oil for retinal detachment. An extensive history and clinical examination is crucial in making the correct diagnosis. Also, it is very important to be aware of low vision needs and refer the patients, if expressing any sort of functional issues with completing daily living skills, especially reading. In this article, we report one case of unilateral ARN 20 years after herpetic encephalitis.

  11. Prophylactic Antiviral Treatment in Recurrent Herpes Zoster: A Case Report

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    Hatice Gamze Bayram

    2011-06-01

    Full Text Available Herpes zoster (HZ occurs in older ages with activation of varicella-zoster virus (VZV which persists in a dormant phase within the dorsal root ganglia. The incidence of HZ in immunosuppressed patients is 20-100 times higher and the clinical progress is more severe than in immunocompetent individuals. A 48-year-old man who had been diagnosed with acute myelocytic leukemia type M3 and had been treated with immunosuppressive agents was admitted to our clinic. The patient was clinically diagnosed as having HZ. He was treated with acyclovir 800 mg five times daily for 7 days. In the consecutive three months, he attended our clinic again with similar complaints. The left cervical (C5, C6 dermatomes were involved at the fourth attack of HZ. Multinucleated giant cells were determined on the Tzanck smear. VZV DNA was detected by polymerase chain reaction (PCR. Treatment with valacyclovir 1 g three times daily for 14 days was prescribed and then, prophylactic treatment with valacyclovir 500 mg two times a day was administered. Although immunosuppressive treatment was continued, no new attacks of herpes zoster occurred. We think that prophylactic antiviral therapy should be initiated in immunosuppressive individuals who have recurrent herpes zoster attacks.

  12. Dancing with chemical formulae of antivirals: A panoramic view (Part 2).

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    De Clercq, Erik

    2013-11-15

    In this second part of "Dancing with antivirals as chemical formulae" I will focus on a number of chemical compounds that in the last few years have elicited more than common attraction from a commercial viewpoint: (i) favipiravir (T-705), as it is active against influenza, but also several other RNA viruses; (ii) neuraminidase inhibitors such as zanamivir and oseltamivir; (iii) peramivir and laninamivir octanoate, which might be effective against influenza virus following a single (intravenous or inhalation) administration; (iv) sofosbuvir, the (anticipated) cornerstone for the interferon-free therapy of HCV infections; (v) combinations of DAAs (direct antiviral agents) to achieve, in no time, a sustained virus response (SVR) against HCV infection; (vi) HIV protease inhibitors, the latest and most promising being darunavir; (vii) the integrase inhibitors (INIs) (raltegravir, elvitegravir, dolutegravir), representing a new dimension in the anti-HIV armamentarium; (viii), a new class of helicase primase inhibitors (HPIs) that may exceed acyclovir and the other anti-herpes compounds in both potency and safety; (ix) CMX-001, as the latest of Dr. Antonín Holý's legacy for its activity against poxviruses and CMV infections, and (x) noroviruses for which the ideal antiviral compounds are still awaited for.

  13. Marine natural seaweed products as potential antiviral drugs against Bovine viral diarrhea virus

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    Ana Maria Viana Pinto

    2012-08-01

    Full Text Available Bovine viral diarrhea virus (BVDV is an etiologic agent that causes important economic losses in the world. It is endemic in cattle herds in most parts of the world. The purpose of this study was to evaluate the in vitro cytotoxic effect and antiviral properties of several marine natural products obtained from seaweeds: the indole alkaloid caulerpin (CAV, 1 and three diterpenes: 6-hydroxydichotoma-3,14-diene-1,17-dial (DA, 2, 10,18-diacetoxy-8-hydroxy-2,6-dolabelladiene (DB1, 3 and 8,10,18-trihydroxy-2,6-dolabelladiene (DB3, 4. The screening to evaluate the cytotoxicity of compounds did not show toxic effects to MDBK cells. The antiviral activity of the compounds was measured by the inhibition of the cytopathic effect on infected cells by plaque assay (PA and EC50 values were calculated for CAV (EC=2,0± 5.8, DA (EC 2,8± 7.7, DB1 (EC 2,0±9.7, and DB3 (EC 2,3±7.4. Acyclovir (EC50 322± 5.9 was used in all experiments as the control standard. Although the results of the antiviral activity suggest that all compounds are promising as antiviral agents against BVDV, the Selectivity Index suggests that DB1 is the safest of the compounds tested.

  14. A REVIEW ARTICLE ON HERPES SIMPLEX ENCEPHALITIS

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    A. Karimi MD

    2009-01-01

    Full Text Available Abstract:Herpes Simplex encephalitis (HSE is a life threatening outcome of Herpes simplex virus (HSV infection of the central nervous system (CNS. HSVaccounts for 2-5 percent of all cases of encephalitis. One third of cases occur in those younger than 20 years old and one half in those older than 50 years old.Clinical diagnosis is recommended in the encephalopathic, febrile patients with focal neurological signs. However, the clinical findings are not pathogonomic because numerous other diseases of CNS can mimic HSE. Diagnosis should be confirmed based on medical history, analysis of cerebrospinal fluid (CSF for protein and glucose contents, the cellular analysis and identifying the pathogens by serology and Polymerase Chain Reaction (PCR amplification .The diagnostic gold standard is the detection of HSV DNA in the cerebrospinal fluid by PCR. But negative results need to be interpreted regarding thepatients clinical signs and symptoms and the time of CSF sampling. Spike and slow wave patterns is observed in Electroencephalogram (EEG.Neuroimaging, especially Magnetic Resonance Imaging (MRI is essential for evaluating the patients, which shows temporal lobe edema or hemorrhage.All patients with HSE should be treated by intravenous Acyclovir (10mg/kg q8hr for 14-21 days. After completing therapy, PCR of the CSF can confirmthe elimination of replicating virus, assisting further management of the patient.Keywords:Herpes Simplex Virus (HSV, Encephalitis, Children

  15. A REVIEW ARTICLE ON HERPES SIMPLEX ENCEPHALITIS

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    A. Karimi MD,

    2007-02-01

    Full Text Available Herpes Simplex encephalitis (HSE is a life threatening outcome of Herpes simplex virus (HSV infection of the central nervous system (CNS. HSVaccounts for 2-5 percent of all cases of encephalitis. One third of cases occur in those younger than 20 years old and one half in those older than 50 years old.Clinical diagnosis is recommended in the encephalopathic, febrile patients with focal neurological signs. However, the clinical findings are not pathogonomic because numerous other diseases of CNS can mimic HSE. Diagnosis should be confirmed based on medical history, analysis of cerebrospinal fluid (CSF for protein and glucose contents, the cellular analysis and identifying the pathogens by serology and Polymerase Chain Reaction (PCR amplification .The diagnostic gold standard is the detection of HSV DNA in the cerebrospinal fluid by PCR. But negative results need to be interpreted regarding thepatients clinical signs and symptoms and the time of CSF sampling. Spike and slow wave patterns is observed in Electroencephalogram (EEG.Neuroimaging, especially Magnetic Resonance Imaging (MRI is essential for evaluating the patients, which shows temporal lobe edema or hemorrhage.All patients with HSE should be treated by intravenous Acyclovir (10mg/kg q8hr for 14-21 days. After completing therapy, PCR of the CSF can confirmthe elimination of replicating virus, assisting further management of the patient.

  16. Diagnosis and management of genital ulcers.

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    Roett, Michelle A; Mayor, Mejebi T; Uduhiri, Kelechi A

    2012-02-01

    Herpes simplex virus infection and syphilis are the most common causes of genital ulcers in the United States. Other infectious causes include chancroid, lymphogranuloma venereum, granuloma inguinale (donovanosis), secondary bacterial infections, and fungi. Noninfectious etiologies, including sexual trauma, psoriasis, Behçet syndrome, and fixed drug eruptions, can also lead to genital ulcers. Although initial treatment of genital ulcers is generally based on clinical presentation, the following tests should be considered in all patients: serologic tests for syphilis and darkfield microscopy or direct fluorescent antibody testing for Treponema pallidum, culture or polymerase chain reaction test for herpes simplex virus, and culture for Haemophilus ducreyi in settings with a high prevalence of chancroid. No pathogen is identified in up to 25 percent of patients with genital ulcers. The first episode of herpes simplex virus infection is usually treated with seven to 10 days of oral acyclovir (five days for recurrent episodes). Famciclovir and valacyclovir are alternative therapies. One dose of intramuscular penicillin G benzathine is recommended to treat genital ulcers caused by primary syphilis. Treatment options for chancroid include a single dose of intramuscular ceftriaxone or oral azithromycin, ciprofloxacin, or erythromycin. Lymphogranuloma venereum and donovanosis are treated with 21 days of oral doxycycline. Treatment of noninfectious causes of genital ulcers varies by etiology, and ranges from topical wound care for ulcers caused by sexual trauma to consideration of subcutaneous pegylated interferon alfa-2a for ulcers caused by Behçet syndrome.

  17. Atypical Presentation of Disseminated Zoster in a Patient with Rheumatoid Arthritis

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    Nirav Patel

    2015-01-01

    Full Text Available Patients with rheumatoid arthritis (RA have 2-fold increased risk of herpes zoster. In literature, limited information exists about disseminated cutaneous zoster in RA patients. An 83-year-old African-American female with RA presented with generalized and widespread vesicular rash covering her entire body. Comorbidities include hypertension, type II diabetes, and dyslipidemia. Patient was on methotrexate 12.5 mg and was not receiving any corticosteroids, anti-TNF therapy, or other biological agents. The patient was afebrile (98 F with no SIRS criteria. Multiple vesicular lesions were present covering patient’s entire body including face. Lesions were in different stages, some umbilicated with diameter of 2–7 cm. Many lesions have a rim of erythema with no discharge. On admission, patient was also pancytopenic with leukocyte count of 1.70 k/mm3. Biopsies of lesions were performed, which were positive for Varicella antigen. Subsequently, patient was started on Acyclovir. The patient’s clinical status improved and rash resolved. Our patient presented with “atypical” clinical picture of disseminated cutaneous zoster with no obvious dermatome involvement. Disseminated zoster is a potentially serious infection that can have an atypical presentation in patients with immunocompromised status. High index of suspicion is needed to make the diagnosis promptly and to initiate therapy to decrease mortality and morbidity.

  18. Ⅰ型和Ⅱ型单纯疱疹病毒感染的抗病毒治疗

    Institute of Scientific and Technical Information of China (English)

    郭芳; 王得新

    2011-01-01

    目前,在有效的抗Ⅰ型单纯疱疹病毒(HSV-1)和Ⅱ型单纯疱疹病毒(HSV-2)的药物中,除膦甲酸(fosarnet)和西多福韦(cidofovir)外,其他所有抗病毒药物均为核苷类似物.其中阿昔洛韦(acyclovir)、泛昔洛韦(famciclovir)和伐昔洛韦(valaciclovir)均为适用于大多数单纯疱疹病毒感染的一线抗病毒药物,而西多福韦、膦甲酸、更昔洛韦(ganciclovir)、缬更昔洛韦(valganciclovir)等二线抗单纯疱疹病毒药物对α疱疹病毒亚科病毒也有效,尤其是治疗抗阿昔洛韦的单纯疱疹病毒分离株.本文对Ⅰ型和Ⅱ型单纯疱疹病毒感染的抗病毒治疗进行全面综述.

  19. The management of herpes simplex virus infections in HIV infected patients: current issues and the role of cidofovir

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    Nakakawa E

    2011-06-01

    Full Text Available Ethel Nakakawa1, Steven J Reynolds21Makerere University College of Health Sciences, Department of Microbiology, Kampala, Uganda; 2Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD and Johns Hopkins University School of Medicine, Baltimore, MD, USAAbstract: Herpes simplex virus (HSV type 1 and 2 are among the most common transmitted viral infections causing a spectrum of mucocutaneous and other syndromes. Treatment of these infections has primarily been with acyclovir (ACV and prodrugs valacyclovir and famcyclovir. Immunocompromised hosts either due to human immunodeficiency virus (HIV or other factors have given rise to an increase in ACV resistant viruses most commonly due to a mutation in the cellular thymidine kinase enzyme. This review focuses on the spectrum of disease caused by HSV 1 and 2, the emergence of ACV resistant disease, and the role of alternative agents including cidofovir in the treatment of ACV resistant disease.Keywords: herpes simplex virus, HIV, resistance, cidofovir

  20. Diagnosis and management of herpes zoster by the family and community physician

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    Pedro Alexandre Barreto Coelho

    2014-08-01

    Full Text Available The herpes virus that causes varicella (chickenpox persists in a latent form in the nervous system and can reactivate and propagate through nerve roots, manifesting years later through painful skin lesions, a condition called herpes zoster. The diagnosis is primarily clinical, but it is important to make a differential diagnosis with impetigo, contact dermatitis, dermatitis herpetiformis and also herpes simplex itself. After the diagnosis is confirmed, treatment should be initiated within the first 72 hours after onset of the rash and it is based upon antiviral therapy. Valacyclovir and famciclovir are more effective when compared to acyclovir. The most common complication of herpes zoster is post-herpetic neuralgia, usually managed with tricyclic antidepressants, anticonvulsants, topical lidocaine or capsaicin. Recently, a live attenuated vaccine against herpes zoster was introduced in Brazil, with the same components as the vaccine against varicella, but in a greater concentration. However, it still has a high cost and is not available in the public health system.

  1. Acute hemicerebellitis in a young adult: a case report and literature review.

    Science.gov (United States)

    Suzuki, Keisuke; Nakamura, Toshiki; Numao, Ayaka; Fujita, Hiroaki; Komagamine, Tomoko; Nagashima, Takahide; Asakawa, Yohei; Watanabe, Yuji; Takekawa, Hidehiro; Hirata, Koichi

    2014-12-15

    Acute hemicerebellitis, marked by headache with or without cerebellar signs, is a rare clinical entity involving a unilateral cerebellar hemisphere. The pathogenesis of acute hemicerebellitis remains unclear, and the disease rarely occurs in adults. Here, we report an 18-year-old woman who presented with a lack of coordination of the right hand and leg lasting longer than one week, following a pulsatile headache. A neurological examination disclosed ocular dysmetria, right-sided limb ataxia and slight truncal ataxia. Cerebrospinal fluid analysis showed mononuclear pleocytosis. The serology and autoimmune studies were unremarkable. Brain magnetic resonance imaging (MRI) revealed a focal signal change in the right cerebellar hemisphere and vermis. Acute hemicerebellitis was diagnosed, and the patient was treated with intravenous methylprednisolone sodium succinate and acyclovir. Subsequently, the headache resolved, and the cerebellar signs were markedly improved. Twenty days after admission, she became asymptomatic and brain MRI showed resolution of cerebellar hyperintensity on the right side. In conclusion, we identified only 6 additional patients with adult-onset acute hemicerebellitis from previous reports, highlighting the importance of recognizing this rare clinical entity. Its clinical outcome is usually favorable, but in the acute phase, attention should be directed toward clinical symptoms that are suggestive of increased intracranial pressure.

  2. Extensive VZV Encephalomyelitis without Rash in an Elderly Man

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    Karen Lynch

    2014-01-01

    Full Text Available Introduction. Varicella zoster virus (VZV encephalomyelitis with cranial nerve involvement is rare. Characteristically it is preceded by a rash and primarily presents in the immunocompromised. The spectrum of VZV neurologic disease is extensive and it is not uncommon to present without rash. We report the case of an elderly otherwise immunocompetent patient who presented with diverse manifestations of VZV CNS infection all occurring without rash. Case Report. A 78-year-old man presented with 1 week of progressive paraparesis and sensory loss, malaise, and fevers. MRI of the neuraxis demonstrated numerous enhancing lesions: intramedullary, leptomeningeal, pachymeningeal, and cranial nerves. Cerebrospinal fluid (CSF showed a white blood cell count of 420/μL with elevated protein (385 mg/dL. CSF VZV qualitative PCR was positive and CSF VZV immunofluorescence assay detected IgM antibody, confirming the diagnosis of VZV encephalomyelitis. Clinical and radiological improvement was observed after intravenous acyclovir treatment. Conclusion. This is a rare report of an immunocompetent patient with extensive VZV encephalomyelitis. We highlight the importance of considering this diagnosis even in the absence of the characteristic rash, and the potential risk of premature discontinuation of antiviral therapy once HSV has been excluded. Prompt recognition and treatment can dramatically reduce morbidity and mortality in patients.

  3. Varicella-Zoster Virus Keratitis with Asymptomatic Conjunctival Viral Shedding in the Contralateral Eye

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    Akio Miyakoshi

    2012-10-01

    Full Text Available Purpose: To report a case of varicella-zoster virus (VZV keratitis with detection of VZV DNA in the tear fluid of not only the symptomatic eye but also the contralateral asymptomatic eye by polymerase chain reaction (PCR. Methods: This is a case report. A 63-year-old otherwise healthy woman presented with circular corneal ulcer and stromal opacity with infiltration accompanied by mild conjunctival and ciliary injections in the left eye. Bacterial cultures of the corneal scrapings and virus PCR analyses of tear fluid from both eyes were performed. Results: No pathogen was found by bacterial cultures. PCR was negative for Acanthamoeba, herpes simplex virus and cytomegalovirus, but positive for VZV. VZV DNA was also detected in the unaffected eye. Based on the diagnosis of VZV keratitis, oral valacyclovir and acyclovir eye ointment were administered to the corneal infected eye. The infected eye was healed and VZV DNA turned negative in the tear fluid of the treated eye after 6 months of treatment; however, VZV DNA was still positive in the tear fluid of the contralateral eye. Conclusions: To our knowledge, this is the first case report of the detection of VZV DNA in the tear fluid of both affected and unaffected eyes in a patient with VZV keratitis. Asymptomatic conjunctival shedding of VZV may continue in the healthy unaffected eye in VZV keratitis patients.

  4. Substrate specificity and molecular modelling of the feline herpesvirus-1 thymidine kinase.

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    Hussein, Islam T M; Miguel, Ricardo Núñez; Tiley, Laurence S; Field, Hugh J

    2008-01-01

    Feline herpesvirus-1 (FHV-1) causes a severe upper respiratory and ocular disease in cats. An effective antiviral compound is required for treating FHV-1 infections. The virus-encoded thymidine kinase (TK) is the molecular basis for selective activation of commonly used antiviral nucleoside analogue drugs, e.g. acyclovir (ACV), penciclovir (PCV) and ganciclovir (GCV). The substrate specificity of a recombinant FHV-1 TK, expressed in Escherichia coli, was studied. FHV-1 TK efficiently phosphorylated its natural substrate deoxythymidine. However, it exhibited relatively lower affinity for the guanosine analogue substrates. PCV was most efficiently phosphorylated, followed by GCV, with approximately twofold reduction in the phosphorylation rate. The lowest phosphorylation rate was recorded for ACV. To correlate these biochemical data with structural features of the FHV-1 TK, a three-dimensional (3D) model of this enzyme was constructed based on sequence homology with two other herpesviral TKs, encoded by equine herpesvirus-4 (EHV-4) and herpes simplex-1 (HSV-1). Mutational analysis of the amino acids forming the FHV-1 TK active site identified two residues (Y29 and F144) as being critical for the differential ability of this enzyme to phosphorylate nucleoside analogues. A double substitution of Y29H/F144Y resulted in a threefold increase in the ACV phosphorylation rate.

  5. Síndrome do ápice orbitário causada por herpes zóster oftálmico: relato de caso e revisão da literatura Herpes zoster ophthalmicus and orbital apex syndrome: case report and literature review

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    Kenzo Hokazono

    2009-10-01

    Full Text Available OHerpes Zoster Oftálmico (HZO decorre da infecção pelo vírus da varicela-zoster que permanece latente no gânglio de Gasser até que seja reativado e comprometa a divisão oftálmica do nervo trigêmeo. HZO freqüentemente causa manifestações oftalmológicas como lesões vesiculares palpebrais, ceratoconjuntivite, esclerite, uveíte, paralisia oculomotora, miosite orbitária e neurite óptica. Raramente o acometimento do ápice da órbita pode ser a manifestação inicial desta grave afecção. Este trabalho relata um caso de síndrome do ápice orbitário associado à meningite, causado por HZO e que foi tratado com corticosteróide e aciclovir sistêmicos.Herpes Zoster ophthalmicus (HZO is caused by a varicella-zoster virus infection which remains latent in the ganglion of Gasser until it is reactivated and compromise the ophthalmic division of the trigeminal nerve. HZO commonly causes neuro-ophthalmic complications such as vesicular lesions in the eyelids, keratoconjunctivitis, sclertis, uveitis, ocular palsy, orbital miositis and optic neuritis. HZO rarely presents as an orbital apex syndrome. This paper describes a patient with of orbital apex syndrome associate and meningitis caused by HZO which was treated with systemic steroids and acyclovir.

  6. April 2015 critical care case of the month: half-sided light house

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    Loftsgard T

    2015-04-01

    Full Text Available No abstract available. Article truncated after 150 words. History of Present Illness: A 55 year old woman was transferred to the ICU from the general medicine ward for tachycardia and acute hypoxic respiratory distress. She has multiple myeloma and had received cycle one of bortezomib, dexamethasone, thalidomide, cisplatin, doxorubicin, cyclophosphamide and etoposide (VDT-PACE and radiotherapy to T7 for a pathologic compression. She was admitted for pain control from mucositis.Past Medical History: In addition to the multiple myeloma she has a past medical history of asthma, ovarian cysts, diverticulitis, eczema, pneumonia, laparoscopic cholecystectomy, total abdominal hysterectomy with bilateral salpingo-oophorectomy, appendectomy, ectopic pregnancy in the past, and left Bell's palsy. Current Medications: Acyclovir 400 mg BID, Albuterol 90 HFA prn, Allopurinol 300 mg daily, Fluconazole 200 mg BID, Gabapentin 300 mg BID, Hydromorphone , Levofloxacin 500 daily, Morphine, Omeprazole, Bactrim 400-80 mg daily for PCP prophylaxis, Thalomid 200 mg capsule daily, Ativan 0.5 mg just prior to transfer. Physical Examination ...

  7. Highly reliable heterologous system for evaluating resistance of clinical herpes simplex virus isolates to nucleoside analogues.

    Science.gov (United States)

    Bestman-Smith, J; Schmit, I; Papadopoulou, B; Boivin, G

    2001-04-01

    Clinical resistance of herpes simplex virus (HSV) types 1 and 2 to acyclovir (ACV) is usually caused by the presence of point mutations within the coding region of the viral thymidine kinase (TK) gene. The distinction between viral TK mutations involved in ACV resistance or part of viral polymorphism can be difficult to evaluate with current methodologies based on transfection and homologous recombination. We have developed and validated a new heterologous system based on the expression of the viral TK gene by the protozoan parasite Leishmania, normally devoid of TK activity. The viral TK genes from 5 ACV-susceptible and 13 ACV-resistant clinical HSV isolates and from the reference strains MS2 (type 2) and KOS (type 1) were transfected as part of an episomal expression vector in Leishmania. The susceptibility of TK-recombinant parasites to ganciclovir (GCV), a closely related nucleoside analogue, was evaluated by a simple measurement of the absorbance of Leishmania cultures grown in the presence of the drug. Expression of the TK gene from ACV-susceptible clinical isolates resulted in Leishmania susceptibility to GCV, whereas expression of a TK gene with frameshift mutations or nucleotide substitutions from ACV-resistant isolates gave rise to parasites with high levels of GCV resistance. The expression of the HSV TK gene in Leishmania provides an easy, reliable, and sensitive assay for evaluating HSV susceptibility to nucleoside analogues and for assessing the role of specific viral TK mutations.

  8. Hypertrophic herpes simplex simulating anal neoplasia in AIDS patients: report of five cases.

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    Nadal, Sidney R; Calore, Edenilson E; Manzione, Carmen R; Horta, Sergio C; Ferreira, Aurea F; Almeida, Lis V

    2005-12-01

    Five patients (4 males; mean age, 46.4 years) with painful verrucous perianal lesions caused by herpes simplex virus are described. All patients had had AIDS for a long time and were using highly active antiretroviral therapy. CD4+ counts ranged from 73 to 370/mm3. All lesions were submitted to resection under subdural anesthesia. Histologic examinations revealed epithelial hyperplasia and dense inflammatory process, composed mainly of lymphocytes and plasma cells, extended just to the hypodermis. Immunohistochemistry was positive for herpes simplex virus Type 2 in four patients and for herpes simplex virus Type 1 in one patient, and did not detect human papillomavirus antigens. Three patients had recurrences after 3, 10, and 12 months. Resection was performed on two patients; one had a new recurrence after three months. Oral acyclovir eliminated the lesion in the third patient. The analysis of our patients suggests that herpes simplex virus, Types 1 and 2, may cause verrucous lesions simulating neoplasia in patients with AIDS using antiretroviral therapy.

  9. Valacyclovir in the treatment of acute retinal necrosis

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    Taylor Simon RJ

    2012-09-01

    Full Text Available Abstract Background To report the outcome of oral valacyclovir as the sole antiviral therapy for patients with acute retinal necrosis (ARN. Methods This study reports a retrospective, interventional case series of nine consecutive patients with ten eyes with newly diagnosed ARN treated with oral valacyclovir as the sole antiviral agent. Eight patients received oral valacyclovir 2 g tid (Valtrex, GlaxoSmithKline and one patient with impaired renal function received oral 1 g tid. The main outcome measures were response to treatment, time to initial response to treatment, time to complete resolution of retinitis, best corrected visual acuity (BCVA at final follow-up, retinal detachment and development of recurrent or second eye disease. Results Retinitis resolved in ten of ten (100% affected eyes. The median time to initial detectable response was seven days and the median time to complete resolution was 21 days. A final BCVA of 20/40 or better was achieved in 6/10 (60% of eyes. 3/10 eyes (30% developed a retinal detachment. No patients developed either disease reactivation or second eye involvement over the course of the study (mean follow up 31 weeks, range 7 to 104 weeks. Conclusions Treatment with oral valacyclovir as the sole antiviral therapy resulted in complete resolution of retinitis. Final BCVA and retinal detachment rate were comparable with previously reported outcomes for intravenous acyclovir.

  10. Progressive outer retinal necrosis (PORN) in AIDS patients: a different appearance of varicella-zoster retinitis.

    Science.gov (United States)

    Pavesio, C E; Mitchell, S M; Barton, K; Schwartz, S D; Towler, H M; Lightman, S

    1995-01-01

    Retinal infections caused by the varicella-zoster virus (VZV) have been reported in immunocompetent and immunocompromised individuals. Two cases of a VZV-related retinitis are described with the characteristic features of the recently described progressive outer retinal necrosis (PORN) syndrome. Both patients suffered from the acquired immunodeficiency syndrome (AIDS) with greatly reduced peripheral blood CD4+ T lymphocyte counts, and presented with macular retinitis without vitritis. The disease was bilateral in one case and unilateral in the other. The clinical course was rapidly progressive with widespread retinal involvement and the development of rhegmatogenous retinal detachment with complete loss of vision in the affected eyes despite intensive intravenous antiviral therapy. VZV DNA was identified in vitreous biopsies, by molecular techniques based on the polymerase chain reaction (PCR), in both patients. At present, the use of very high-dose intravenous acyclovir may be the best therapeutic option in these patients for whom the visual prognosis is poor. Intravitreal antiviral drugs could also contribute to the management of these cases.

  11. Atypical manifestation of progressive outer retinal necrosis in AIDS patient with CD4+ T-cell counts more than 100 cells/microL on highly active antiretroviral therapy.

    Science.gov (United States)

    Vichitvejpaisal, Pornpattana; Reeponmahar, Somporn; Tantisiriwat, Woraphot

    2009-06-01

    Typical progressive outer retinal necrosis (PORN) is an acute ocular infectious disease in acquired immunodeficiency syndrome (AIDS) patients with extremely low CD4+ T-cell counts. It is a form of the Varicella- zoster virus (VZV) infection. This destructive infection has an extremely rapid course that may lead to blindness in affected eyes within days or weeks. Attempts at its treatment have had limited success. We describe the case of a bilateral PORN in an AIDS patient with an initial CD4+ T-cell count >100 cells/microL that developed after initiation of highly active antiretroviral therapy (HAART). A 29-year-old Thai female initially diagnosed with human immunodeficiency virus (HIV) in 1998, presented with bilaterally decreased visual acuity after initiating HAART two months earlier. Multiple yellowish spots appeared in the deep retina without evidence of intraocular inflammation or retinal vasculitis. Her CD4+ T-cell count was 127 cells/microL. She was diagnosed as having PORN based on clinical features and positive VZV in the aqueous humor and vitreous by polymerase chain reaction (PCR). Despite combined treatment with intravenous acyclovir and intravitreous ganciclovir, the patient's visual acuity worsened with no light-perception in either eye. This case suggests that PORN should be included in the differential diagnosis of reduced visual acuity in AIDS patients initiating HAART with higher CD4+ T-cell counts. PORN may be a manifestation of the immune reconstitution syndrome.

  12. Coincidence of Varicella-Zoster Virus Anterior Uveitis in a Patient with Chandler's Syndrome

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    Takeshi Joko

    2013-11-01

    Full Text Available Purpose: We report a patient who, based on the clinical manifestations, was originally diagnosed as having Chandler's syndrome and later developed varicella-zoster virus (VZV DNA-positive anterior uveitis. Methods: The patient with Chandler's syndrome who manifested anterior uveitis underwent a complete ophthalmologic examination. Polymerase chain reaction (PCR was used to amplify the viral DNA in the aqueous humor to determine the cause of the intraocular inflammation. Results: Slit-lamp biomicroscopy showed focal iris atrophy and peripheral anterior synechiae (PAS; specular microscopy of the corneal endothelium disclosed the hammered-silver appearance. Based on these clinical findings, we diagnosed this patient as having Chandler's syndrome. During the follow-up period, however, the inflammatory cells suddenly appeared in the anterior chamber with formation of keratic precipitates and an increased intraocular pressure (IOP. VZV DNA was displayed in the aqueous humor by PCR. Based upon the diagnosis of VZV anterior uveitis, corticosteroids and acyclovir were given topically and systemically. The inflammation subsided with these medications; however, trabeculectomy was finally needed to control the IOP due to PAS progression. Conclusion: The coincidence of VZV anterior uveitis with Chandler's syndrome may constitute an implication for the possible viral etiology of iridocorneal endothelial syndrome.

  13. The treatment of facial palsy from the point of view of physical and rehabilitation medicine.

    Science.gov (United States)

    Shafshak, T S

    2006-03-01

    There are evidences to support recommending the early intake of prednisone (in its appropriate dose of 1 mg/kg body weight for up to 70 or 80 mg/day) or the combined use of prednisone and acyclovir (or valacyclovir) within 72 h following the onset of paralysis in order to improve the outcome of Bell's palsy (BP). Although there may be a controversy about the role of physiotherapy in BP or facial palsy, it seemed that local superficial heat therapy, massage, exercises, electrical stimulation and biofeedback training have a place in the treatment of lower motor facial palsy. However, each modality has its indications. Moreover, some rehabilitative surgical methods might be of benefit for some patients with traumatic facial injuries or long standing paralysis without recovery, but early surgery in BP is usually not recommended. However, few may recommend early surgery in BP when there is 90-100% facial nerve degeneration. The efficacy of acupuncture, magnetic pellets and other modalities of physiotherapy needs further investigation. The general principles and the different opinions in treating and rehabilitating facial palsy are discussed and the need for further research in this field is suggested.

  14. Flexibility as a Strategy in Nucleoside Antiviral Drug Design.

    Science.gov (United States)

    Peters, H L; Ku, T C; Seley-Radtke, K L

    2015-01-01

    As far back as Melville Wolfrom's acyclic sugar synthesis in the 1960's, synthesis of flexible nucleoside analogues have been an area of interest. This concept, however, went against years of enzyme-substrate binding theory. Hence, acyclic methodology in antiviral drug design did not take off until the discovery and subsequent FDA approval of such analogues as Acyclovir and Tenofovir. More recently, the observation that flexible nucleosides could overcome drug resistance spawned a renewed interest in the field of nucleoside drug design. The next generation of flexible nucleosides shifted the focus from the sugar moiety to the nucleobase. With analogues such as Seley-Radtke "fleximers", and Herdewijn's C5 substituted 2'-deoxyuridines, the area of base flexibility has seen great expansion. More recently, the marriage of these methodologies with acyclic sugars has resulted in a series of acyclic flex-base nucleosides with a wide range of antiviral properties, including some of the first to exhibit anti-coronavirus activity. Various flexible nucleosides and their corresponding nucleobases will be compared in this review.

  15. Varicella-Zoster-Mediated Radiculitis Reactivation following Cervical Spine Surgery: Case Report and Review of the Literature

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    Doniel Drazin

    2013-01-01

    Full Text Available Varicella-zoster virus and herpes simplex virus types 1 and 2 are neurotropic viruses that can be reactivated after a surgical or stressful intervention. Although such cases are uncommon, consequences can be debilitating, and variable treatment responses merit consideration. We describe a 41-year-old male with a history of varicella-mediated skin eruptions, who presented with continuing right arm pain, burning, and numbness in a C6 dermatomal distribution following a C5-6 anterior cervical discectomy and fusion and epidural steroid injections. The operative course was uncomplicated and he was discharged home on postoperative day 1. Approximately ten days after surgery, the patient presented to the emergency department complaining of severe pain in his right upper extremity and a vesicular rash from his elbow to his second digit. He was started on Acyclovir and discharged home. On outpatient follow-up, his rash had resolved though his pain continued. The patient was started on a neuromodulating agent for chronic pain. This case adds to the limited literature regarding this rare complication, brings attention to the symptoms for proper diagnosis and treatment, and emphasizes the importance of prompt antiviral therapy. We suggest adding a neuromodulating agent to prevent long-term sequelae and resolve acute symptoms.

  16. Acute isolated appendicitis due to Aspergillus carneus in a neutropenic child with acute myeloid leukemia.

    Science.gov (United States)

    Decembrino, Nunzia; Zecca, Marco; Tortorano, Anna Maria; Mangione, Francesca; Lallitto, Fabiola; Introzzi, Francesca; Bergami, Elena; Marone, Piero; Tamarozzi, Francesca; Cavanna, Caterina

    2016-01-01

    We describe a case of isolated acute appendicitis due to Aspergillus carneus in a neutropenic child with acute myeloid leukemia (AML) treated according to the AIEOP AML 2002/01 protocol. Despite prophylaxis with acyclovir, ciprofloxacin and fluconazole administered during the neutropenic phase, 16 days after the end of chemotherapy the child developed fever without identified infective foci, which prompted a therapy shift to meropenem and liposomial amphotericin B. After five days of persisting fever he developed ingravescent abdominal lower right quadrant pain. Abdominal ultrasound was consistent with acute appendicitis and he underwent appendectomy with prompt defervescence. PAS+ fungal elements were found at histopathology examination of the resected vermiform appendix, and galactomannan was low positive. A. carneus, a rare species of Aspergillus formerly placed in section Flavipedes and recently considered a member of section Terrei, was identified in the specimen. Treatment with voriconazole was promptly started with success. No other site of Aspergillus localization was detected. Appendicitis is rarely caused by fungal organisms and isolated intestinal aspergillosis without pulmonary infection is unusual. To our knowledge, this is the first report of infection due to A. carneus in a child and in a primary gastrointestinal infection.

  17. Antitumor and Antiviral Activity of Colombian Medicinal Plant Extracts

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    Betancur-Galvis LA

    1999-01-01

    Full Text Available Extracts of nine species of plants traditionally used in Colombia for the treatment of a variety of diseases were tested in vitro for their potential antitumor (cytotoxicity and antiherpetic activity. MTT (Tetrazolium blue and Neutral Red colorimetric assays were used to evaluate the reduction of viability of cell cultures in presence and absence of the extracts. MTT was also used to evaluate the effects of the extracts on the lytic activity of herpes simplex virus type 2 (HSV-2. The 50% cytotoxic concentration (CC50 and the 50% inhibitory concentration of the viral effect (EC50 for each extract were calculated by linear regression analysis. Extracts from Annona muricata, A. cherimolia and Rollinia membranacea, known for their cytotoxicity were used as positive controls. Likewise, acyclovir and heparin were used as positive controls of antiherpetic activity. Methanolic extract from Annona sp. on HEp-2 cells presented a CC50 value at 72 hr of 49.6x103mg/ml. Neither of the other extracts examined showed a significant cytotoxicity. The aqueous extract from Beta vulgaris, the ethanol extract from Callisia grasilis and the methanol extract Annona sp. showed some antiherpetic activity with acceptable therapeutic indexes (the ratio of CC50 to EC50. These species are good candidates for further activity-monitored fractionation to identify active principles.

  18. Preparation and Properties of Gelatin-Chitosan/Montmorillonite Drug-loaded Microspheres

    Institute of Scientific and Technical Information of China (English)

    ZHENG Junping; SHAN Jiahui; FAN Zhaoming; YAO Kangde

    2011-01-01

    A kind of slow release drug-loaded microspheres were prepared with gelatin,chitosan and montmorillonite(MMT)by an emulsification/chemical cross-linking method using glutaraldehyde as cross-linking agent and acyclovir as model drug.The microspheres were characterized by X-ray diffraction(XRD),Fourier transform infrared(FT-IR)and scanning electron microscopy(SEM),respectively.The morphology,drug content,encapsulation efficiency and drug-release behavior were investigated with different MMT contents.The experimental results indicated that intercalated microspheres could be prepared,the morphology of microspheres was markedly affected by MMT.The glomeration performance of uncross-linked microspheres was improved because of the physical cross-linking of MMT.Drug content and encapsulation efficiency were decreased when increased the content of MMT,but burst release and the drug release were significantly decreased with the addition of MMT.Effective physical cross-linking could be formed when added MMT,and MMT could reduce the content of toxic chemical cross-linking agents.

  19. A Rare Complication of Herpes Zoster: Segmental Zoster Paresis

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    Hooi Khee Teo

    2016-01-01

    Full Text Available Herpes zoster is a common presentation in both the community and emergency department; however segmental zoster paresis is a rare complication that can lead to misdiagnosis. We present a case of a 74-year-old Indian gentleman with a background of well controlled diabetes mellitus, hypertension, and ischaemic heart disease who presented with sudden right lower limb weakness. This was preceded by a 5-day history of paraesthesia starting in the right foot and ascending up the right lower limb. On examination, there was a characteristic vesicular rash in the L2/3 region with MRC grading 3/5 in the right hip flexors. The rest of the neurological examination was unremarkable. MRI of the spine did not show any evidence of spinal disease. The patient was initiated on IV acyclovir with improvement of the lower limb weakness to MRC grading 5/5 as the vesicles improved. This is an interesting case as it highlights a rare presentation of zoster: segmental motor paresis that recovered fully with resolution of the rash. It shows the importance of recognizing motor neuropathy as a complication of shingles as it has a very good prognosis with most patients regaining full motor function of the affected limb with treatment.

  20. MENINGOENCEPHALITIS DUE TO VARICELLA ZOSTER VIRUS IN AIDS PATIENTS. REPORT OF ELEVEN CASES AND REVIEW OF THE LITERATURE

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    Marcelo CORTI

    2015-12-01

    Full Text Available Neurological complications of varicella-zoster virus (VZV are infrequent and include various clinical pictures. The reactivation of VZV in patients with AIDS is generally associated with an acute and severe meningoencephalitis. We report the epidemiological, clinical and virological data from 11 consecutive patients with diagnosis of HIV/AIDS and central nervous system (CNS involvement due to VZV. All patients were male and seropositive for HIV. The primary risk factor for HIV infection was unprotected sexual contact. The median of CD4 T cell count was 142 cells/µL. All of them presented signs and symptoms of meningoencephalitis. Six patients (54.5% presented pleocytosis; they all showed high CSF protein concentrations with a median of 2.1 g/dL. Polymerase chain reaction of cerebrospinal fluid specimen was positive for VZV in all of them and they were treated with intravenous acyclovir at doses of 30/mg/kg/day for 21 days. Overall survival was 63% (7 of 11 patients. The four dead patients had low cellular counts in CSF, below the median of this parameter. VZV should be included among the opportunistic pathogens that can involve CNS with a diffuse and severe meningoencephalitis in patients with advanced HIV/AIDS disease.

  1. Seronegative Herpes simplex Associated Esophagogastric Ulcer after Liver Transplantation

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    Edouard Matevossian

    2008-03-01

    Full Text Available Herpes simplex infection is characterized by acute or subacute infection, often followed by a chronic carrier state. Consecutive recurrences may flare up if immunocompromise occurs. Herpes simplex associated esophagitis or duodenal ulcer have been reported in immunocompromised patients due to neoplasm, HIV/AIDS or therapeutically induced immune deficiency. Here we report the case of an HSV-DNA seronegative patient who developed grade III dysphagia 13 days after allogeneic liver transplantation. Endoscopy revealed an esophageal-gastric ulcer, and biopsy histopathology showed a distinct fibroplastic and capillary ulcer pattern highly suspicious for viral infection. Immunohistochemistry staining revealed a distinct nuclear positive anti-HSV reaction. Antiviral therapy with acyclovir and high-dose PPI led to a complete revision of clinical symptoms within 48 h. Repeat control endoscopy after 7 days showed complete healing of the former ulcer site at the gastroesophageal junction. Although the incidence of post-transplantation Herpes simplex induced gastroesophageal disease is low, the viral HSV ulcer may be included into a differential diagnosis if dysphagia occurs after transplantation even if HSV-DNA PCR is negative.

  2. A Case of 72 Diabetic Woman with Zoster Paresis

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    E. Sajadi

    2009-10-01

    Full Text Available Introduction: VZV is an exclusively human pathogen. The primary infection typically occurs during childhood and causes varicella. As with other members of the herpes viruses’ family, VZV is noninfectious in its latent form but can reactivate at a later time to form intact virions in the involved sensory neurons. These virions then migrate to the skin through axons, spread from cell to cell, and penetrate the epidermis.Case Report: In this case a 72 years old woman with history of diabetes mellitus and hypertension is reported hospitalized because of urinary retention, weakness and parestesia in the right leg, complicated with vesiculoulcerative lesions in sacral area with distribution to the right buttock and vagina. L.P was done to confirm inflammatory radicopathy that showed aseptic meningitis and therapy started with acyclovir and prednisolone. Patient got well and discharged from the hospital.Conclusion: Motor weakness in noncranial nerve is one of the zoster complications known as zoster paresis. Weakness begins suddenly 2-3 weeks after rash and progresses to extremities. In this case 3 weeks after rash, nerve complications were observed. We recommend to do paresthesia examination of skin for eruption in all patients presented with paresis.

  3. Herpes simplex ulcerative esophagitis in healthy children

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    Abdulrahman A Al-Hussaini

    2011-01-01

    Full Text Available Herpes simplex virus is a common cause of ulcerative esophagitis in the immunocompromised or debilitated host. Despite a high prevalence of primary and recurrent Herpes simplex virus infection in the general population, Herpes simplex virus esophagitis (HSVE appears to be rare in the immunocompetent host. We report three cases of endoscopically-diagnosed HSVE in apparently immunocompetent children; the presentation was characterized by acute onset of fever, odynophagia, and dysphagia. In two cases, the diagnosis was confirmed histologically by identification of herpes viral inclusions and culture of the virus in the presence of inflammation. The third case was considered to have probable HSVE based on the presence of typical cold sore on his lip, typical endoscopic finding, histopathological evidence of inflammation in esophageal biopsies and positive serologic evidence of acute Herpes simplex virus infection. Two cases received an intravenous course of acyclovir and one had self-limited recovery. All three cases had normal immunological workup and excellent health on long-term follow-up.

  4. Iontophoretic delivery of lipophilic and hydrophilic drugs from lipid nanoparticles across human skin.

    Science.gov (United States)

    Charoenputtakun, Ponwanit; Li, S Kevin; Ngawhirunpat, Tanansait

    2015-11-10

    The combined effects of iontophoresis and lipid nanoparticles on drug delivery across human epidermal membrane (HEM) were investigated. The delivery of lipophilic and hydrophilic drugs, all trans-retinoic acid (ATRA), salicylate (SA), and acyclovir (ACV), across HEM from lipid nanoparticles, solid lipid nanoparticles (SLN) and nanostructured lipid carriers (NLC), was compared in passive and iontophoresis experiments in vitro. Iontophoresis experiments were also performed with synthetic Nuclepore membrane for comparison. Drug distribution in the skin after iontophoretic delivery with the lipid nanoparticles was examined using a model probe rhodamine B base (RhoB). The drug-loaded lipid nanoparticles had average sizes of ∼ 118-169 nm and a negative zeta potential. Iontophoresis did not enhance the delivery of ATRA across HEM from SLN and NLC. However, HEM distribution study of RhoB suggested that lipophilic drugs could be delivered into the deeper layer of the skin following iontophoretic delivery of the drugs from the lipid nanoparticles. Iontophoresis enhanced the delivery of hydrophilic drug SA with the lipid nanoparticles. Similarly, iontophoresis enhanced the delivery of ACV when it was loaded in SLN. These results suggest that lipid nanoparticles are a promising drug delivery method that can be combined with iontophoresis to improve skin delivery of hydrophilic drugs.

  5. In vitro antiviral activity of Ficus carica latex against caprine herpesvirus-1.

    Science.gov (United States)

    Camero, Michele; Marinaro, Mariarosaria; Lovero, Angela; Elia, Gabriella; Losurdo, Michele; Buonavoglia, Canio; Tempesta, Maria

    2014-01-01

    The latex of Ficus carica Linn. (Moraceae) has been shown to possess antiviral properties against some human viruses. To determine the ability of F. carica latex (F-latex) to interfere with the infection of caprine herpesvirus-1 (CpHV-1) in vitro, F-latex was resuspended in culture media containing 1% ethanol and was tested for potential antiviral effects against CpHV-1. Titration of CpHV-1 in the presence or in the absence of F-latex was performed on monolayers of Madin Darby Bovine Kidney (MDBK) cells. Simultaneous addition of F-latex and CpHV-1 to monolayers of MDBK cells resulted in a significant reduction of CpHV-1 titres 3 days post-infection and this effect was comparable to that induced by acyclovir. The study suggests that the F-latex is able to interfere with the replication of CpHV-1 in vitro on MDBK cells and future studies will determine the mechanisms responsible for the observed antiviral activity.

  6. Herpes Simplex Virus Hepatitis in an Immunocompetent Adult: A Fatal Outcome due to Liver Failure

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    Rachel A. Poley

    2011-01-01

    Full Text Available Objective. To present a case of a healthy 41-year-old female who developed fulminant hepatic failure leading to death. The cause of hepatic failure identified on postmortem exam was herpes simplex virus hepatitis. Design. Observation of a single patient. Setting. Intensive care unit of a tertiary care university teaching hospital in Canada. Patient. 41-year-old previously healthy female presenting with a nonspecific viral illness and systemic inflammatory response syndrome. Intervention. The patient was treated with intravenous fluids and broad-spectrum antibiotics. On the second day of admission, she was found to have elevated transaminases, and, over 48 hours, she progressed to fulminant liver failure with disseminated intravascular coagulopathy, refractory lactic acidosis, and shock. She progressed to respiratory failure requiring intubation and mechanical ventilation. She was started on N-acetylcysteine, a bicarbonate infusion, hemodialysis, and multiple vasopressors and inotropes. Measurements and Main Results. Despite treatment, the patient died roughly 70 hours after her initial presentation to hospital. Her postmortem liver biopsy revealed herpes simplex virus hepatitis as her cause of death. Conclusions. Herpes simplex virus must be considered in all patients presenting with liver failure of unknown cause. If suspected, prompt treatment with acyclovir should be initiated.

  7. Varicella vaccine for immunocompromised children: results of collaborative studies in the United States and Canada.

    Science.gov (United States)

    LaRussa, P; Steinberg, S; Gershon, A A

    1996-11-01

    Varicella vaccine in immunocompromised children was clinically evaluated in 575 US and Canadian children with leukemia in remission by the Varicella Vaccine Collaborative Study. Most children had chemotherapy stopped 1 week before and 1 week after immunization. Steroids were stopped for 3 weeks (1 week before to 2 weeks after vaccination). Varicella vaccine was safe, immunogenic, and effective in leukemic children at risk for serious disease or death from chickenpox. The major side effect was mild rash in 50% approximately 1 month after immunization. About 40% of children who developed rash were treated with acyclovir. Vaccine efficacy was judged by the degree of protection after a household exposure to varicella; of 123 exposed children, 17 (14%) developed a mild form of varicella. The vaccine protected completely against severe varicella. Leukemic vaccines were less likely to develop zoster than were comparable children with leukemia who had wild type varicella. Thus, varicella vaccine, administered carefully with close follow-up, is extremely beneficial for leukemic children.

  8. Rare cause of odynophagia: Giant esophageal ulcer.

    Science.gov (United States)

    Veroux, Massimiliano; Aprile, Giuseppe; Amore, Francesca F; Corona, Daniela; Giaquinta, Alessia; Veroux, Pierfrancesco

    2016-04-14

    Gastrointestinal complications are a frequent cause of morbidity after transplantation and may affect up to 40% of kidney transplant recipients. Here we report a rare case of idiopathic giant esophageal ulcer in a kidney transplant recipient. A 37-year-old female presented with a one-week history of odynophagia and weight loss. Upon admission, the patient presented cold sores, and a quantitative cytomegalovirus polymerase chain reaction was positive (10(5) copies/mL). An upper endoscopy demonstrated the presence of a giant ulcer. Serological test and tissue biopsies were unable to demonstrate an infectious origin of the ulcer. Immunosuppression was reduced and everolimus was introduced. An empirical i.v. therapy with acyclovir was started, resulting in a dramatic improvement in symptoms and complete healing of the ulcer. Only two cases of idiopathic giant esophageal ulcer in kidney transplant recipients have been reported in the literature; in both cases, steroid therapy was successful without recurrence of symptoms or endoscopic findings. However, this report suggests that correction of immune imbalance is mandatory to treat such a rare complication.

  9. Stomatitis Aftosa Rekuren dengan Kecurigaan Klinik Infeksi Virus Herpes Simpleks (Laporan Kasus

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    Afi Savitri Sarsito

    2015-10-01

    Full Text Available   Stomatitis Aftosa Rekuren (SAR merupakan penyakit mulut yang paling banyak dijumpai di masyarakat.Pada umumnya penyakit ini memberikan gejala-gejala klinik yang khas yaitu adanya ulserasi yang bersifat ulang kambuh pada mukosa mulut, tanpa disertai dengan tanda-tanda lain dari penyakit. Pada makalah ini dibahas 3 kasus SAR yang tidak biasa yaitu selain gejala SAR, terdapat pula tanda-tanda adanya infeksi virus Herpes SImpleks (VHS.Dari pemeriksaan sitologi pada ketiga kasus ini, dijumpai adanya badan inklusi VHS, tetapi dari pemberian terapi dengan Acyclovir ternyata 2 kasus memberikan manfaat, dan pada 1 kasus tidak ada manfaatnya. Hal ini berarti pada 2 kasus yang pertama terdapat peran dari VHS pada proses penyakit dan pada 1 kasus tidak ada. Keadaan semacam ini perlu diamati dan diwaspadai mengingat kedua penyakit mempunyai prinsip terapi yang berbeda.Pada SAR seringkali diperlukan pemberian terapi dengan bahan-bahan golongan kortikosteroid, sedangkan pada infeksi VHS pemberian bahan ini merupakan kontra indikasi. Selanjutnya pada makalah ini juga diberikan saran-saran untuk pengelolaan penyakit yang dapat digunakan oleh para dokter gigi apabila mendapatkan masalah yang sama.

  10. Adult-onset opsoclonus-myoclonus-ataxia syndrome as a manifestation of brazilian lyme disease-like syndrome: a case report and review of literature

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    Angelina Maria Martins Lino

    2014-03-01

    Full Text Available Described in 1962, the opsoclonus-myoclonus-ataxia syndrome (OMAS is a rare, neurologically debilitating disorder with distinct characteristics that may begin in childhood or adult life. Although many cases remain without etiological diagnosis, others are related to neoplasms and infectious diseases. We report a 41-year-old previously healthy male with an 8-day history of headache, vertigo, nausea, vomiting, and nystagmus. After a normal brain computed tomography and lymphocytic pleocytosis in cerebral spinal fluid (CSF, intravenous acyclovir therapy was initiated in the emergency room. On the third day of hospitalization, the diagnosis of OMAS was made based on the presence of chaotic and irregular eye movements, dysarthric speech, gait instability, generalized tremor, and myoclonic jerks. In the face of his neurological worsening, ampicillin followed by nonspecific immunotherapy (methylprednisolone and intravenous immunoglobulin was prescribed, with mild clinical improvement. After a thorough laboratory workup, the definite diagnosis of neuroborreliosis was established and ceftriaxone (4 g/daily/3wks and doxycycline (200 mg/day/2 mo was administered. Toward the end of the ceftriaxone regimen, the neurologic signs substantially improved. We believe this to be the first case description of OMAS as clinical presentation of Brazilian Lyme disease-like syndrome (Baggio-Yoshinari syndrome.

  11. [Amphiphilic cyclodextrins and their applications. Preparation of nanoparticles based on amphiphilic cyclodextrins for biomedical applications].

    Science.gov (United States)

    Parrot-Lopez, H; Perret, F; Bertino-Ghera, B

    2010-01-01

    Solubilization of hydrophobic drugs at the molecular level as inclusion complexes inside cyclodextrins (CDs) offers a good alternative for improving their stability, solubility and bioavailability, and for preventing against their possible toxicity or controlling secondary effects. Therefore CDs are widely used as solubilizing excipients. However since dissociation takes place too readily upon dilution, inclusion complexes inside simple water-soluble CD appears ineffective for drug delivery applications. Chemical modifications of CDs allow them to self-organize as larger assemblies useful for resolving this lability issue. Depending on the position, the number and the nature of these groups, amphiphilic CDs can form assemblies such as vesicles, solid-lipid nanoparticles, nanospheres, liquid crystals, or micellar systems. This review deals with the synthesis of amphiphilic cyclodextrins leading to supramolecular assemblies and the physical properties of these assemblies. From the first sulfonated amphiphilic cyclodextrins isolated in our laboratory in 2003, to the latest ones being regioselectively functionalized by two or four fluoroalkyl chains, through the persubstituted fluorinated cyclodextrines, all these amphiphilic cyclodextrins have shown good abilities for encapsulation. Complexation of bioactive molecules (acyclovir) by these modified alpha-cyclodextrin derivatives, the encapsulation efficiency and release profile were measured as an assessment of the properties of such nanoparticles regarding drug delivery applications.

  12. Sudden onset unilateral sensorineural hearing loss after rabies vaccination.

    Science.gov (United States)

    Okhovat, Saleh; Fox, Richard; Magill, Jennifer; Narula, Antony

    2015-12-15

    A 33-year-old man developed profound sudden onset right-sided hearing loss with tinnitus and vertigo, within 24 h of pretravel rabies vaccination. There was no history of upper respiratory tract infection, systemic illness, ototoxic medication or trauma, and normal otoscopic examination. Pure tone audiograms (PTA) demonstrated right-sided sensorineural hearing loss (thresholds 90-100 dB) and normal left-sided hearing. MRI internal acoustic meatus, viral serology (hepatitis B, C, HIV and cytomegalovirus) and syphilis screen were normal. Positive Epstein-Barr virus IgG, viral capsid IgG and anticochlear antibodies (anti-HSP-70) were noted. Initial treatment involved a course of high-dose oral prednisolone and acyclovir. Repeat PTAs after 12 days of treatment showed a small improvement in hearing thresholds. Salvage intratympanic steroid injections were attempted but failed to improve hearing further. Sudden onset sensorineural hearing loss (SSNHL) is an uncommon but frightening experience for patients. This is the first report of SSNHL following rabies immunisation in an adult.

  13. Psychosis in a 15-Year-Old Female with Herpes Simplex Encephalitis in a Background of Mannose-Binding Lecithin Deficiency

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    Kenneth Asogwa

    2017-01-01

    Full Text Available Historically, psychotic disorder has been associated with viral infection. Herpes simplex infections and Epstein-Barr virus (EBV among other viral infections have been implicated in psychotic disorder. Of note in this case report is psychotic disorder that occurred following reactivation of herpes simplex infection in a background of mannose-binding lecithin (MBL deficiency, childhood EBV infection, and severe psychosocial stress. Herpes simplex encephalitis (HSE remains a significant cause of morbidity and mortality despite advancement in its treatment with intravenous acyclovir. Many studies have reported psychiatric and neurological manifestation of herpes simplex infection following primary or reactivated infection, while others suggest milder clinical course of herpes simplex encephalitis in a background of immunosuppression. Another contributory factor to psychotic disorder in this case is childhood EBV exposure which has been reported to increase the risk of psychosis in adolescence and adulthood. This case report describes a 15-year-old female with MBL deficiency who presented with psychosis caused by reactivated herpes simplex infection and had good clinical recovery. Based on childhood Epstein-Barr virus exposure and psychosis in adolescence (current case, she is at increased risk of psychotic disorder in adulthood, which underscores the importance of long-term monitoring.

  14. Chickenpox pneumonia. Case presentation. Dora Ngiza hospital, Port Elizabeth, South Africa.

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    Gilberto Serrano Ocaña

    2009-03-01

    Full Text Available Chickenpox is an exanthematic highly infectious disease produced by the Varicella zoster virus (VZV, commonly occurs in childhood, 90% of cases occurred in children under 12 years of age, 10% of the population over 15 years is susceptible to suffer it. It is an airborne illness, the inhale virus cause an infection in the initial respiratory epithelium, the virus spreads to distant cells of the reticuloendothelial system, finally, there is a state of viremia with skin lesions, although the spread can also be extended to the viscera. The deterioration of the cell-mediated immunity caused by coexisting diseases, HIV infection, cancer, hemato-oncology illnesses, steroid use, as well as advanced age, smoking, chronic obstructive pulmonary disease and hemorrhagic nature of the Skin lesions, are risk factors for developing Varicella-Zoster pneumonia. In this article we describe a case of chickenpox in a young HIV positive patient complicated with Varicella-Zoster pneumonia. Despite of the treatment with acyclovir, prednisone and supportive measures had a fatal outcome.

  15. Antiviral activity of extracts from Brazilian seaweeds against herpes simplex virus

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    Angélica Ribeiro Soares

    2012-08-01

    Full Text Available Organic extracts of 36 species of marine algae (sixteen species of Rhodophyta, eight species of Ochrophyta and twelve species of Chlorophyta from seven locations on the Brazilian coast were evaluated for their anti-HSV-1 and anti-HSV-2 activity resistant to Acyclovir (ACV. Activity tests in crude extracts, followed by the identification of the major compounds present, were performed for all species. The chemical profiles of all crude extracts were obtained by ¹H-NMR and 13C-NMR spectroscopy. The percentage of extracts with antiviral activity was higher for HSV-1 (86.1% than for HSV-2 (55.5%. The green algae Ulva fasciata and Codium decorticatum both showed the highest activity (99.9% against HSV-1, with triacylglycerols and fatty acids as the major components. The red alga Laurencia dendroidea showed good activity against HSV-1 (97.5% and the halogenated sesquiterpenes obtusol and (--elatol were identified as the major components in the extract. Against HSV-2, the green alga Penicillus capitatus (Chlorophyta and Stypopodium zonale (Ochrophyta were the most active (96.0 and 95.8%. Atomaric acid, a meroditerpene, was identified as the major secondary metabolite in the S. zonale extract. These results reinforce the role of seaweeds as important sources of compounds with the potential to enter into the pipeline for development of new drugs against herpes simplex.

  16. Coinfection with a novel fibropapilloma-associated herpesvirus and a novel Spirorchis sp. in an eastern box turtle (Terrapene carolina) in Florida.

    Science.gov (United States)

    Yonkers, Sara B; Schneider, Renata; Reavill, Drury R; Archer, Linda L; Childress, April L; Wellehan, James F X

    2015-07-01

    Herpesviruses are important pathogens of chelonians, and include Chelonid herpesvirus 5, which is associated with fibropapillomatosis in sea turtles. Spirorchid trematodes are blood flukes that reside within the cardiovascular system of marine turtles and may be associated with severe disease. An eastern box turtle (Terrapene carolina) at the South Florida Wildlife Care Center (Fort Lauderdale, Florida) was presented to the facility with papillomatous growths behind both rear legs. Surgical removal resulted in remission for 8 months; however, lesions recurred, prompting a second surgery and acyclovir therapy. Surgical biopsies revealed subacute superficial inflammation associated with the supporting stroma of the cutaneous papillomas and granulomas within the superficial dermis containing fragmented and collapsed brown trematode eggs surrounded by multinucleated giant cells and epithelioid macrophages. Pan-herpesviral and pan-trematode consensus polymerase chain reaction and sequencing were run on tissue samples. Comparative sequence analysis revealed a novel alphaherpesvirus and a novel trematode in the genus Spirorchis. The animal became anorexic and was euthanized due to poor quality of life. While we do not yet have a complete understanding of the effects of herpesvirus and trematode infections in eastern box turtles, the findings thus presented provide initial insights into the disease relationships among these chelonians.

  17. Varicella zoster meningitis complicating combined anti-tumor necrosis factor and corticosteroid therapy in Crohn's disease.

    Science.gov (United States)

    Ma, Christopher; Walters, Brennan; Fedorak, Richard N

    2013-06-01

    Opportunistic viral infections are a well-recognized complication of anti-tumor necrosis factor (TNF) therapy for inflammatory bowel disease (IBD). Cases of severe or atypical varicella zoster virus infection, both primary and latent reactivation, have been described in association with immunosuppression of Crohn's disease (CD) patients. However, central nervous system varicella zoster virus infections have been rarely described, and there are no previous reports of varicella zoster virus meningitis associated with anti-TNF therapy among the CD population. Here, we present the case of a 40-year-old male with severe ileocecal-CD who developed a reactivation of dermatomal herpes zoster after treatment with prednisone and adalimumab. The reactivation presented as debilitating varicella zoster virus meningitis, which was not completely resolved despite aggressive antiviral therapy with prolonged intravenous acyclovir and subsequent oral valacyclovir. This is the first reported case of opportunistic central nervous system varicella zoster infection complicating anti-TNF therapy in the CD population. This paper also reviews the literature on varicella zoster virus infections of immunosuppressed IBD patients and the importance of vaccination prior to initiation of anti-TNF therapy.

  18. A prodigious lichen planus pigmentosus: The Wolf’s isotopic response

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    Yugandar I, Shiva Kumar, Sai Prasad, Srilakshmi P, Akshaya N, Abhiram R, Sujalalitha K, Meghana GB

    2014-07-01

    Full Text Available Lichen planus is a pruritic, benign, papulosquamous, inflammatory dermatosis of unknown etiology that affects either or all of the skin, mucous membrane, hair and nail. In its classic form, it presents with violaceous, scaly, flat-topped, polygonal papules. A female patient aged 43 years with a history of pruritic eruptions for a period of one month over the right armpit and back of the right chest (C8, T1, T2, T3 Dermatomes. She had a history of herpes zoster in the same localization, which had been treated with topical and oral acyclovir two months prior to this visit. This variant may represent as an example of the Wolf’s isotopic response. We presented our case because of its rarity as a Dermatomal distribution of lichen planus pigmentosus (LPP and its appearance in the area of healed herpes zoster as an isotopic response. The case well highlights this unusual condition and represents the first case reported in Indian dermatology literature to our best of knowledge. The clinical and histological features of this case are described here.

  19. Herpes simplex 1 stomatitis after cleft palate repair: a case report and guidelines for management.

    Science.gov (United States)

    Evangelista, Maristella S; Tracy, Lauren; Wells, James H

    2015-05-01

    Herpes simplex virus (HSV) primary infection and reactivation has been associated with the inflammation and transient decrease in immunocompetence after surgery and local trauma. In addition, HSV infection is known to impair wound healing, increase risk of scarring, and impede connective tissue graft transplantation. To our knowledge, this is the first case of HSV infection complicating cleft palate repair presented in literature. In this report, we present a case of primary HSV infection occurring in a healthy 26-month-old patient after repair of the secondary cleft palate with mucoperichondrial flaps and V-Y pushback. The patient developed high fever on postoperative day 1, which was followed by perioral vesicular lesions and multiple intraoral ulcerations involving the lips, palate, and posterior pharynx. Unknown to the surgeons, the patient was exposed to HSV before surgery by a sibling with orolabial HSV infection. The infective cause was ascertained via polymerase chain reaction for HSV-1 DNA, and the infection was treated with topical and intravenous acyclovir for 1 week. The patient recovered well with adequate flap healing, good aesthetic outcome, and no complications on 1-month follow-up. This report underscores the importance of prompt recognition of herpetic infections in the patient with craniofacial surgery and reviews the association and complications of HSV infection in surgical healing. Early identification with prompt antiviral therapy and meticulous wound care are essential to ameliorate the scarring and delayed wound healing associated with HSV infection.

  20. Infectious complications in 126 patients treated with high-dose chemotherapy and autologous peripheral blood stem cell transplantation.

    Science.gov (United States)

    Salazar, R; Solá, C; Maroto, P; Tabernero, J M; Brunet, J; Verger, G; Valentí, V; Cancelas, J A; Ojeda, B; Mendoza, L; Rodríguez, M; Montesinos, J; López-López, J J

    1999-01-01

    The effect of an extensive prophylactic antimicrobial regimen was prospectively assessed in 126 patients after high-dose chemotherapy and autologous PBSC. They received ciprofloxacin (500 mg/12 h), acyclovir (200 mg/6 h), and itraconazole (200 mg/12 h) orally until neutrophil recovery. Febrile patients received i.v. imipenem (500 mg/6 h) to which vancomycin and amikacin were added if fever persisted for 2-3 and 5 days, respectively. Amphotericin B lipid complex was further given on day 7 or 8 of fever. Median times for a neutrophil count of >0.5 x 10(9)/l and a platelet count of >20 x 10(9)/l were 9 and 11 days. Severe neutropenia (<0.1 x 10(9)/l) lasted for a median of 5 days in which 72% of febrile episodes and 50% of cases of bacteremia occurred. Gram-positive bacteria were isolated in 30 of 40 episodes of bacteremia, 25 of which were caused by Staphylococcus epidermidis. Clinical foci were the intravascular catheter in 35 cases, respiratory infection in 11, cellulitis in two, anal abscess in one, and neutropenic enterocolitis in one. The high incidence of febrile episodes (94%) and bacteremias (31%) may be due to the lack of efficacy of antimicrobial prophylaxis and the persistence of a 5-day period of severe neutropenia.

  1. Association between unprotected ultraviolet radiation exposure and recurrence of ocular herpes simplex virus.

    Science.gov (United States)

    Ludema, Christina; Cole, Stephen R; Poole, Charles; Smith, Jennifer S; Schoenbach, Victor J; Wilhelmus, Kirk R

    2014-01-15

    Studies have suggested that exposure to ultraviolet (UV) light may increase risk of herpes simplex virus (HSV) recurrence. Between 1993 and 1997, the Herpetic Eye Disease Study (HEDS) randomized 703 participants with ocular HSV to receipt of acyclovir or placebo for prevention of ocular HSV recurrence. Of these, 308 HEDS participants (48% female and 85% white; median age, 49 years) were included in a nested study of exposures thought to cause recurrence and were followed for up to 15 months. We matched weekly UV index values from the National Oceanic and Atmospheric Administration to each participant's study center and used marginal structural Cox models to account for time-varying psychological stress and contact lens use and selection bias from dropout. There were 44 recurrences of ocular HSV, yielding an incidence of 4.3 events per 1,000 person-weeks. Weighted hazard ratios comparing persons with ≥8 hours of time outdoors to those with less exposure were 0.84 (95% confidence interval (CI): 0.27, 2.63) and 3.10 (95% CI: 1.14, 8.48) for weeks with a UV index of <4 and ≥4, respectively (ratio of hazard ratios = 3.68, 95% CI: 0.43, 31.4). Though results were imprecise, when the UV index was higher (i.e., ≥4), spending 8 or more hours per week outdoors was associated with increased risk of ocular HSV recurrence.

  2. Evaluation of critical formulation parameters in design and differentiation of self-microemulsifying drug delivery systems (SMEDDSs) for oral delivery of aciclovir.

    Science.gov (United States)

    Janković, Jovana; Djekic, Ljiljana; Dobričić, Vladimir; Primorac, Marija

    2016-01-30

    The study investigated the influence of formulation parameters for design of self-microemulsifying drug delivery systems (SMEDDSs) comprising oil (medium chain triglycerides) (10%), surfactant (Labrasol(®), polysorbate 20, or Kolliphor(®) RH40), cosurfactant (Plurol(®) Oleique CC 497) (q.s. ad 100%), and cosolvent (glycerol or macrogol 400) (20% or 30%), and evaluate their potential as carriers for oral delivery of a poorly permeable antivirotic aciclovir (acyclovir). The drug loading capacity of the prepared formulations ranged from 0.18-31.66 mg/ml. Among a total of 60 formulations, three formulations meet the limits for average droplet size (Z-ave) and polydispersity index (PdI) that have been set for SMEDDSs (Z-ave≤100nm, PdIdrug release rates of 0.325 mg cm(-2)min(-1) and 0.323 mg cm(-2)min(-1), respectively, and significantly enhanced drug permeability in the parallel artificial membrane permeability assay (PAMPA), in comparison with the pure drug substance. The results revealed that development of SMEDDSs with enhanced drug loading capacity and oral delivery potential, required optimization of hydrophilic ingredients, in terms of size of hydrophilic moiety of the surfactant, surfactant-to-cosurfactant mass ratio (Km), and log P of the cosolvent.

  3. Antiviral activity of monoterpenes beta-pinene and limonene against herpes simplex virus in vitro.

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    Akram Astani

    2014-06-01

    Full Text Available Essential oils are complex mixtures containing compounds of several different functional- group classes. Depending on the structure, we can distinguish monoterpenes, phenylpropanes, and other components. Here in this study two monoterpene compounds of essential oils, i.e. β-pinene and limonene were examined for their antiviral activity against herpes simplex virus type 1 (HSV-1 in vitro.All antiviral assays were performed using RC-37 cells. Cytotoxicity was determined in a neutral red assay, antiviral assays were performed with HSV-1 strain KOS. The mode of antiviral action was evaluated at different periods during the viral replication cycle. Acyclovir was used as positive antiviral control.Beta-pinenene and limonenen reduced viral infectivity by 100 %. The mode of antiviral action has been determined, only moderate antiviral effects were revealed by monoterpenes when these drugs were added to host cells prior infection or after entry of HSV into cells. However, both monoterpenes exhibited high anti-HSV-1 activity by direct interaction with free virus particles. Both tested drugs interacted with HSV-1 in a dose-dependent manner thereby inactivating viral infection.These results suggest that monoterpenes in essential oils exhibit antiherpetic activity in the early phase of viral multiplication and might be used as potential antiviral agents.

  4. Prolonged varicella-zoster virus reinfection in an adult after unrelated cord blood transplantation

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    Masahiro Oka

    2012-01-01

    Full Text Available Most varicella-zoster virus (VZV infections after cord blood transplantation (CBT present as localized herpes zoster. Here, we report a case of VZV reinfection in an adult patient after CBT that appeared clinically to be varicella. A 50-year-old Japanese man underwent CBT for the management of acute lymphoblastic leukemia. Seventeen months later, he developed a small number of vesicles with umbilicated centers. A skin biopsy showed an intraepidermal blister containing degenerated balloon cells. Subsequently, the skin eruption developed over his entire body. The patient was treated with intravenous acyclovir for 5 days, followed by oral valacyclovir for 9 days. It took more than 3 weeks for most of the skin lesions to scab. Serum levels of anti-VZV IgG on days 3 and 33 after the onset of the skin eruption were negative and 260 mIU/ml, respectively. Serum anti-VZV IgM on days 3 and 33 was not detected. Our patient was diagnosed with VZV reinfection.

  5. Effect of Traditional Chinese Medicine Antiviral Capsules On Animal Model Genital Herpes and HSV-2 in Cell Culture

    Institute of Scientific and Technical Information of China (English)

    范瑞强; 李红毅; 谢长才; 禤国维; 朱宇同

    2001-01-01

    Objective: To study the effect of traditional Chinese medicine antiviral capsules in the treatment of genital herpes.Methods: Using female guinea pig genital herpes as the animal model, this study used oral administration of two formulations of antiviral capsules (AC) and observed the effect on vaginal HSV-2 titers and vulvar symptoms. Cell cultures were also used to examine the direct inactivation of HSV-2 by the antiviral capsules and the suppression of HSV-2 via three drug administration methods.Results: There was no significant difference of mean vaginal virus titers between the antiviral capsule groups and that of the positive acyclovir (ACV) control (P>0.05). Mean vulvar symptom scores of the two antiviral capsule groups were also significantly lower than that of the saline negative control group on days 2, 3, 5, 7 and 8 (P<0.05) and similar to that of the ACV control (P>0.05). Cell culture showed the minimum inhibitory concentrations of antiviral capsules No. 1 and No. 2 were 0.390625 mg/ml and 1,5625 mg/ml, respectively.Conclusion: The traditional Chinese medicine antiviral capsules had suppressive effects on HSV-2 in both animal model GH and in vitro cell culture.

  6. Cytotoxic, Virucidal, and Antiviral Activity of South American Plant and Algae Extracts

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    Paula Faral-Tello

    2012-01-01

    Full Text Available Herpes simplex virus type 1 (HSV-1 infection has a prevalence of 70% in the human population. Treatment is based on acyclovir, valacyclovir, and foscarnet, three drugs that share the same mechanism of action and of which resistant strains have been isolated from patients. In this aspect, innovative drug therapies are required. Natural products offer unlimited opportunities for the discovery of antiviral compounds. In this study, 28 extracts corresponding to 24 plant species and 4 alga species were assayed in vitro to detect antiviral activity against HSV-1. Six of the methanolic extracts inactivated viral particles by direct interaction and 14 presented antiviral activity when incubated with cells already infected. Most interesting antiviral activity values obtained are those of Limonium brasiliense, Psidium guajava, and Phyllanthus niruri, which inhibit HSV-1 replication in vitro with 50% effective concentration (EC50 values of 185, 118, and 60 μg/mL, respectively. For these extracts toxicity values were calculated and therefore selectivity indexes (SI obtained. Further characterization of the bioactive components of antiviral plants will pave the way for the discovery of new compounds against HSV-1.

  7. Monitoring apoptosis of TK-GFP-expressing ACC-M cells induced by ACV using FRET technique

    Science.gov (United States)

    Xiong, Tao; Zhang, Zhihong; Lin, Juqiang; Yang, Jie; Zeng, Shaoqun; Luo, Qingming

    2006-09-01

    Apoptosis is an evolutionary conserved cellular process that plays an important role during development, but it is also involved in tissue homeostasis and in many diseases. To study the characteristics of suicide gene system of the herpes simplex virus thymidine kinase (HSV-tk) gene in tumor cells and explore the apoptosis phenomena in this system and its effect on the human adenoid cystic carcinoma line ACC-M cell, we detected apoptosis of CD3- (ECFP-CRS-DsRed) and TK-GFP-expressing ACC-M (ACC-M-TK-GFP-CD3) cells induced by acyclovir (ACV) using fluorescence resonance energy transfer (FRET) technique. CD3 is a FRET-based indicator for activity of caspase-3, which is composed of an enhanced cyan fluorescent protein, a caspase-3 sensitive linker, and a red fluorescent protein from Discosoma with efficient maturation property. FRET from ECFP to DsRed could be detected in normal ACC-M-TK-GFP-CD3 cells, and the FRET efficient was remarkably decreased and then disappeared during the cells apoptosis induced by ACV. It was due to the activated caspase-3 cleaved the CD3 fusion protein. In this study, the results suggested that the AVC-induced apoptosis of ACC-M-TK-GFP-CD3 cells was through caspase-3 pathway.

  8. Neonatal testicular cell transplantation restores murine spermatogenesis damaged in the course of herpes simplex virus-induced orchitis.

    Science.gov (United States)

    Malolina, Ekaterina A; Kulibin, Andrey Yu; Kushch, Alla A

    2016-04-01

    Genital tract infection and inflammation may affect male fertility, causing germ and Sertoli cell loss. We determined if testicular cell transplantation is effective at repairing testicular injury induced by herpes simplex virus (HSV) orchitis. ROSA26 mice were used as donors and the recipients were C57BL/6 mice after HSV testicular inoculation; some of the recipients were treated with the antiviral drug acyclovir (ACV). ACV reduced the amount of HSV antigen in testes on Day 3 after transplantation and enhanced the efficacy of transplantation at Day 30. In recipient testes, donor Sertoli cells formed new seminiferous tubules; significantly more new tubules were observed in the testes of ACV-treated mice compared with mice not treated with ACV (17.8% vs 3.6%). Over half (50.4%) of new tubules in ACV-treated testes contained germ cells and round spermatids were detected in 14.2% of new tubules compared with 15.9% and 5.3% in testes not treated with ACV, respectively. At Day 150 the seminiferous epithelium was completely recovered in some donor tubules and elongated spermatids were observed inside it. Thus, our findings reveal the effectiveness of the combination of antiviral therapy with neonatal testis-cell transplantation for the restoration of spermatogenesis damaged by viral infection.

  9. Long-term observation of herpes simplex virus type 1 (HSV-1) infection in a child with Wiskott-Aldrich syndrome and a possible reactivation mechanism for thymidine kinase-negative HSV-1 in humans.

    Science.gov (United States)

    Shiota, Tomoyuki; Kurane, Ichiro; Morikawa, Shigeru; Saijo, Masayuki

    2011-01-01

    Herpes simplex virus type 1 (HSV-1) infections in a child with congenital immunodeficiency syndrome were observed over a 10-year period. The child suffered from recurrent and severe HSV-1 mucocutaneous infections. He frequently suffered from acyclovir (ACV)-resistant (ACV(r)) HSV-1 infection in the later phase of his life, especially after the episode of ACV(r) HSV-1 infection. Virological analyses on the HSV-1 isolates recovered from this patient revealed that all the ACV(r) HSV-1 isolates were thymidine kinase (TK)-negative (TK(-)) due to a single cytosine (C) deletion within the 4-C residues (positions 1061 to 1064) in the TK gene, indicating that the recurrent TK(-)/ACV(r) HSV-1 infections throughout the patient's life were due to the identical ACV(r) HSV-1 strain. Furthermore, it was found that the ACV-sensitive (ACV(s)) isolate recovered from the skin lesions that appeared between the episodes of ACV(r) infection at the ages of 8 and 9 contained ACV(r) HSV-1 with the same mutation in the TK gene. These results indicate that, although TK activity is required for reactivation of TK(+)/ACV(s) HSV-1 from latency and TK(-)/ACV(r) HSV-1 is unable to reactivate from latency, the TK(-)/ACV(r) HSV-1 strain isolated herein reactivated in this patient, possibly by using the TK activity induced by the latently co-infected TK(+)/ACV(s) HSV-1.

  10. Development of mannosylated liposomes for bioadhesive oral drug delivery via M cells of Peyer's patches.

    Science.gov (United States)

    Pukanud, Pongthep; Peungvicha, Penchom; Sarisuta, Narong

    2009-07-01

    The aim of this study was to develop mannosylated liposomes as bioadhesive carriers for oral drug delivery. Two kinds of acyclovir (ACV)-entrapped mannosylated liposomes, i.e. ManN-ACV-lip and PAM-ACV-lip, were prepared by the use of mannosamine HCl (ManN) and p-aminophenyl-alpha-D-mannopyranoside (PAM), respectively. The mean sizes, drug entrapment efficiency, and loading capacity values of all liposomal formulations were in the ranges of 233-371 nm, 82-95%, and 42-47%, respectively. The mean size of PAM-ACV-lip was significantly smaller than those of conventional ACV liposomes and ManN-ACV-lip due to the more conical packing parameter of mannose-conjugated phospholipid. The mannosylating group grafted into bilayer membrane resulted in a decrease in drug entrapment, owing to competitive binding. The in vitro drug absorptions through everted sacs of mice ileum of both mannosylated ACV liposomes were significantly higher than those of conventional ACV liposomes or suspension.

  11. In vitro and in vivo antiherpetic effects of (1R,2R)-1-(5'-methylful-3'-yl)propane-1,2,3-triol.

    Science.gov (United States)

    Sasaki, Kohei; Hayashi, Kyoko; Matsuya, Yuji; Sugimoto, Kenji; Lee, Jung-Bum; Kurosaki, Fumiya; Hayashi, Toshimitsu

    2016-04-01

    In this study, we demonstrated the in vitro and in vivo antiherpetic activities of a stable furan derivative, (1R,2R)-1-(5'-methylful-3'-yl)propane-1,2,3-triol (MFPT), which had originally been isolated from Streptomyces sp. strain FV60. In the present study, we synthesized MFPT from (5-methylfuran-3-yl)methanol in 6 steps for use in the experiments. MFPT showed potent in vitro antiviral activities against two acyclovir (ACV)-sensitive (KOS and HF) strains and an ACV-resistant (A4-3) strain of herpes simplex virus type 1 (HSV-1) and an ACV-sensitive HSV type 2 (HSV-2) UW 268 strain, their selectivity indices ranging from 310 to 530. By intravaginal application of MFPT to mice, the virus yields decreased dose-dependently against the three strains of HSV-1 and HSV-2. When MFPT was applied at a dose of 1.0 mg/day, the lesion scores, as clinical signs manifested by viral infection, were extensively suppressed in HSV-1-infected mice, whereas the lesion scores in HSV-2-infected mice were not markedly decreased. Interestingly, MFPT exerted an inhibitory effect against ACV-resistant HSV-1 in mice to a similar degree as in ACV-sensitive HSV-1-infected mice. Therefore, the compound might have potential for developing a topical antiviral agent that could be also applied to the infections caused by ACV-resistant viruses.

  12. [Preparation of hepatic targeting antivirus agent NGA-ACV and its targeting property].

    Science.gov (United States)

    Fan, J Z; Li, T L; Pang, Q J; Guan, C T; He, Y; Su, K Y

    1996-01-01

    Neoglycoalbumin (NGA), a special ligend of asialoglycoprotein receptor on the hepatocyte, was linked via a butanediacyl bridge to acyclovir to form a conjugate NGA-ACV. By using DTA (Differential thermoanalysis) and HPLC analysis, ACV was shown to be connected with NGA by covalent bonds and stable in blood. The radio-biodistribution of 131I-NGA-ACV with high drug density in vivo was carried out in mice. The maximum absorption of 131I-NGA-ACV in liver was 81.7 +/- 10.4% at 5 min. The radioimage of 131I-NGA-ACV with high or low drug density in rabbit showed no significant difference in liver targeting property. The competitive connection tests indicated that 131I-NGA-ACV was concentrated in liver through receptor mediated mechanism. A tentative test of antihepatitis B of NGA-ACV and ACV in vitro showed that the effective dose of the former was significantly lower than that of the latter.

  13. ACV对Ⅰ型病毒感染豚鼠皮肤阳性细胞计数的分析%To Analyze the Effect of ACV on Positive Cell Counts of Skin of Guinea Pig Infested with I Virus

    Institute of Scientific and Technical Information of China (English)

    杨虹; 邓成国; 张端莲; 王志洁; 黄铁牛

    2004-01-01

    为了进一步了解和研究Ⅰ型人类单纯疱疹病毒引起的疱疹性皮肤病变的动态病理过程,将HSV-1HS-1株感染的豚鼠皮肤动物模型分为HSV-1感染组(抹PBS)和HSV-1治疗组(抹ACV),采用组织学方法,观察了病变发生过程中的皮肤组织学改变.结果显示,感染组豚鼠皮肤发生形态学改变,上皮细胞水肿,胞核和胞浆内形成空泡;治疗组豚鼠皮肤经用阿昔洛韦(acyclovir,ACV)后,豚鼠皮肤形态结构恢复正常,结构清晰.

  14. Acute toxicity evaluation of aminomethylnaphthoquinone (AMNQ 1 in BALB/c mice

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    Valeria Garrido

    2016-06-01

    Full Text Available We report the first preclinical tests showing that aminomethylnaphthoquinone - 3-[N-(n-butyl amino-2,4-diclorobenzyl]-2-hydroxy-1,4-naphthoquinone (AMNQ 1 has low cytotoxicity and anti-HSV-1 activity in vitro in Vero cells. The aim of this study was to evaluate the acute toxicity of AMNQ 1 in BALB/c mice. We used BALB/c female mice to evaluate the median lethal dose (LD50 of AMNQ 1 with 2000 mg/kg body weight and other three concentrations using 550, 175 and 55 mg/kg. We compared this to acyclovir (ACV-50 mg/kg and 10% dimethyl sulfoxide (10% DMSO over a 14-day period. The BALB/c mice received a single oral dose by gavage. There were no deaths in either group and no change in the murine clinical signs. The hematological and biochemical analyses showed some changes that returned to reference levels without impairment of hemostasis. The AMNQ 1 treatment did not induce untoward changes in organs as shown by histological studies. The in vivo results showed that AMNQ 1 has low toxicity. In conclusion, AMNQ 1 is safe and can be potentially used as an anti-HSV-1 agent in future studies.

  15. Synergistic activity of amenamevir (ASP2151) with nucleoside analogs against herpes simplex virus types 1 and 2 and varicella-zoster virus.

    Science.gov (United States)

    Chono, Koji; Katsumata, Kiyomitsu; Suzuki, Hiroshi; Shiraki, Kimiyasu

    2013-02-01

    ASP2151 (amenamevir) is a helicase-primase complex inhibitor with antiviral activity against herpes simplex virus HSV-1, HSV-2, and varicella-zoster virus (VZV). To assess combination therapy of ASP2151 with existing antiherpes agents against HSV-1, HSV-2, and VZV, we conducted in vitro and in vivo studies of two-drug combinations. The combination activity effect of ASP2151 with nucleoside analogs acyclovir (ACV), penciclovir (PCV), or vidarabine (VDB) was tested via plaque-reduction assay and MTS assay, and the data were analyzed using isobolograms and response surface modeling. In vivo combination therapy of ASP2151 with valaciclovir (VACV) was studied in an HSV-1-infected zosteriform spread mouse model. The antiviral activity of ASP2151 combined with ACV and PCV against ACV-susceptible HSV-1, HSV-2, and VZV showed a statistically significant synergistic effect (P<0.05). ASP2151 with VDB was observed to have additive effects against ACV-susceptible HSV-2 and synergistic effects against VZV. In the mouse model of zosteriform spread, the inhibition of disease progression via combination therapy was more potent than that of either drugs as monotherapy (P<0.05). These results indicate that the combination therapies of ASP2151 with ACV and PCV have synergistic antiherpes effects against HSV and VZV infections and may be feasible in case of severe disease, such as herpes encephalitis or in patients with immunosuppression.

  16. Efficacy of ASP2151, a helicase-primase inhibitor, against thymidine kinase-deficient herpes simplex virus type 2 infection in vitro and in vivo.

    Science.gov (United States)

    Himaki, Takehiro; Masui, Yumi; Chono, Koji; Daikoku, Tohru; Takemoto, Masaya; Haixia, Bo; Okuda, Tomoko; Suzuki, Hiroshi; Shiraki, Kimiyasu

    2012-02-01

    ASP2151 was developed as a novel inhibitor of herpes simplex virus (HSV) and varicella-zoster virus helicase-primase. The anti-HSV activity of ASP2151 toward a clinical HSV isolate with acyclovir (ACV)-resistant/thymidine kinase (TK)-deficiency was characterized in vitro and in vivo using a plaque reduction assay and the ear pinna infection in mice. The IC(50) ranged from 0.018 to 0.024 μg/ml, indicating the susceptibility of TK-deficient HSV-2 was similar to that of wild-type HSV-2 strains. Anti-HSV activity of ASP2151 in vivo was evaluated in mice infected with wild-type HSV-2 and TK-deficient HSV-2. ASP2151 significantly reduced the copy numbers of wild-type HSV-2 and TK-deficient HSV-2 at the inoculation ear pinna, while valacyclovir significantly reduced the copy number of wild type HSV-2 but not that of TK-deficient HSV-2 in the inoculated ear pinna. Thus, ASP 2151 showed therapeutic efficacy in mice infected with both wild-type and TK-deficient HSV-2. In conclusion, ASP2151 is a promising novel herpes helicase-primase inhibitor that indicates the feasibility of ASP2151 for clinical application for the treatment of HSV infections, including ACV-resistant/TK-deficient HSV infection.

  17. Susceptibility of herpes simplex virus isolated from genital herpes lesions to ASP2151, a novel helicase-primase inhibitor.

    Science.gov (United States)

    Katsumata, Kiyomitsu; Weinberg, Adriana; Chono, Koji; Takakura, Shoji; Kontani, Toru; Suzuki, Hiroshi

    2012-07-01

    ASP2151 (amenamevir) is a helicase-primase inhibitor against herpes simplex virus type 1 (HSV-1), HSV-2, and varicella-zoster virus. To evaluate the anti-HSV activity of ASP2151, susceptibility testing was performed on viruses isolated from patients participating in a placebo- and valacyclovir-controlled proof-of-concept phase II study for recurrent genital herpes. A total of 156 HSV strains were isolated prior to the dosing of patients, and no preexisting variants with less susceptibility to ASP2151 or acyclovir (ACV) were detected. ASP2151 inhibited HSV-1 and HSV-2 replication with mean 50% effective concentrations (EC(50)s) of 0.043 and 0.069 μM, whereas ACV exhibited mean EC(50)s of 2.1 and 3.2 μM, respectively. Notably, the susceptibilities of HSV isolates to ASP2151 and ACV were not altered after dosing with the antiviral agents. Taken together, these results demonstrate that ASP2151 inhibits the replication of HSV clinical isolates more potently than ACV, and HSV resistant to this novel helicase-primase inhibitor as well as ACV may not easily emerge in short-term treatment for recurrent genital herpes patients.

  18. Atividade antiviral de Musa acuminata Colla, Musaceae Antiviral activity of Musa acuminata Colla, Musaceae

    Directory of Open Access Journals (Sweden)

    Fernanda Otaviano Martins

    2009-09-01

    Full Text Available O presente trabalho avalia a atividade antiviral de extratos e frações de Musa acuminata Colla, Musaceae, coletada em duas regiões do Estado do Rio de Janeiro (Petrópolis e Santo Antônio de Pádua. As inflorescências de M. acuminata apresentaram excelente atividade para os dois vírus avaliados: herpesvírus simples humano tipo 1 e herpesvírus simples humano tipo 2, ambos resistentes ao Aciclovir. Os resultados indicam que os extratos de M. acuminata testados podem constituir alvo potencial para uso em terapias antivirais.This study evaluates the antiviral activity of extracts and fractions of Musa acuminata Colla collected in two regions of Rio de Janeiro State (Petrópolis and Santo Antônio de Pádua. The inflorescences of M. acuminata showed excellent activity for the two virus evaluated: simple human herpesvirus type 1 and simple human herpesvirus type 2, both resistant to Acyclovir. The results indicate that the tested extracts of M. acuminata can be potential target for use in antiviral therapy.

  19. A Review of the Teratogenic Factors Effect on Embryo

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    Manzarbanoo Shojaei fard

    2017-02-01

    Full Text Available Background & Objectives: Teratology is a branch of embryology science that studies causes, mechanisms and abnormal pattern development. Embryo growth traumatic factors during pregnancy are called teratogens that some teratogens pass the placental barrier and cause adverse effect during development stages and malformation, however a drug may improve general health of the mother, but it might be poisonous for embryo and cause diverse malformation. Since study of embryo health and risk factor in this stage is important, the aim of this review article was the investigation of some types of teratosgens (such as radiation, infectious agents, heat disorders, maternal conditions and particularly the effect of teratogenic drugs on embryo including some legal drugs (such as acetaminophen, thalidomide, acyclovir, sedatives and anticonvulsants and illegal drugs (such as nicotine, alcohol, cocaine and marijuana. Conclusion: In general, teratogens depending on the type and duration of exposure in pregnancyperiod, adversely affect embryo and cause various disorders. A better understanding of these teratogens can contribute to prevent these defects, since many other drugs with similar effects and lower teratogenicity can be used to improve mothers’ health.

  20. Evaluation of poly(lactic-co-glycolic acid) and poly(dl-lactide-co-ε-caprolactone) electrospun fibers for the treatment of HSV-2 infection.

    Science.gov (United States)

    Aniagyei, Stella E; Sims, Lee B; Malik, Danial A; Tyo, Kevin M; Curry, Keegan C; Kim, Woihwan; Hodge, Daniel A; Duan, Jinghua; Steinbach-Rankins, Jill M

    2017-03-01

    More diverse multipurpose prevention technologies are urgently needed to provide localized, topical pre-exposure prophylaxis against sexually transmitted infections (STIs). In this work, we established the foundation for a multipurpose platform, in the form of polymeric electrospun fibers (EFs), to physicochemically treat herpes simplex virus 2 (HSV-2) infection. To initiate this study, we fabricated different formulations of poly(lactic-co-glycolic acid) (PLGA) and poly(dl-lactide-co-ε-caprolactone) (PLCL) EFs that encapsulate Acyclovir (ACV), to treat HSV-2 infection in vitro. Our goals were to assess the release and efficacy differences provided by these two different biodegradable polymers, and to determine how differing concentrations of ACV affected fiber efficacy against HSV-2 infection and the safety of each platform in vitro. Each formulation of PLGA and PLCL EFs exhibited high encapsulation efficiency of ACV, sustained-delivery of ACV through one month, and in vitro biocompatibility at the highest doses of EFs tested. Additionally, all EF formulations provided complete and efficacious protection against HSV-2 infection in vitro, regardless of the timeframe of collected fiber eluates tested. This work demonstrates the potential for PLGA and PLCL EFs as delivery platforms against HSV-2, and indicates that these delivery vehicles may be expanded upon to provide protection against other sexually transmitted infections.

  1. Pentagalloylglucose Blocks the Nuclear Transport and the Process of Nucleocapsid Egress to Inhibit HSV-1 Infection.

    Science.gov (United States)

    Jin, Fujun; Ma, Kaiqi; Chen, Maoyun; Zou, Muping; Wu, Yanting; Li, Feng; Wang, Yifei

    2016-01-01

    Herpes simplex virus type 1 (HSV-1), a widespread virus, causes a variety of human viral diseases worldwide. The serious threat of drug-resistance highlights the extreme urgency to develop novel antiviral drugs with different mechanisms of action. Pentagalloylglucose (PGG) is a natural polyphenolic compound with significant anti-HSV activity; however, the mechanisms underlying its antiviral activity need to be defined by further studies. In this study, we found that PGG treatment delays the nuclear transport process of HSV-1 particles by inhibiting the upregulation of dynein (a cellular major motor protein) induced by HSV-1 infection. Furthermore, PGG treatment affects the nucleocapsid egress of HSV-1 by inhibiting the expression and disrupting the cellular localization of pEGFP-UL31 and pEGFP-UL34, which are indispensable for HSV-1 nucleocapsid egress from the nucleus. However, the over-expression of pEGFP-UL31 and pEGFP-UL34 could decrease the antiviral effect of PGG. In this study, for the first time, the antiviral activity of PGG against acyclovir-resistant virus was demonstrated in vitro, and the possible mechanisms of its anti-HSV activities were identified based on the inhibition of nuclear transport and nucleocapsid egress in HSV-1. It was further confirmed that PGG could be a promising candidate for HSV therapy, especially for drug-resistant strains.

  2. Histiocitosis sinusal con linfadenopatía masica (enfermedad de Rosai Dorfman Sinusal histiocytosis with massive lymphadenopathy: report of a case

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    Alejandro Vélez Hoyos

    1995-04-01

    Full Text Available

    Se presenta el caso de una Joven de 14 años con adenomegalias cervicales bilaterales masivas, con diagnóstico clínico de linfoma y cuyo estudio anatomopatológico demostró los hallazgos morfológicos de la histiocitosis sinusal con linfadenopatía masiva. Esta entidad debe tenerse en cuenta en todo diagnóstico diferencial de adenomegalias masivas en niños o pacientes Jóvenes, pues el curso clínico y el pronóstico en general son benignos.

    The case of a 14 year-old girl with massive, bilateral, cervical adenopathies is reported. The Initial diagnosis was a Iymphoma but histological study revealed typical changes of sinusal histiocytosis with massive Iymphadenopathy. The patient was treated with acyclovir and two months later left adenopathies had considerably decreased while the right ones remained unchanged. This disease should be taken Into account in the differential diagnosis of massive adenopathies in children or young people. Its clinical course and prognosis are usually benign.

  3. Mini outbreak of Kaposi′s varicelliform eruption in skin ward: A study of five cases

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    Rao GRR

    2007-01-01

    Full Text Available Background: Kaposi`s varicelliform eruption (KVE represents widespread cutaneous herpes simplex virus (HSV infection in patients with preexisting dermatoses. Occasionally, this infection can present as a nosocomial infection in skin wards, if adequate bed-spacing and barrier nursing methods are not followed. We are reporting five cases of KVE; four cases acquired the infection in a makeshift ward after admission of the first case in May 2005, due to the renovation work of the regular skin ward. Aim: The purpose of this study is to create clinical awareness about this uncommon dermatologic entity and to stress upon the importance of bed-spacing and barrier nursing in skin wards. Methods: Five cases of KVE, three females and two males with different primary dermatoses (pemphigus foliaceus - one, pemphigus vulgaris - two, paraneoplastic pemphigus - one and toxic epidemal necrolysis - one were included in this study. Diagnosis was made clinically and supported with Tzanck smear and HSV serology. All the cases were treated with oral acyclovir. Results: Four out of five cases of KVE recovered with treatment, one case of extensive pemphigus vulgaris with KVE succumbed to death. Conclusion: Mini outbreaks of KVE can occur in skin wards with inadequate bed-spacing and overcrowding of patients. Therefore adequate bed-spacing, barrier nursing and isolation of suspected cases are mandatory to prevent such life-threatening infections.

  4. Role of Autoantibodies to N-Methyl-d-Aspartate (NMDA) Receptor in Relapsing Herpes Simplex Encephalitis: A Retrospective, One-Center Experience.

    Science.gov (United States)

    Sutcu, Murat; Akturk, Hacer; Somer, Ayper; Tatli, Burak; Torun, Selda Hancerli; Yıldız, Edibe Pembegul; Şık, Guntulu; Citak, Agop; Agacfidan, Ali; Salman, Nuran

    2016-03-01

    Post-herpes simplex virus encephalitis relapses have been recently associated with autoimmunity driven by autoantibodies against N-methyl-d-aspartate (NMDA) receptors. Because it offers different treatment options, determination of this condition is important. Between 2011 and 2014, 7 children with proven diagnosis of herpes simplex virus encephalitis were identified in a university hospital of Istanbul. Two patients had neurologic relapse characterized mainly by movement disorders 2 to 3 weeks after initial encephalitis. The first patient received a second 14 days of acyclovir treatment together with antiepileptic drugs and left with severe neurologic sequelae. The second patient was found to be NMDA receptors antibody positive in the cerebrospinal fluid. She was treated with intravenous immunoglobulin and prednisolone. She showed substantial improvement, gradually regaining lost neurologic abilities. Post-herpes simplex virus encephalitis relapses may frequently be immune-mediated rather than a viral reactivation, particularly in children displaying movement disorders like choreoathetosis. Immunotherapy may provide benefit for this potentially devastating condition, like the case described in this report.

  5. Detection of serum IgA to HSV1 and its diagnostic role in sudden hearing loss.

    Science.gov (United States)

    Scalia, Guido; Palermo, Concetta Ilenia; Maiolino, Luigi; Costanzo, Carmela Maria; Zappal, Domenica; Grillo, Caterina; Martines, Anna Maria; Cocuzza, Salvatore; Russo, Raffaela; Serra, Agostino

    2013-01-01

    A viral etiology of sudden hearing loss has been hypothesized by many authors. HSV1 neurotropism and its involvement in sudden hearing loss has implicated HSV1 as one of the most accredited etiological agents. A non-invasive method such as the titration of HSV1-specific IgA was evaluated to determine the role of HSV1 as a possible cause sudden hearing loss. A prospective study was carried out by titration of serum IgA to HSV1 in 93 patients and in a control group of 50 healthy subjects and 35 subjects suffering from recent herpes labialis reactivation. Statistical analysis of the results disclosed that IgA titers to HSV1 higher than 1:80 are suggestive for the association of HSV1 infection and sudden hearing loss. Moreover, acyclovir therapy was effective in 81% of patients who showed high specific IgA titers. Overall, the titration of specific serum IgA to HSV1 can be a useful tool to determine the viral etiology of certain cases of sudden hearing loss. This method is simple to perform and minimally invasive. It can lead to a rapid presumptive diagnosis and to prompt specific therapy, reducing the need for corticosteroids.

  6. Second National Conference on Human Retroviruses. Good news, bad news, and no news.

    Science.gov (United States)

    Del Rio, C

    1995-04-01

    The second annual National Conference on Human Retroviruses and Related Infections was held in Washington, D.C., January 29-February 2, 1995. Lectures addressed such topics as viral dynamics, United States AIDS epidemiology, immunopathogenesis, antiretroviral therapy, and HIV vaccines. Symposia were held on the interactivity of sexually transmitted diseases (STDs) and AIDS, the causes leading to long-term nonprogressors, and factors causing individuals to be exposed but uninfected. Oral presentations reviewed the following: 1) a study on the efficacy of oral ganciclovir for prevention of CMV disease in CMV-seropositive, HIV-infected individuals with CD4 counts of 50 or less; 2) data supporting rifabutin prophylaxis against MAC infection once the CD4 count is below 100; 3) the safety of the screened blood supply in the United States; 4) ACTG 063, a study examining the use of AZT with and without acyclovir; 5) perinatal transmission; and 6) four independent studies examining the efficacy of 3TC (lamivudine) as part of a combination of antiretroviral drugs in HIV-infected patients who were both AZT-naive and AZT-experienced.

  7. June 2012 pulmonary case of the month: what's a millet seed look like?

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    Wesselius LJ

    2012-06-01

    Full Text Available No abstract available. Article truncated at 145 words. History of Present IllnessA 32 year old woman presents with a week long history of dyspnea, cough, fatigue, tiredness and pruritis. She has a past medical history (PMH of Stage IIB, nodular sclerosing Hodgkin’s disease diagnosed in January, 2011. She underwent several cycles of chemotherapy and eventually an autologous stem cell transplant in January, 2012. Her current medications include:■Acyclovir 800mg bid■Ativan 0.5mg q4h/ prn■Hydromorphone 8mg q4h/ prn■Atarax 100mg q6h/ prn■Compazine 10mg q6h/ prnShe had just finished a course of levofloxacin.PMH, SH and FHAs above. She is a life-long nonsmoker and has no history of lung disease.Physical ExaminationHer physical examination was normal.Chest X-rayHer chest x-ray was interpreted as unchanged from previous examinations. Which of the following are indicated?1.Thoracic CT scanning 2.PET scanning 3.Empiric treatment with broad spectrum antibiotics4.All of the above ...

  8. Ethosomes for the delivery of anti-HSV-1 molecules: preparation, characterization and in vitro activity.

    Science.gov (United States)

    Cortesi, R; Ravani, L; Zaid, A N; Menegatti, E; Romagnoli, R; Drechsler, M; Esposito, E

    2010-10-01

    This paper describes the production, characterization and in vitro activity of ethosomes containing two molecules with antiviral activity, such as acyclovir (ACY) and N1-beta-D-ribofuranosyl-pyrazole [3,4d]pyridazin-7(6p-chlorine-phenyl)-one nucleoside (N1CP). Ethosomes were prepared and morphologically characterized by Cryo-TEM. The encapsulation efficiency was 92.3 +/- 2.5% for ACY and 94.2 +/- 2.8% for N1CP. The release of the drug from vesicles, determined by a Franz cell method, indicated that both drugs were released in a controlled manner. In order to possibly guarantee the stability during long-term storage ethosome suspensions was freeze-dried. It was found that the freeze-dried ethosomes' cakes were compact, glassy characterized by low density and quick re-hydration. However, the storage time slightly influences the percentage of drug encapsulation within ethosomes showing a drug leakage after re-hydration around 10%. The antiviral activity against HSV-1 of both drugs was tested by plaque reduction assay in monolayer cultures of Vero cells. Data showed that ethosomes allowed a reduction of the ED50 of N1CP evidencing an increase of its antiviral activity. However, ACY remains more active than N1CP. No differences are appreciable between drug-containing ethosomes before and after freeze-drying. Taken together these results, ethosomal formulation could be possibly proposed as mean for topical administration of anti-herpetic molecules.

  9. Ethosomes: new prospects in transdermal delivery.

    Science.gov (United States)

    Godin, Biana; Touitou, Elka

    2003-01-01

    Ethosomes are noninvasive delivery carriers that enable drugs to reach the deep skin layers and/or the systemic circulation. Although ethosomal systems are conceptually sophisticated, they are characterized by simplicity in their preparation, safety, and efficacy--a combination that can highly expand their application. Ethosomes are soft, malleable vesicles tailored for enhanced delivery of active agents. This article reviews work carried out in vitro, in vivo, in animal models, and in humans with various ethosomal systems incorporating a wide range of drugs. Because of their unique structure, ethosomes are able to encapsulate and deliver through the skin highly lipophilic molecules such as cannabinoids, testosterone, and minoxidil, as well as cationic drugs such as propranolol and trihexyphenidil. Results obtained in a double-blind two-armed randomized clinical study showed that treatment with the ethosomal acyclovir formulation significantly improved all the evaluated parameters. Preliminary studies with plasmids and insulin revealed that the ethosomal carrier may be used for enhanced delivery of these agents. In further work, the ethosomal technology was broadened to introduce agents into cultured cells and microorganisms. Enhanced delivery of bioactive molecules through the skin and cellular membranes by means of an ethosomal carrier opens numerous challenges and opportunities for the research and future development of novel improved therapies.

  10. Expression of Cytokines IL-2, IL-10 and TNF-α in Mice with Herpes Simplex Viral Encephalitis

    Institute of Scientific and Technical Information of China (English)

    WEI Guirong; ZHANG Min; MEI Yuanwu; DONG Jihua

    2006-01-01

    The expression of the cytokines IL-2, IL-10, TNF-α and their roles in mice with herpes simplex viral encephalitis (HSE) were studied. By using semiquantitative reverse transcription polymerase chain reaction (RT-PCR), the expressions of IL-2, IL-10 and TNF-α mRNA in control group, HSE group and acyclovir (ACV)-treated group were detected and the pathological changes of brain were observed. It was found that after HSV1 infection, the cerebral lesions of haemorrhage and necrosis in mice were observed under the microscopy, and the levels of IL-2, IL-10 and TNF-α were increased remarkably. After treatment with ACV after HSV1 infection, the cerebral lesions in mice were improved, the level of IL-2 maintained stable, IL-10 was increased consistently, and TNF-α was decreased significantly as compared with those in HSE group. In acute HSE, many cytokines are upregulated, including IL-2, IL-10 and TNF-α to eliminate virus and TH1 type response is dominant. In convalescence, there is a shift in the cytokine expression profile from TH1 profile to TH2 profile and the shift can inhibit the overexpression of immune response in animals. ACV has remarkable effects in the treatment of HSE.

  11. Probable warfarin and dapsone interaction.

    Science.gov (United States)

    Truong, Teresa; Haley, James

    2012-01-01

    We describe a case of a 41-year-old woman who was stable for over a year on 22.5 mg/week of warfarin. At a follow-up visit, her international normalized ratio (INR) was found to be supratherapeutic at 3.9. Her only significant change was acyclovir initiation for shingles, and clindamycin and dapsone for infection on her right foot. An interaction report was run using Micromedex with no interactions reported. Sixteen percent of the weekly dose was held and maintenance dose was continued. Two weeks later, the INR remained supratherapeutic at 4.3, with discontinuation of clindamycin and dapsone, 5 days earlier, as the only change. This time an interaction report was run using Lexi-Comp, which identified an interaction between warfarin and dapsone. The INR has been therapeutic and stable since discontinuation of transient factors. It is hypothesized that warfarin and dapsone compete for binding on the CYP2C9 and CYP3A4 isoenzymes and therefore serum concentration of warfarin was elevated.

  12. Moyamoya Disease Mimicking Encephalitis

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    Maryam Khalesi

    2014-09-01

    Full Text Available Moyamoya disease is a rare vaso-occlusive illness with an unknown etiology characterized by stenosis of the internal carotid arteries with spontaneous development of a collateral vascular network. A 15-month-old girl was referred to the emergency ward of Imam Reza Hospital due to decreased level of consciousness, focal seizures and fever during the previous 24 hours with an impression of encephalitis. Physical examination revealed left side hemiparesis; however brain CT-Scan did not show any significant lesions. Initial therapy with vancomycin, ceftriaxone and acyclovir was administered. CSF analysis did not show any abnormality and the blood as well as CSF cultures results were negative. Brain MRI showed hyperintensity at right frontal and parietal regions, suggesting vascular lesion. Magnetic resonance angiography (MRA showed bilaterally multiple torsions in vessels at the basal ganglia consistent with moyamoya vessels. In all children exhibiting encephalitis, vascular events such as moyamoya disease should be considered. Brain MRI is a critical tool for this purpose. Common causes of encephalitis such as herpes simplex should also be ruled out.

  13. 点刺拔罐配合氦氖激光联合药物治疗早期带状疱疹的临床观察%Venesection Ventouse Coordinated with Helium-neon Laser Combined with Drugs Treat Early Herpes Zoster

    Institute of Scientific and Technical Information of China (English)

    马荣; 陈宏

    2015-01-01

    Objective]Observe the clinical effect of early herpes zoster which were treated by venesection ventouse combined with helium-neon laser and drugs. [Methods]The control group 32 cases used Famciclovir Tablet,transfer factor capsules,mecobalamin and acyclovir cream-drug for external use. While the experimental group 32 cases used Famciclovir Tablet,transfer factor capsules,mecobalamin and acyclovir cream-drug for external use. While the experimental group besides taking above-medicine, were treated with venesection ventouse and helium-neon laser at the pathological change. [Results]The control group used to cure for an average of 13 ±2.5 days. The experimental group used to cure for an average of 9.6 ±2.4 days. There were significant differences(P<0.05). [Conclusion] Early herpes zoster treated by venesection ventouse combined with helium-neon laser and drugs, can significantly shorten the duration of symptoms, alleviate suffering, and has good clinical efficacy.%[目的]观察点刺拔罐配合氦氖激光联合药物治疗早期带状疱疹的临床疗效。[方法]选取天津市长征医院2013年5月至2013年10月皮肤科门诊就诊的早期带状疱疹患者64例,按其就诊的先后顺序随机分为实验组32例和对照组32例,对照组给予口服药泛昔洛韦片、转移因子胶囊、甲钴胺片及外用药阿昔洛韦软膏;实验组32例,在对照组治疗基础上再施以点刺拔罐配合氦氖激光辅助治疗。运用统计学分析两组患者的平均治愈时间。[结果]对照组达到治愈所用的平均时间为13±2.5天,实验组达到治愈所用的平均时间为9.6±2.4天,实验组优于对照组,差异有统计学意义(P<0.05)。[结论]运用点刺拔罐配合氦氖激光联合药物治疗早期带状疱疹可以明显缩短病程、减轻病痛,有较好的临床疗效。

  14. Infección por herpes virus 1-2 como manifestación del síndrome de reconstitución inmune: Actualización y reporte de un caso de difícil diagnóstico Herpes virus 1-2 infection as a manifestation of the immune reconstitution syndrome: Actualization and case report of difficult diagnose

    Directory of Open Access Journals (Sweden)

    J. Casariego Zulema

    2010-12-01

    Full Text Available Frecuentemente en pacientes Sida las lesiones bucales son de difícil diagnóstico. Nuestro objetivo es actualizar la etiofisiopatogenia de lesiones producidas por herpes virus como una manifestación del síndrome de reconstitución inmune, en mucosa bucal y presentar un paciente inmunosuprimido con lesiones difícilmente diagnosticables de herpes virus simple 1/2. Caso clínico. Paciente masculino, 39 años, homosexual, antecedentes de HZV, TBC y ETS. CMV, hepatitis B y Toxoplasmosis negativas y hepatoesplenomegalia, fibrosis granulomatosa peritoneal y adenopatías mesentéricas activas; 12 CD4 y 5,54 log. de carga viral. Se instaló TARV con buena respuesta. Al mes presentó dificultad para hablar, hipersalia, dolor, y lesiones exofíticas en lengua, aspecto rizado, irregular, con surcos, erosiones, úlceras, y pápulas, cubiertas por pseudomembrana amarillenta. Los cultivos resultaron negativos para hongos, bacterias o parásitos. Sucesivas biopsias analizadas por cinco patólogos descartaron malignidad o autoinmunidad. Diagnósticos similares refirieron "reacción inflamatoria crónica". Un sexto experto por detalles histológicos e inmunomarcación con antisuero HSV-I/HSV-II reveló positividad nuclear y citoplasmática Epifluorescencia y microscopía electrónica certificaron el diagnóstico. El Acyclovir 4g/diarios, 4 semanas fue eficaz. Conclusión. la infección por Herpes virus en pacientes con inmunosupresión severa complica el diagnóstico clínico, por lo cual conviene agotar la búsqueda.Frequently on Aids patients, oral lesions are difficult to diagnose. Our objective is to actualize the etiopathogenie of Herpes virus infection, especially on oral mucosa and to present an immunosupressed patient with atypical oral tonge´s lesions of Herpes virus. A case report. Male 39 years old, homosexual, with HZV, TBC and ETS history. CMV, B hepatitis and toxoplasmosis negative. Activated hepatospleenmegalia, peritoneum granulomatous

  15. 一株溶藻弧菌噬菌体的生理特性研究%A Study of the Biochemical Characteristics of the Vibrio alginolyticus Bacteriophage

    Institute of Scientific and Technical Information of China (English)

    曾林; 邱德全; 谢警鸿; 于鸽

    2012-01-01

    The physiological characteristics of a Vibrio alginolyticus Bacteriophage was studied and the Bacteriophage was isolated from market of aquatic products in Zhanjiang. The results showed that the diameter of Bacteriophage plaque was l-1.5mm (12h). Lytic activity of Bacteriophage lost within 30 min when Bacteriophage exposed to UV light (20W, 30cm). Bacteriophage were UV-sensitive. They had strong lytic activity at pH 8 -11, and the optimum pH value was 11. The lytic cycle of them was 65 min. They were sensitive as the ambient temperature was more than 65℃. They were tolerated with ether and chloroform. They were sensitive to antiviral drugs acyclovir. Routine test dilution(RTD) was 106. Optimal multiplicity of infection was 10.%对从湛江市水产品批发市场分离得到一株溶藻弧菌噬菌体的生理特性进行测定,结果表明:该株噬菌体噬菌斑12h直径为1~1.5mm,对紫外线敏感,暴露在紫外灯(20W,30 cm)下30 min可丧失全部裂解活性;在pH8-11范围内裂解活性较强,最适pH值为11,裂解周期为65 min,对65℃以上的高温敏感,对乙醚和氯仿有较好的耐受性,对抗病毒药物阿昔洛韦敏感,最大常规稀释度为106 CFU/mL,最佳感染复数为10.

  16. The choice of regimens based on bortezomib for patients with newly diagnosed multiple myeloma.

    Directory of Open Access Journals (Sweden)

    Jingsong He

    Full Text Available INTRODUCTION: Bortezomib has significantly improved multiple myeloma (MM response rates, but strategies for choosing bortezomib-based regimens for initial MM therapy are not standardized. Here, we describe four bortezomib-based therapies in Chinese MM patients to determine the optimal chemotherapeutic approach. METHODS: Newly diagnosed symptomatic MM patients at three hematological centers between February 1, 2006 and May 31, 2013 were treated with therapies including bortezomib plus dexamethasone (PD or combinations of PD with either adriamycin (PAD, cyclophosphamide (PCD or thalidomide (PTD for every 28 days. RESULTS: The overall response rate of all the 215 eligible patients was 90.2%. The ORR for PCD, PAD, PTD and PD were 97.4%, 93.2%, 85.3% and 77.8% while the effects with VGPR or better were 63.7%, 62.7%, 44.2% and 37.8%, respectively. The effect of ORR, VGPR and CR/nCR for the PCD regimen was better than the PD protocol. Median PFS for all patients was 29.0 months with significant differences observed among treatment groups. Median OS of all the patients was not reached, but three-drug combinations were superior to PD alone. Frequently observed toxicities were neutropenia, thrombocytopenia, fatigue, infection, herpes zoster, and peripheral neuropathy. The incidence of peripheral neuropathy (PN in PTD group was significantly higher than other three groups, especially grade 2-3 PN. Treatment with anti-viral agent acyclovir significantly reduced the incidence of herpes zoster. CONCLUSIONS: Our experience indicated that bortezomib-based regimens were effective and well-tolerated in the Chinese population studied; three-drug combinations PCD, PAD were superior to PD, especially with respect to PCD.

  17. Varicella-zoster viruses associated with post-herpetic neuralgia induce sodium current density increases in the ND7-23 Nav-1.8 neuroblastoma cell line.

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    Peter G E Kennedy

    Full Text Available Post-herpetic neuralgia (PHN is the most significant complication of herpes zoster caused by reactivation of latent Varicella-Zoster virus (VZV. We undertook a heterologous infection in vitro study to determine whether PHN-associated VZV isolates induce changes in sodium ion channel currents known to be associated with neuropathic pain. Twenty VZV isolates were studied blind from 11 PHN and 9 non-PHN subjects. Viruses were propagated in the MeWo cell line from which cell-free virus was harvested and applied to the ND7/23-Nav1.8 rat DRG x mouse neuroblastoma hybrid cell line which showed constitutive expression of the exogenous Nav 1.8, and endogenous expression of Nav 1.6 and Nav 1.7 genes all encoding sodium ion channels the dysregulation of which is associated with a range of neuropathic pain syndromes. After 72 hrs all three classes of VZV gene transcripts were detected in the absence of infectious virus. Single cell sodium ion channel recording was performed after 72 hr by voltage-clamping. PHN-associated VZV significantly increased sodium current amplitude in the cell line when compared with non-PHN VZV, wild-type (Dumas or vaccine VZV strains ((POka, Merck and GSK. These sodium current increases were unaffected by acyclovir pre-treatment but were abolished by exposure to Tetrodotoxin (TTX which blocks the TTX-sensitive fast Nav 1.6 and Nav 1.7 channels but not the TTX-resistant slow Nav 1.8 channel. PHN-associated VZV sodium current increases were therefore mediated in part by the Nav 1.6 and Nav 1.7 sodium ion channels. An additional observation was a modest increase in message levels of both Nav1.6 and Nav1.7 mRNA but not Nav 1.8 in PHN virally infected cells.

  18. The short- and long-term risk of stroke after herpes zoster - a nationwide population-based cohort study.

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    Nandini Sreenivasan

    Full Text Available BACKGROUND AND OBJECTIVE: Varicella zoster virus (VZV is known to cause VZV vasculopathy, which may be associated with stroke. A recent study found an increased risk of stroke within one year of herpes zoster. We aimed to investigate the short and long-term effects of herpes zoster on the risk of stroke. METHODS: Using Danish national registers, we constructed a cohort consisting of all Danish adults ≥18 years old between 1995 and 2008 (n = 4.6 million; person-years of follow-up = 52.9 million. Individual-level information on prescriptions for herpes zoster antiviral treatment and diagnoses of stroke was obtained from national registers. We compared the risk of stroke in persons who had received the specific dosage of acyclovir for herpes zoster with persons who had never received antiviral treatment by Poisson regression. RESULTS: During follow-up, 2.5% received treatment for herpes zoster and 5.0% were diagnosed with stroke. Individuals who had received medication had a 127% (95% CI 83-182% increased risk the first two weeks, 17% (CI 9-24% between two weeks and one year, and 5% (2-9% after the first year. The increased risk was greatest in the youngest age group (<40. To control for healthcare-seeking behaviour, we conducted parallel analyses investigating the risk of selected fractures after herpes zoster and found no similar increased risks. CONCLUSIONS: This large nationwide cohort study found an increased risk of stroke after treatment for herpes zoster. Although the short-term risk was particularly high, we cannot rule out the possibility of a small but important long-term risk.

  19. Herpes simplex encephalitis (HSE) and the immunocompromised: a clinical and autopsy study of HSE in the settings of cancer and human immunodeficiency virus-type 1 infection.

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    Schiff, D; Rosenblum, M K

    1998-03-01

    Although herpes simplex encephalitis (HSE) is not regarded as an opportunistic infection, the occurrence of HSE in immunocompromised patients has been documented and the suggestion made that unusual clinical and neuropathologic features characterize the disorder in this population. To further characterize HSE as it affects the immunodeficient, the authors reviewed the clinical and pathological findings in three immunocompromised patients with autopsy-proven HSE. Two patients had cancer (one with lymphoma and another with glioblastoma multiforme), one was known to be human immunodeficiency virus-type 1 (HIV-1)-seropositive and a second was suspected of harboring underlying HIV-1 infection. Two were receiving dexamethasone at onset of HSE. All had fever, mental status changes and new, focal neurological deficits or worsening of established deficits. Cerebrospinal fluid (CSF) pleocytosis was absent or minimal and head computerized tomographic (CT) scans, performed in all cases, were unrevealing. No patient was clinically suspected of having HSE, only one received acyclovir (for concurrent mucocutaneous herpes) and HSE played a major role in all deaths. Autopsy revealed an unusual form of HSE characterized by a noninflammatory, pseudoischemic histological presentation and the unexpected persistence of viral antigens in abundance despite survival beyond the clinical stage during which inflammatory responses usually peak and productive brain infection wanes. The incidence of HSE in the immunocompromised may be underestimated. Preexistent neurological disease, a noninflammatory CSF profile and negative CT scan may confound the diagnosis in this population, a typical clinical presentation notwithstanding. Increased clinical suspicion, the use of magnetic resonance imaging and polymerase chain reaction analysis of CSF for herpes simplex virus nucleic acid sequences may permit more rapid diagnosis and treatment. The absence of inflammatory infiltrates in some fatal cases of

  20. [Cerebral infarction and intracranial aneurysm related to the reactivation of varicella zoster virus in a Japanese acquired immunodeficiency syndrome (AIDS) patient].

    Science.gov (United States)

    Yasuda, Chiharu; Okada, Kazumasa; Ohnari, Norihiro; Akamatsu, Naoki; Tsuji, Sadatoshi

    2013-01-01

    A 35-years-old right-handed man admitted to our hospital with a worsening of dysarthria, left facial palsy and left hemiparesis for 2 days. Acquired immunodeficiency syndrome (AIDS) was diagnosed when he was 28 years old. At that time, he also was treated for syphilis. After highly active antiretroviral treatment (HAART) was introduced at the age of 35 years old, serum level of human immunodeficiency virus (HIV) was not detected, but the number of CD4+ T cells was still less than 200/μl. He had no risk factors of atherosclerosis including hypertension, diabetes and hyperlipidemia. He had neither coagulation abnormality nor autoimmune disease. Magnetic resonance imaging (MRI) showed acute ischemic infarction spreading from the right corona radiate to the right internal capsule without contrast enhancement. Stenosis and occlusion of intracranial arteries were not detected by MR angiography. Although argatroban and edaravone were administered, his neurological deficits were worsened to be difficult to walk independently. Cerebrospinal fluid (CSF) examination showed a mild mononuclear pleocytosis (16/μl). Oligoclonal band was positive. The titer of anti-varicella zoster virus (VZV) IgG antibodies was increased, that indicated VZV reactivation in the central nervous system (CNS), although VZV DNA PCR was not detected. Therefore, acyclovir (750 mg/day for 2 weeks) and valaciclovir (3,000 mg/day for 1 month) were administered in addition to stroke therapy. He recovered to be able to walk independently 2 month after the admission.Angiography uncovered a saccular aneurysm of 3 mm at the end of branch artery of right anterior cerebral artery, Heubner artery, 28 days after the admission. We speculated that VZV vasculopathy caused by VZV reactivation in CNS was involved in the pathomechanism of cerebral infarction rather than HIV vasculopathy in the case.

  1. Effect of combinations of antiviral drugs on herpes simplex encephalitis

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    Bryan M Gebhardt

    2009-12-01

    Full Text Available Bryan M Gebhardt1, Federico Focher2, Richard Eberle3, Andrzej Manikowski4, George E Wright41LSU Eye Center, Department of Ophthalmology, Louisiana State University Health Sciences Center, New Orleans, LA, USA; 2Istituto di Genetica Molecolare, Consiglio Nazionale delle Ricerche, Pavia, Italy; 3Department of Veterinary Pathobiology, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA; 4GLSynthesis Inc., Worcester, MA, USAAbstract: 2-Phenylamino-6-oxo-9-(4-hydroxybutylpurine (HBPG is a thymidine kinase inhibitor that prevents encephalitic death in mice caused by herpes simplex virus (HSV types 1 and 2, although its potency is somewhat less than that of acyclovir (ACV. The present study was undertaken to determine the effect of combinations of HBPG and either ACV, phosphonoformate (PFA, or cidofovir (CDF against HSV encephalitis. BALB/c mice were given ocular infections with HSV-1 or HSV-2, and treated twice daily intraperitoneally for five days with HBPG, alone or in combination with ACV, PFA, or CDF. Animals were observed daily for up to 30 days, and the day of death of each was recorded. All of the combinations showed additivity, and the combination of HBPG + ACV appeared to be synergistic, ie, protected more mice against HSV-1 encephalitis compared with each drug given alone. Delay of treatment with HBPG for up to two days was still effective in preventing HSV-2 encephalitis. The combination of the thymidine kinase inhibitor HBPG and the antiherpes drug ACV may have synergistic activity against HSV encephalitis. The development of a potent and safe combination therapy for the prevention and/or treatment of HSV infection of the central nervous system can improve the outcome of this infection in humans.Keywords: antivirals, herpetic encephalitis

  2. Prevention of vaginal and rectal herpes simplex virus type 2 transmission in mice: mechanism of antiviral action

    Science.gov (United States)

    Ceña-Diez, Rafael; Vacas-Córdoba, Enrique; García-Broncano, Pilar; de la Mata, FJ; Gómez, Rafael; Maly, Marek; Muñoz-Fernández, Mª Ángeles

    2016-01-01

    Topical microbicides to stop sexually transmitted diseases, such as herpes simplex virus type 2 (HSV-2), are urgently needed. The emerging field of nanotechnology offers novel suitable tools for addressing this challenge. Our objective was to study, in vitro and in vivo, antiherpetic effect and antiviral mechanisms of several polyanionic carbosilane dendrimers with anti-HIV-1 activity to establish new potential microbicide candidates against sexually transmitted diseases. Plaque reduction assay on Vero cells proved that G2-S16, G1-S4, and G3-S16 are the dendrimers with the highest inhibitory response against HSV-2 infection. We also demonstrated that our dendrimers inhibit viral infection at the first steps of HSV-2 lifecycle: binding/entry-mediated events. G1-S4 and G3-S16 bind directly on the HSV-2, inactivating it, whereas G2-S16 adheres to host cell-surface proteins. Molecular modeling showed that G1-S4 binds better at binding sites on gB surface than G2-S16. Significantly better binding properties of G1-S4 than G2-S16 were found in an important position for affecting transition of gB trimer from G1-S4 prefusion to final postfusion state and in several positions where G1-S4 could interfere with gB/gH–gL interaction. We demonstrated that these polyanionic carbosilan dendrimers have a synergistic activity with acyclovir and tenofovir against HSV-2, in vitro. Topical vaginal or rectal administration of G1-S4 or G2-S16 prevents HSV-2 transmission in BALB/c mice in values close to 100%. This research represents the first demonstration that transmission of HSV-2 can be blocked by vaginal/rectal application of G1-S4 or G2-S16, providing a step forward to prevent HSV-2 transmission in humans. PMID:27274240

  3. Varicella-zoster viruses associated with post-herpetic neuralgia induce sodium current density increases in the ND7-23 Nav-1.8 neuroblastoma cell line.

    Science.gov (United States)

    Kennedy, Peter G E; Montague, Paul; Scott, Fiona; Grinfeld, Esther; Ashrafi, G H; Breuer, Judith; Rowan, Edward G

    2013-01-01

    Post-herpetic neuralgia (PHN) is the most significant complication of herpes zoster caused by reactivation of latent Varicella-Zoster virus (VZV). We undertook a heterologous infection in vitro study to determine whether PHN-associated VZV isolates induce changes in sodium ion channel currents known to be associated with neuropathic pain. Twenty VZV isolates were studied blind from 11 PHN and 9 non-PHN subjects. Viruses were propagated in the MeWo cell line from which cell-free virus was harvested and applied to the ND7/23-Nav1.8 rat DRG x mouse neuroblastoma hybrid cell line which showed constitutive expression of the exogenous Nav 1.8, and endogenous expression of Nav 1.6 and Nav 1.7 genes all encoding sodium ion channels the dysregulation of which is associated with a range of neuropathic pain syndromes. After 72 hrs all three classes of VZV gene transcripts were detected in the absence of infectious virus. Single cell sodium ion channel recording was performed after 72 hr by voltage-clamping. PHN-associated VZV significantly increased sodium current amplitude in the cell line when compared with non-PHN VZV, wild-type (Dumas) or vaccine VZV strains ((POka, Merck and GSK). These sodium current increases were unaffected by acyclovir pre-treatment but were abolished by exposure to Tetrodotoxin (TTX) which blocks the TTX-sensitive fast Nav 1.6 and Nav 1.7 channels but not the TTX-resistant slow Nav 1.8 channel. PHN-associated VZV sodium current increases were therefore mediated in part by the Nav 1.6 and Nav 1.7 sodium ion channels. An additional observation was a modest increase in message levels of both Nav1.6 and Nav1.7 mRNA but not Nav 1.8 in PHN virally infected cells.

  4. In vitro inhibition of herpes simplex virus type 1 replication by Mentha suaveolens essential oil and its main component piperitenone oxide.

    Science.gov (United States)

    Civitelli, Livia; Panella, Simona; Marcocci, Maria Elena; De Petris, Alberto; Garzoli, Stefania; Pepi, Federico; Vavala, Elisabetta; Ragno, Rino; Nencioni, Lucia; Palamara, Anna Teresa; Angiolella, Letizia

    2014-05-15

    Several essential oils exert in vitro activity against bacteria and viruses and, among these latter, herpes simplex virus type 1 (HSV-1) is known to develop resistance to commonly used antiviral agents. Thus, the effects of the essential oil derived from Mentha suaveolens (EOMS) and its active principle piperitenone oxide (PEO) were tested in in vitro experimental model of infection with HSV-1. The 50% inhibitory concentration (IC50) was determined at 5.1μg/ml and 1.4μg/ml for EOMS and PEO, respectively. Australian tea tree oil (TTO) was used as control, revealing an IC50 of 13.2μg/ml. Moreover, a synergistic action against HSV-1 was observed when each oil was added in combination with acyclovir. In order to find out the mechanism of action, EOMS, PEO and TTO were added to the cells at different times during the virus life-cycle. Results obtained by yield reduction assay indicated that the antiviral activity of both compounds was principally due to an effect after viral adsorption. Indeed, no reduction of virus yield was observed when cells were treated during viral adsorption or pre-treated before viral infection. In particular, PEO exerted a strong inhibitory effect by interfering with a late step of HSV-1 life-cycle. HSV-1 infection is known to induce a pro-oxidative state with depletion of the main intracellular antioxidant glutathione and this redox change in the cell is important for viral replication. Interestingly, the treatment with PEO corrected this deficit, thus suggesting that the compound could interfere with some redox-sensitive cellular pathways exploited for viral replication. Overall our data suggest that both EOMS and PEO could be considered good candidates for novel anti-HSV-1 strategies, and need further exploration to better characterize the targets underlying their inhibition.

  5. Methisoprinol as an immunomodulator for treating infectious mononucleosis

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    Maharani Laillyza Apriasari

    2016-12-01

    Full Text Available Background: Infectious mononucleosis (IM is the self limiting disease that associated with primary Epstein Barr virus (EBV. It is a gamma herpes virus. EBV infection is follows saliva-transfer by kissing or sexual intercourse. The most clinical manifestation in IM consists mainly of the specific sign: pharyngitis, fever, and lymphadenopathy. The main therapy is supportive treatment. Actually the antiviral therapy is required for the host with high response immune. Purpose: The aimed of this study was to report the therapy of IM using methisoprinol. Case: The woman patient, 33 years old, came to hospital by suffering pharyngitis and swolen on left neck. It had been since 3 days ago. Case management: She had come to Puskesmas that were given amoxycillin capsul 500 mg three times a day for three days and paracetamol tablet 500mg three times a day for three days, but she was still ill. Then she came to RSGM Hasan Aman Banjarmasin. She was diagnosed as IM. The instruction were isolation and bed rest for a week. She had to eat sofly and drink water highly. The therapy were amoxycillin capsul 500 mg three times a day for seven days, methisoprinol caplet 500 mg three times a day for seven days, natrium dikofenak tablet 50 mg three times a day for seven days. She was asked to see the dentist next 7 days. In this case, she were not given acyclovir. Conclusion: IM is self limiting disease. IM is the disease with spesific clinical syndrome that associated with primary EBV infection. Depend on the base of clinical experiences, the supportive treatment is adviced for patient of IM. Methisoprinol has both immunomodulator and antiviral properties.

  6. Varicella Zoster Virus Myelitis in Two Elderly Patients: Diagnostic Value of Nested Polymerase Chain Reaction Assay and Antibody Index for Cerebrospinal Fluid Specimens

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    Teruyuki Takahashi

    2013-04-01

    Full Text Available Background: Myelitis is one of the rarest neurological complications of the varicella zoster virus (VZV infection. Focal muscle weakness with or without sensory disturbance occurs in approximately 5% of the cases after acute VZV infection, with complete recovery in 50-70%. Case Presentation: This report describes two rare cases of elderly patients with VZV myelitis secondary to dermatomal zoster rash. Patient 1 was a 79-year-old woman who developed paraplegia, numbness and decreased sensation in the left arm and below thoracic (Th-10 after sacral zoster. Spinal cord MRI showed a high-signal-intensity lesion at the cervical spinal nerve 2 on a T2-weighted image. Patient 2 was a 73-year-old man who developed right flaccid leg weakness and urinary retention after right dorsal Th 5-8 zoster. Spinal cord MRI showed a high-signal-intensity lesion at Th 3-4 on a T2-weighted image. In both cases, although the conventional single polymerase chain reaction (PCR assays all showed negative results, the original nested PCR assay detected VZV DNA in the cerebrospinal fluid (CSF specimen collected on admission. In addition, the anti-VZV IgG antibody by enzyme immunoassay and antibody index were elevated in the CSF specimens during the clinical courses of both patients. On the basis of these findings, both patients were diagnosed with VZV myelitis and were treated with high-dose acyclovir and corticosteroid. This combined treatment was appropriate and effective for the improvement of their functional outcomes. Conclusion: The detection of VZV DNA in CSF by nested PCR assay and the evaluation of the antibody index to VZV had significant diagnostic value.

  7. The Prevalence and Trends of Antiviral Medication Use during Pregnancy in the U.S. A population-based study of 664,297 deliveries in 2001-2007

    Science.gov (United States)

    Avalos, Lyndsay A.; Chen, Hong; Yang, Chunmei; Andrade, Susan E.; Cooper, William O.; Cheetham, Craig T.; Davis, Robert L.; Dublin, Sascha; Hammad, Tarek A.; Kaplan, Sigal; Pawloski, Pamala A.; Raebel, Marsha A.; Scott, Pamela E.; Smith, David H.; Toh, Sengwee; Li, De-Kun

    2013-01-01

    Objectives To evaluate the prevalence, trends, timing and duration of exposure to antiviral medications during pregnancy within a US cohort of pregnant women and to evaluate the proportion of deliveries with a viral infection diagnosis among women given antiviral medication during pregnancy. Methods Live-born deliveries between 2001 and 2007, to women aged 15 to 45 years, were included from the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP), a collaborative research program between the U.S. Food and Drug Administration and eleven health plans. They were evaluated for prevalence, timing, duration, and temporal trends of exposure to antiviral medications during pregnancy. We also calculated the proportion of deliveries with a viral infection diagnosis among those exposed to antiviral medications. Results Among 664,297 live births, the overall prevalence of antiviral exposure during pregnancy was 4% (n=25,155). Between 2001 and 2007, antiviral medication exposure during pregnancy doubled from 2.5% to 5%. The most commonly used antiviral medication was acyclovir, with 3% of the deliveries being exposed and most of the exposure occurring after the 1st trimester. Most deliveries exposed to antiviral medications were exposed for less than 30 days (2% of all live births). Forty percent of the women delivering an infant exposed to antiviral medications had a herpes diagnosis. Conclusions Our findings highlight the increased prevalence of women delivering an infant exposed to antiviral medications over time. These findings support the need for large, well-designed studies to assess the safety and effectiveness of these medications during pregnancy. PMID:23420306

  8. Tsetse salivary gland hypertrophy virus: hope or hindrance for tsetse control?

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    Adly M M Abd-Alla

    2011-08-01

    Full Text Available MANY SPECIES OF TSETSE FLIES (DIPTERA: Glossinidae are infected with a virus that causes salivary gland hypertrophy (SGH, and flies with SGH symptoms have a reduced fecundity and fertility. The prevalence of SGH in wild tsetse populations is usually very low (0.2%-5%, but higher prevalence rates (15.2% have been observed occasionally. The successful eradication of a Glossina austeni population from Unguja Island (Zanzibar using an area-wide integrated pest management approach with a sterile insect technique (SIT component (1994-1997 encouraged several African countries, including Ethiopia, to incorporate the SIT in their national tsetse control programs. A large facility to produce tsetse flies for SIT application in Ethiopia was inaugurated in 2007. To support this project, a Glossina pallidipes colony originating from Ethiopia was successfully established in 1996, but later up to 85% of adult flies displayed symptoms of SGH. As a result, the colony declined and became extinct by 2002. The difficulties experienced with the rearing of G. pallidipes, epitomized by the collapse of the G. pallidipes colony originating from Ethiopia, prompted the urgent need to develop management strategies for the salivary gland hypertrophy virus (SGHV for this species. As a first step to identify suitable management strategies, the virus isolated from G. pallidipes (GpSGHV was recently sequenced and research was initiated on virus transmission and pathology. Different approaches to prevent virus replication and its horizontal transmission during blood feeding have been proposed. These include the use of antiviral drugs such as acyclovir and valacyclovir added to the blood for feeding or the use of antibodies against SGHV virion proteins. In addition, preliminary attempts to silence the expression of an essential viral protein using RNA interference will be discussed.

  9. Facing medical care problems of victims of sexual violence in Goma/Eastern Democratic Republic of the Congo

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    Dünser Martin W

    2011-03-01

    Full Text Available Abstract Background Since 1998, the Eastern Democratic Republic of the Congo has been torn by a military conflict. A particular atrocity of the war is widespread sexual violence. Methods In this combined retrospective analysis and prospective survey, we sought to identify hospital facilities and resources available to treat victims of sexual violence in Goma, the capital city of the North Kivu province. Results Of twenty-three acute care hospitals registered in the area of Goma, four (17% regularly cared for victims of sexual violence. One hospital had all resources always available to appropriately care for victims of sexual violence. From Jan 2009 until Oct 2010, 7,048 females sought medical care because of physical or psychological sequelae from sexual violence in the four hospitals of Goma. Only half of the hospitals had physicians specialized in gynaecology or gynaecological surgery available. Similarly, anaesthetists and psychiatrists/psychologists were available in two (50% and one (25% hospital, respectively. Post-discharge care facilities, material resources, such as surgical and anaesthesiological equipment and drugs, were inconsistently available in the hospitals caring for sexually abused females. At one selected hospital, acyclovir and/or antibiotics were administered to 1,202 sexually abused females (89.5%, whereas post-exposure HIV prophylaxis and surgery because of vesico-vaginal fistula was provided to only 75 (5.6% and 121 (9% patients, respectively. Conclusions This study provides data that only few hospitals in Goma care for victims of sexual violence. In addition, these hospitals suffer from a relevant shortage of human and material resources to provide adequate care for sexually abused females. Aside from establishment of adequate protection strategies, steps must be taken to increase the availability of trained health care professionals and resources to provide adequate care for victims of sexual violence in Goma and the

  10. Piroxicam inhibits herpes simplex virus type 1 infection in vitro.

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    Astani, A; Albrecht, U; Schnitzler, P

    2015-05-01

    Piroxicam is a potent, nonsteroidal, anti-inflammatory agent (NSAID) which also exhibits antipyretic activity. The antiviral effect of piroxicam against herpes simplex virus type 1 (HSV-1) was examined in vitro on RC-37 monkey kidney cells using a plaque reduction assay. Piroxicam was dissolved in ethanol or dimethylsulfoxide (DMSO) and the 50% inhibitory concentration (IC50) was determined at 4 μg/ml and 75 μg/ml, respectively. The IC50 for the standard antiherpetic drug acyclovir was determined at 1.6 μM. At non-cytotoxic concentrations of these piroxicam solutions, plaque formation was significantly reduced by 62.4% for ethanolic piroxicam and 72.8% for piroxicam in DMSO. The mode of antiviral action of these drugs was assessed by time-on-addition assays. No antiviral effect was observed when cells were incubated with piroxicam prior to infection with HSV-1 or when HSV-1 infected cells were treated with dissolved piroxicam. Herpesvirus infection was, however, significantly inhibited when HSV-1 was incubated with piroxicam prior to the infection of cells. These results indicate that piroxicam affected the virus before adsorption, but not after penetration into the host cell, suggesting that piroxicam exerts a direct antiviral effect on HSV-1. Free herpesvirus was sensitive to piroxicam in a concentration-dependent manner and the inhibition of HSV-1 appears to occur before entering the cell but not after penetration of the virus into the cell. Considering the lipophilic nature of piroxicam, which enables it to penetrate the skin, it might be suitable for topical treatment of herpetic infections.

  11. Clinical Study on Longdan Xiegan Decoction Application%龙胆泻肝汤的临床应用研究

    Institute of Scientific and Technical Information of China (English)

    赵秋艳

    2015-01-01

    目的:研究龙胆泻肝汤在带状疱疹临床治疗中的应用效果。方法搜集2013年10月~2014年10月我院带状疱疹40例,根据治疗方法不同进行分组。研究组共22例,治疗时应用龙胆泻肝汤;对照组共18例,治疗时应用阿昔洛韦。观察两组疗效,并对比分析。结果与对照组相比,研究组治疗有效率较高,有较大差异,有统计学意义(P<0.05)。结论龙胆泻肝汤在带状疱疹临床治疗中的应用效果确切,有效率高。%Objective Clinical efficacy of longdan xiegan decoction in treatment of shingles is to be analyzed. Methods We chose 40 shingles patients who were treated in hospital from October 2013 to October 2014 and separated them into two groups according to different treatment approaches,22 patients in study group were given longdan xiegan decoction treatment,while 18 patients in control group were given acyclovir treatment. And then observed and compared treatment efficacy between two groups. Results Treatment efficacy in study group was higher than that in control group,there was a treatment differential between two groups,and such a differential had statistic value(P<0.05). Conclusion Longdan xiegan decoction is of efficiency in treatment of shingles patients.

  12. 刺络拔罐治疗带状疱疹40例临床疗效观察%Effective observation on treating 40 cases of shingles by prick cupping

    Institute of Scientific and Technical Information of China (English)

    任玉乐; 朱红梅

    2014-01-01

    Objective: To explore clinical effects of prick cupping on treating shingles. Methods: 80 cases of shingles were randomly divided into two groups, the treatment group given prick cupping, the control given acyclovir plus acupuncture. Results: In treatment group, total efficacy was 97.5%, the control group was 75.0%, there was significant difference (P<0.05);VAS scores comparison before and after the treatment were extremely significant difference (P<0.01), the comparison had significant difference (P<0.05). Conclusion:Prick cupping for shingles achieved good effect, and can significantly shorten the treatment courses and improve curing rate.%目的:探讨刺血拔罐治疗带状疱疹的临床疗效。方法:将80例带状疱疹患者按就诊顺序随机分成两组,治疗组40例采用疱疹刺血拔罐法治疗;对照组40例采用口服阿昔洛韦加沿疱疹边缘围刺法治疗。结果:治疗组总有效率为97.5%,对照组为75.0%,差异显著(P<0.05);两组治疗前后VAS评分比较均有极显著性差异(P<0.01),两组治疗后VAS评分比较有显著性差异(P<0.05)。结论:疱疹局部刺血拔罐治疗带状疱疹疗效显著,可显著缩短疗程,治愈率高。

  13. Electroretinogram Changes in the Sound Eye of Subjects with Unilateral Necrotizing Herpetic Retinitis

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    Mohsen Azarmina

    2014-01-01

    Full Text Available Purpose: To evaluate electroretinogram (ERG changes in the contralateral normal appearing eye of patients with unilateral acute necrotizing herpetic retinitis (NHR. Methods: This interventional case series includes subjects with acute unilateral NHR. All patients were treated with intravenous followed by oral acyclovir and systemic steroids. Main outcome measures were changes in a- and b-wave amplitudes of scotopic and photopic full-field ERG in the sound eye, 1 and 3 months after therapy as compared to baseline. Twenty normal subjects served as controls. Results: Forty eyes of 20 patients including 12 male and 8 female subjects with mean age of 44.1±11.5 (range 22 to 66 years were studied. Twenty unaffected eyes were the subject of the current study. The retina in all of these eyes remained intact during the course of the study. In the sound eyes, mean b-wave amplitude of the maximal combined response ERG before initiation of treatment was 229.5±38.8 microvolts which increased to 356.1±34.0 (P<0.001 and 365.8±32.7 (P<0.001 microvolts 1 and 3 months after treatment, respectively. Corresponding figures for b-wave amplitudes of the cone response ERG were 24.9±6.0, 47.0±12.9 (P<0.001 and 52.8±12.7 (P<0.001 microvolts, respectively. Visual acuity of all sound eyes remained unchanged throughout the study. Conclusion: Despite normal retinal appearance and intact visual acuity in the sound eyes of patients with NHR, electrophysiological changes were observed. Prompt diagnosis and management of NHR and continuation of medication for 3 months may reverse subclinical ERG changes and reduce the risk of progression to overt clinical disease.

  14. Long-term outcomes in patients undergoing vitrectomy for retinal detachment due to viral retinitis

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    Almeida DRP

    2015-07-01

    Full Text Available David RP Almeida,1 Eric K Chin,1 Ryan M Tarantola,1 Elizabeth O Tegins,1 Christopher A Lopez,1 Herbert Culver Boldt,1 Karen M Gehrs,1 Elliott H Sohn,1 Stephen R Russell,1 James C Folk,1 Vinit B Mahajan1,2 1Department of Ophthalmology and Visual Sciences, 2Omics Laboratory, University of Iowa Hospitals and Clinics, Iowa City, IA, USA Purpose: To determine the outcomes in patients with rhegmatogenous retinal detachment (RRD secondary to viral retinitis. Patients and methods: This was a retrospective, consecutive, noncomparative, interventional case series of 12 eyes in ten patients with RRD secondary to viral retinitis. Results of vitreous or aqueous biopsy, effect of antiviral therapeutics, time to retinal detachment, course of visual acuity, and anatomic and surgical outcomes were investigated. Results: There were 1,259 cases of RRD during the study period, with 12 cases of RRD secondary to viral retinitis (prevalence of 0.95%. Follow-up was available for a mean period of 4.4 years. Varicella zoster virus was detected in six eyes, herpes simplex virus in two eyes, and cytomegalovirus in two eyes. Eight patients were treated with oral valacyclovir and two patients with intravenous acyclovir. Lack of optic nerve involvement correlated with improved final visual acuity of 20/100 or greater. Pars plana vitrectomy (n=12, silicone-oil tamponade (n=11, and scleral buckling (n=10 provided successful anatomic retinal reattachment in all cases, with no recurrent retinal detachment and no cases of hypotony during the follow-up period. Conclusion: Varicella zoster virus was the most frequent cause of viral retinitis, and lack of optic nerve involvement was predictive of a favorable visual acuity prognosis. Vitrectomy with silicone-oil tamponade and scleral buckle placement provided stable anatomical outcomes. Keywords: viral retinitis, acute retinal necrosis, herpetic retinitis, vitrectomy, retinal detachment 

  15. HIV-1 transmission linkage in an HIV-1 prevention clinical trial

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    Leitner, Thomas [Los Alamos National Laboratory; Campbell, Mary S [UNIV OF WASHINGTON; Mullins, James I [UNIV OF WASHINGTON; Hughes, James P [UNIV OF WASHINGTON; Wong, Kim G [UNIV OF WASHINGTON; Raugi, Dana N [UNIV OF WASHINGTON; Scrensen, Stefanie [UNIV OF WASHINGTON

    2009-01-01

    HIV-1 sequencing has been used extensively in epidemiologic and forensic studies to investigate patterns of HIV-1 transmission. However, the criteria for establishing genetic linkage between HIV-1 strains in HIV-1 prevention trials have not been formalized. The Partners in Prevention HSV/HIV Transmission Study (ClinicaITrials.gov NCT00194519) enrolled 3408 HIV-1 serodiscordant heterosexual African couples to determine the efficacy of genital herpes suppression with acyclovir in reducing HIV-1 transmission. The trial analysis required laboratory confirmation of HIV-1 linkage between enrolled partners in couples in which seroconversion occurred. Here we describe the process and results from HIV-1 sequencing studies used to perform transmission linkage determination in this clinical trial. Consensus Sanger sequencing of env (C2-V3-C3) and gag (p17-p24) genes was performed on plasma HIV-1 RNA from both partners within 3 months of seroconversion; env single molecule or pyrosequencing was also performed in some cases. For linkage, we required monophyletic clustering between HIV-1 sequences in the transmitting and seroconverting partners, and developed a Bayesian algorithm using genetic distances to evaluate the posterior probability of linkage of participants sequences. Adjudicators classified transmissions as linked, unlinked, or indeterminate. Among 151 seroconversion events, we found 108 (71.5%) linked, 40 (26.5%) unlinked, and 3 (2.0%) to have indeterminate transmissions. Nine (8.3%) were linked by consensus gag sequencing only and 8 (7.4%) required deep sequencing of env. In this first use of HIV-1 sequencing to establish endpoints in a large clinical trial, more than one-fourth of transmissions were unlinked to the enrolled partner, illustrating the relevance of these methods in the design of future HIV-1 prevention trials in serodiscordant couples. A hierarchy of sequencing techniques, analysis methods, and expert adjudication contributed to the linkage

  16. "Audiometric studies in 53 cases with sudden sensorineural hearing loss:can we suggest an algorithm for treatment? "

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    Nemati Sh

    2007-08-01

    Full Text Available Background: Sudden sensorinueural hearing loss (SSNHL is a baffling condition for patients, and its etiology, audiologic characteristics, prognostic factors, and treatment are still controversial. Methods: In this prospective study, we performed pure tone audiometry (PTA, impedance acoustics (IA, auditory brainstem responses (ABR, otoacoustic emissions (OAE, and transiently evoked otoacoustic emissions (TEOAE before beginning treatment for 53 patients with SSNHL. We then entered each patient, randomly and alternately, in one of two treatment groups: oral steroids + acyclovir vs. intravenous urographin. Results: In 22 (41.5% of the 53 patients (22 female, 31 male, we found negative or no signal to noise ratio and overall correlation in TEOAE. Furthermore, 26 cases (49% had positive overall correlations less than 50%, and five cases (4.4% had overall correlations >50%. Although 15 cases (28.3% responded well, 20 cases (37.7% showed only a partial response, and 18 cases (33.9% had poor or no response to our treatment. The mean value for overall correlation in the three subgroups of patients (no response, partial response, and complete response was -3.5% (±1/16%, + 11% (±1.99%, and +36.6% (±3.07% respectively (P = 0.01. From 52 cases, 20 had no reproducible wave in ABR (38.5%, three cases had abnormal ABR with normal OAE, all of which responded completely to treatments. Thirteen cases had abnormal ABR and OAE, none of which responded to treatment, and six cases had normal ABR with abnormal OAE, which often responded to treatment. Conclusions: ABR and OAE may be useful in the diagnosis of SSNHL and determining the site of such lesions as ischemia or neuropathy. The overall correlation (and S/N ratio in TEOAE is a valuable prognostic factor in SSNHL.

  17. Antivirals reduce the formation of key Alzheimer's disease molecules in cell cultures acutely infected with herpes simplex virus type 1.

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    Matthew A Wozniak

    Full Text Available Alzheimer's disease (AD afflicts around 20 million people worldwide and so there is an urgent need for effective treatment. Our research showing that herpes simplex virus type 1 (HSV1 is a risk factor for AD for the brains of people who possess a specific genetic factor and that the virus causes accumulation of key AD proteins (β-amyloid (Aβ and abnormally phosphorylated tau (P-tau, suggests that anti-HSV1 antiviral agents might slow AD progression. However, currently available antiviral agents target HSV1 DNA replication and so might be successful in AD only if Aβ and P-tau accumulation depend on viral DNA replication. Therefore, we investigated firstly the stage(s of the virus replication cycle required for Aβ and P-tau accumulation, and secondly whether antiviral agents prevent these changes using recombinant strains of HSV1 that progress only partly through the replication cycle and antiviral agents that inhibit HSV1 DNA replication. By quantitative immunocytochemistry we demonstrated that entry, fusion and uncoating of HSV1, are insufficient to induce Aβ and P-tau production. We showed also that none of the "immediate early" viral proteins is directly responsible, and that Aβ and P-tau are produced at a subsequent stage of the HSV1 replication cycle. Importantly, the anti-HSV1 antiviral agents acyclovir, penciclovir and foscarnet reduced Aβ and P-tau accumulation, as well as HSV1, with foscarnet being less effective in each case. P-tau accumulation was found to depend on HSV1 DNA replication, whereas Aβ accumulation was not. The antiviral-induced decrease in Aβ is attributable to the reduced number of new viruses, and hence the reduction in viral spread. Since antiviral agents reduce greatly Aβ and P-tau accumulation in HSV1-infected cells, they would be suitable for treating AD with great advantage unlike current AD therapies, only the virus, not the host cell, would be targeted.

  18. Mechanism of herpes simplex virus type 2 suppression by propolis extracts.

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    Nolkemper, Silke; Reichling, Jürgen; Sensch, Karl Heinz; Schnitzler, Paul

    2010-02-01

    Genital herpes caused by herpes simplex virus type 2 (HSV-2) is a chronic, persistent infection spreading efficiently and silently as sexually transmitted disease through the population. Antiviral agents currently applied for the treatment of herpesvirus infections include acyclovir and derivatives. Aqueous and ethanolic extracts of propolis were phytochemically analysed, different polyphenols, flavonoids and phenylcarboxylic acids were identified as major constituents. The aqueous propolis extract revealed a relatively high amount of phenylcarboxylic acids and low concentrations flavonoids when compared to the ethanolic special extract GH 2002. The cytotoxic and antiherpetic effect of propolis extracts against HSV-2 was analysed in cell culture, and revealed a moderate cytotoxicity on RC-37 cells. The 50% inhibitory concentration (IC(50)) of aqueous and ethanolic GH 2002 propolis extracts for HSV-2 plaque formation was determined at 0.0005% and 0.0004%, respectively. Both propolis extracts exhibited high levels of antiviral activity against HSV-2 in viral suspension tests, infectivity was significantly reduced by >99% and a direct concentration- and time-dependent antiherpetic activity could be demonstrated for both extracts. In order to determine the mode of virus suppression by propolis, the extracts were added at different times during the viral infection cycle. Addition of these drugs to uninfected cells prior to infection or to herpesvirus-infected cells during intracellular replication had no effect on virus multiplication. However both propolis extracts exhibited high anti-herpetic activity when viruses were pretreated with these drugs prior to infection. Selectivity indices were determined at 80 and 42.5 for the aqueous and ethanolic extract, respectively, thus propolis extracts might be suitable for topical therapy in recurrent herpetic infection.

  19. Cryptococcal meningitis post autologous stem cell transplantation.

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    Chaaban, S; Wheat, L J; Assi, M

    2014-06-01

    Disseminated Cryptococcus disease occurs in patients with defective T-cell immunity. Cryptococcal meningitis following autologous stem cell transplant (SCT) has been described previously in only 1 patient, 4 months post SCT and while off antifungal prophylaxis. We present a unique case of Cryptococcus meningitis pre-engraftment after autologous SCT, while the patient was receiving fluconazole prophylaxis. A 41-year-old man with non-Hodgkin's lymphoma underwent autologous SCT. Post-transplant prophylaxis consisted of fluconazole 400 mg daily, levofloxacin 500 mg daily, and acyclovir 800 mg twice daily. On day 9 post transplant, he developed fever and headache. Peripheral white blood cell count (WBC) was 700/μL. Magnetic resonance imaging of the brain showed lesions consistent with meningoencephalitis. Cerebrospinal fluid (CSF) analysis revealed a WBC of 39 with 77% lymphocytes, protein 63, glucose 38, CSF pressure 20.5 cmH2 O, and a positive cryptococcal antigen. CSF culture confirmed Cryptococcus neoformans. The patient was treated with liposomal amphotericin B 5 mg/kg intravenously daily, and flucytosine 37.5 mg/kg orally every 6 h. He was switched to fluconazole 400 mg daily after 3 weeks of amphotericin therapy, with sterilization of the CSF with negative CSFCryptococcus antigen and negative CSF culture. Review of the literature revealed 9 cases of cryptococcal disease in recipients of SCT. Median time of onset was 64 days post transplant. Only 3 meningitis cases were described; 2 of them after allogeneic SCT. Fungal prophylaxis with fluconazole post autologous SCT is recommended at least through engraftment, and for up to 100 days in high-risk patients. A high index of suspicion is needed to diagnose and treat opportunistic infections, especially in the face of immunosuppression and despite adequate prophylaxis. Infection is usually fatal without treatment, thus prompt diagnosis and therapy might be life saving.

  20. Development, validation and application of a 96-well enzymatic assay based on LC-ESI-MS/MS quantification for the screening of selective inhibitors against Mycobacterium tuberculosis purine nucleoside phosphorylase.

    Science.gov (United States)

    Cattaneo, Giulia; Ubiali, Daniela; Calleri, Enrica; Rabuffetti, Marco; Höfner, Georg C; Wanner, Klaus T; De Moraes, Marcela C; Martinelli, Leonardo K B; Santos, Diógenes Santiago; Speranza, Giovanna; Massolini, Gabriella

    2016-11-02

    Mycobacterium tuberculosis (Mtb) purine nucleoside phosphorylase (PNP, EC 2.4.2.1) has been identified as a target for the development of specific inhibitors with potential antimycobacterial activity. We hereby described the development and validation of a new 96-well LC-ESI-MS/MS method to assess the inhibition activity of nucleoside analogues towards MtbPNP and the human PNP (HsPNP). Enzyme activity was determined by monitoring the phosphorolysis of inosine (Ino) to hypoxanthine (Hpx). The enzymatic assay (v = 0.5 mL, enzymeplate for sample processing and 2 min/sample for LC-MS analysis. Validation of the quantification method met the criteria of the CDER guidance of FDA. Kinetic parameters were in agreement with those reported in literature (HsPNP KM = 0.150 ± 0.020 mM vs 0.133 ± 0.015 mM; MtbPNP KM = 0.060 ± 0.009 mM vs 0.040 ± 0.003 mM for Ino), thus demonstrating the reliability of the newly developed enzymatic assay. Preliminary inhibition assays confirmed the effects reported for Acyclovir (Acv) and Formycin A (FA) against HsPNP and MtbPNP. The validated enzymatic assay was applied to the evaluation of a set of 8-halo-, 8-amino-, 8-O-alkyl-substituted purine ribonucleosides synthesized on purpose as potential inhibitors against MtbPNP. The assayed 8-substituted ribonucleosides did not exert a significant inhibitory effect against the tested enzymes up to 1 mM.

  1. Docking and Antiherpetic Activity of 2-Aminobenzo[de]-isoquinoline-1,3-diones

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    Rashad Al-Salahi

    2015-03-01

    Full Text Available As part of our search for new compounds having antiviral effects, the prepared 2-aminonaphthalimide series was examined for its activity against the herpes simplex viruses HSV-1 and HSV-2. This represents the first study of the antiviral effects of this class of compounds. The new series of 2-amino-1H-benzo[de]isoquinoline-1,3-diones was examined against HSV-1 and HSV-2 using a cytopathic effect inhibition assay. In terms of effective concentration (EC50, furaldehyde, thiophene aldehyde and allyl isothiocyanide derivatives 14‒16 showed potent activity against HSV-1 (EC50 = 19.6, 16.2 and 17.8 μg/mL, compared to acyclovir as a reference drug (EC50 = 1.8 μg/mL. Moreover, 14 and 15 were found to exhibit valuable activity against HSV-2. Many of the tested compounds demonstrated weak to moderate EC50 values relative to their inactive parent compound (2-amino-1H-benzo[de]isoquinoline-1,3-dione, while compounds 7, 9, 13, 14, 15, 16, 21 and 22 were the most active set of antiviral compounds throughout this study. The cytotoxicity (CC50, EC50, and the selectivity index (SI values were determined. In a molecular docking study, the ligand-receptor interactions of compounds 1–24 and their parent with the HSV-1 thymidine kinase active site were investigated using the Molegro Virtual Docker (MVD software. Based on the potent anti-HSV properties of the previous naphthalimide condensate products, further exploration of this series of 2-amino-1H-benzo[de]isoquinoline-1,3-diones is warranted.

  2. Inhibition of the host translation shutoff response by herpes simplex virus 1 triggers nuclear envelope-derived autophagy.

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    Radtke, Kerstin; English, Luc; Rondeau, Christiane; Leib, David; Lippé, Roger; Desjardins, Michel

    2013-04-01

    Macroautophagy is a cellular pathway that degrades intracellular pathogens and contributes to antigen presentation. Herpes simplex virus 1 (HSV-1) infection triggers both macroautophagy and an additional form of autophagy that uses the nuclear envelope as a source of membrane. The present study constitutes the first in-depth analysis of nuclear envelope-derived autophagy (NEDA). We established LC3a as a marker that allowed us to distinguish between NEDA and macroautophagy in both immunofluorescence and flow cytometry. NEDA was observed in many different cell types, indicating that it is a general response to HSV-1 infection. This autophagic pathway is known to depend on the viral protein γ34.5, which can inhibit macroautophagy via binding to beclin-1. Using mutant viruses, we were able to show that binding of beclin-1 by γ34.5 had no effect on NEDA, demonstrating that NEDA is regulated differently than macroautophagy. Instead, NEDA was triggered in response to γ34.5 binding to protein phosphatase 1α, an interaction used by the virus to prevent host cells from shutting off protein translation. NEDA was not triggered when late viral protein production was inhibited with acyclovir or hippuristanol, indicating that the accumulation of these proteins might stress infected cells. Interestingly, expression of the late viral protein gH was sufficient to rescue NEDA in the context of infection with a virus that otherwise does not support strong late viral protein expression. We argue that NEDA is a cellular stress response triggered late during HSV-1 infection and might compensate for the viral alteration of the macroautophagic response.

  3. Longitudinal study on oral shedding of herpes simplex virus 1 and varicella-zoster virus in individuals infected with HIV.

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    van Velzen, Monique; Ouwendijk, Werner J D; Selke, Stacy; Pas, Suzan D; van Loenen, Freek B; Osterhaus, Albert D M E; Wald, Anna; Verjans, Georges M G M

    2013-09-01

    Primary herpes simplex virus 1 (HSV-1) and varicella-zoster virus (VZV) infection leads to a life-long latent infection of ganglia innervating the oral mucosa. HSV-1 and VZV reactivation is more common in immunocompromised individuals and may result in viral shedding in saliva. We determined the kinetics and quantity of oral HSV-1 and VZV shedding in HSV-1 and VZV seropositive individuals infected with HIV and to assess whether HSV-1 shedding involves reactivation of the same strain intra-individually. HSV-1 and VZV shedding was determined by real-time PCR of sequential daily oral swabs (n = 715) collected for a median period of 31 days from 22 individuals infected with HIV. HSV-1 was genotyped by sequencing the viral thymidine kinase gene. Herpesvirus shedding was detected in 18 of 22 participants. Shedding of HSV-1 occurred frequently, on 14.3% of days, whereas solely VZV shedding was very rare. Two participants shed VZV. The median HSV-1 load was higher compared to VZV. HSV-1 DNA positive swabs clustered into 34 shedding episodes with a median duration of 2 days. The prevalence, duration and viral load of herpesvirus shedding did not correlate with CD4 counts and HIV load. The genotypes of the HSV-1 viruses shed were identical between and within shedding episodes of the same person, but were different between individuals. One-third of the individuals shed an HSV-1 strain potentially refractory to acyclovir therapy. Compared to HSV-1, oral VZV shedding is rare in individuals infected with HIV. Recurrent oral HSV-1 shedding is likely due to reactivation of the same latent HSV-1 strain.

  4. Valacyclovir for prevention of recurrent herpes labialis: 2 double-blind, placebo-controlled studies.

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    Baker, David; Eisen, Drore

    2003-03-01

    The oral antiviral valacyclovir, which is 3 to 5 times more bioavailable than its parent compound acyclovir, is a good candidate for effective therapy to suppress recurrent herpes labialis lesions. The efficacy of oral valacyclovir in the suppression of herpes labialis has not previously been reported. Two identical, randomized, double-blind, parallel-group studies were conducted to evaluate the efficacy of oral valacyclovir 500 mg (n=49) versus placebo (n=49) once daily for 16 weeks in the suppression of herpes labialis among patients with a history of 4 or more recurrent lesions in the previous year. Data from the studies were pooled for analysis. Twenty-eight patients (60%) in the valacyclovir group compared with only 18 patients (38%) in the placebo group were recurrence-free throughout the 4-month treatment period (P=.041). The mean time to first recurrence was significantly longer with valacyclovir (13.1 weeks) compared with placebo (9.6 weeks) (P=.016). The total number of recurrences in patients using valacyclovir was 24 compared with 41 in patients using placebo. The incidence of adverse events during the 4-month treatment period was slightly lower in the valacyclovir group (22 events, 33% of patients) compared with the placebo group (29 events, 39% of patients). The results of these small double-blind, placebo-controlled studies suggest that oral valacyclovir 500 mg once daily for 4 months is effective and well tolerated for the prevention of recurrent herpes labialis. More research with larger patient numbers is warranted to corroborate and extend these findings.

  5. The Impact of Efflux Pump Inhibitors on the Activity of Selected Non-Antibiotic Medicinal Products against Gram-Negative Bacteria

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    Agnieszka E. Laudy

    2017-01-01

    Full Text Available The potential role of non-antibiotic medicinal products in the treatment of multidrug-resistant Gram-negative bacteria has recently been investigated. It is highly likely that the presence of efflux pumps may be one of the reasons for the weak activity of non-antibiotics, as in the case of some non-steroidal anti-inflammatory drugs (NSAIDs, against Gram-negative rods. The activity of eight drugs of potential non-antibiotic activity, active substance standards, and relevant medicinal products were analysed with and without of efflux pump inhibitors against 180 strains of five Gram-negative rod species by minimum inhibitory concentration (MIC value determination in the presence of 1 mM MgSO4. Furthermore, the influence of non-antibiotics on the susceptibility of clinical strains to quinolones with or without PAβN (Phe-Arg-β-naphthylamide was investigated. The impacts of PAβN on the susceptibility of bacteria to non-antibiotics suggests that amitriptyline, alendronate, nicergoline, and ticlopidine are substrates of efflux pumps in Gram-negative rods. Amitriptyline/Amitriptylinum showed the highest direct antibacterial activity, with MICs ranging 100–800 mg/L against all studied species. Significant decreases in the MIC values of other active substances (acyclovir, atorvastatin, and famotidine tested with pump inhibitors were not observed. The investigated non-antibiotic medicinal products did not alter the MICs of quinolones in the absence and in the presence of PAβN to the studied clinical strains of five groups of species.

  6. Posterior Ischemic Optic Neuropathy following Herpes Zoster Ophthalmicus

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    Mohammad Pakravan

    2009-01-01

    Full Text Available

    PURPOSE: To report a case of posterior ischemic optic neuropathy (PION following herpes zoster ophthalmicus (HZO. CASE REPORT: A 58-year-old woman with history of recent HZO in her right eye presented with acute painless loss of vision in the same eye to no light perception. Examination revealed a positive relative afferent pupillary defect and a normal appearing optic disc. Inflammatory and infiltrative lesions of the optic nerve were ruled out by laboratory and imaging studies. The patient received systemic acyclovir and prednisolone. Three months later, visual acuity improved to counting fingers, but the optic disc became pale and atrophic leading to a presumptive diagnosis of PION. Considering the positive PCR test for varicella zoster virus and the short time interval between the two presentations, HZO was considered as the most probable cause of the optic neuropathy. CONCLUSION: Herpes zoster ophthalmicus can be associated with PION.

  7. Combined Intratympanic and Systemic Steroid Therapy for Poor-Prognosis Sudden Sensorineural Hearing Loss

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    Shima Arastou

    2012-12-01

    Full Text Available Introduction: The aim of this study was to evaluate the efficacy of combined intratympanic and systemic steroid therapy compared with systemic steroid therapy alone in idiopathic sudden sensorineural hearing loss (ISSNHL patients with poor prognostic factors.     Materials and Methods: Seventy-seven patients with sudden sensorineural hearing loss (SSNHL who had at least one poor prognostic factor (age greater than 40 years, hearing loss more than 70 db, or greater than a 2-week delay between the onset of hearing loss and initiation of therapy were included in this study. Patients were randomized to the intervention group (combined intratympanic and systemic steroid therapy or the control group (systemic steroid therapy alone. All patients received oral treatment with systemic prednisolone (1 mg/kg/day for 10 days, acyclovir (2 g/day for 10 days, divided into four doses, triamterene H (daily, and omeprazole (daily, during steroid treatment, and were advised to follow a low salt diet. The intervention group also received intratympanic dexamethasone injections (0.4 ml of 4 mg/ml dexamethasone two times a week for two consecutive weeks (four injections in total. A significant hearing improvement was defined as at least a 15-db decrease in pure tone average (PTA.  Results: Among all participants, 44 patients (57.14% showed significant improvement in hearing evaluation. More patients showed hearing improvement in the intervention group than in the control group (27 patients (75% versus 17 patients (41.4%, respectively; P = 0.001.  Conclusion:  The combination of intratympanic dexamethasone and systemic prednisolone is more effective than systemic prednisolone alone in the treatment of poor-prognosis SSNHL.

  8. Expression of herpes simplex virus type 1 recombinant thymidine kinase and its application to a rapid antiviral sensitivity assay.

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    Shiota, Tomoyuki; Lixin, Wang; Takayama-Ito, Mutsuyo; Iizuka, Itoe; Ogata, Momoko; Tsuji, Masanori; Nishimura, Hidekazu; Taniguchi, Shuichi; Morikawa, Shigeru; Kurane, Ichiro; Mizuguchi, Masashi; Saijo, Masayuki

    2011-08-01

    Antiviral-resistant herpesvirus infection has become a great concern for immunocompromised patients. Herpes simplex virus type 1 (HSV-1) infections are treated with viral thymidine kinase (vTK)-associated drugs such as acyclovir (ACV), and most ACV-resistance (ACV(r)) is due to mutations in the vTK. The standard drug sensitivity test is usually carried out by the plaque reduction assay-based method, which requires over 10 days. To shorten the time required, a novel system was developed by the concept, in which 293T cells transiently expressing recombinant vTK derived from the test sample by transfection of the cells with an expression vector were infected with vTK-deficient and ACV(r) HSV-1 (TAR), and then cultured in a maintenance medium with or without designated concentrations of ACV, ganciclovir (GCV) and brivudine (BVdU). The replication of TAR was strongly inhibited by ACV, GCV and BVdU in 293T cells expressing recombinant vTK of the ACV-sensitive HSV-1, whereas replication was not or slightly inhibited in cells expressing the recombinant vTK of highly resistant or intermediately resistant HSV-1, respectively. An inverse correlation was demonstrated in the 50% effective concentrations (EC(50)s) and inhibitory effects of these compounds on the replication of TAR among ACV(s) and ACV(r) HSV-1 clones. These results indicate that the EC(50)s of the vTK-associated drugs including ACV can be assumed by measuring the inhibitory effect of drugs in 293T cells expressing recombinant vTK of the target virus. The newly developed antiviral sensitivity assay system for HSV-1 makes it possible to estimate EC(50) for vTK-associated drugs, when whole vTK gene is available for use by gene amplification directly from lesion's samples or from virus isolates.

  9. Wild Type p53 gene sensitizes rat C6 glioma cells to HSV-TK/ACV treatment in vitro and in vivo.

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    Huang, Qiang; Xia, Zhibo; You, Yongping; Pu, Peiyu

    2010-12-01

    Suicide gene therapy using herpes simplex virus-thymidine kinase (HSV-TK)/ganciclovir (GCV), has been extensively tested for the treatment of glioma. Our previous study showed that exogenous wild type p53 (wt-p53) enhanced the anti-tumor effect of HSV-TK/GCV therapy. However, the use of GCV is hindered by its low penetration to the brain and its toxicity when used at higher dose. In the present study, we used another pro-drug, acyclovir (ACV), and examined the therapeutic efficacy of HSV-TK/ACV combining with wt-p53 in C6 glioma cells. We observed that wt-p53 combined with HSV-TK/ACV resulted in the super-additive anti-tumor effect in vitro. Exogenous wt-p53 significantly enhanced the sensitivity of TK positive C6 cells to ACV in vitro. Our in vivo experiment demonstrated that the effect of wt-p53 and HSV-TK/ACV combination therapy was better than that of HSV-TK/ACV alone. The survival time of tumor-bearing rats treated with wt-p53 in combination with HSV-TK/ACV was also significantly prolonged than those treated with HSV-TK/ACV alone. These results suggest that wt-p53 can enhance the therapeutic efficacy of HSV-TK/ACV both in vitro and in vivo. These findings are considerably valuable with the respect of using less toxic ACV as prodrug. This novel strategy could provide benefit to HSV-TK/prodrug gene therapy.

  10. Prevention of herpes simplex virus induced stromal keratitis by a glycoprotein B-specific monoclonal antibody.

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    Adalbert Krawczyk

    Full Text Available The increasing incidence of acyclovir (ACV and multidrug-resistant strains in patients with corneal HSV-1 infections leading to Herpetic Stromal Keratitis (HSK is a major health problem in industrialized countries and often results in blindness. To overcome this obstacle, we have previously developed an HSV-gB-specific monoclonal antibody (mAb 2c that proved to be highly protective in immunodeficient NOD/SCID-mice towards genital infections. In the present study, we examined the effectivity of mAb 2c in preventing the immunopathological disease HSK in the HSK BALB/c mouse model. Therefore, mice were inoculated with HSV-1 strain KOS on the scarified cornea to induce HSK and subsequently either systemically or topically treated with mAb 2c. Systemic treatment was performed by intravenous administration of mAb 2c 24 h prior to infection (pre-exposure prophylaxis or 24, 40, and 56 hours after infection (post-exposure immunotherapy. Topical treatment was performed by periodical inoculations (5 times per day of antibody-containing eye drops as control, starting at 24 h post infection. Systemic antibody treatment markedly reduced viral loads at the site of infection and completely protected mice from developing HSK. The administration of the antiviral antibody prior or post infection was equally effective. Topical treatment had no improving effect on the severity of HSK. In conclusion, our data demonstrate that mAb 2c proved to be an excellent drug for the treatment of corneal HSV-infections and for prevention of HSK and blindness. Moreover, the humanized counterpart (mAb hu2c was equally effective in protecting mice from HSV-induced HSK when compared to the parental mouse antibody. These results warrant the future development of this antibody as a novel approach for the treatment of corneal HSV-infections in humans.

  11. Nano and microparticulate chitosan-based systems for antiviral topical delivery.

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    Calderón, L; Harris, R; Cordoba-Diaz, M; Elorza, M; Elorza, B; Lenoir, J; Adriaens, E; Remon, J P; Heras, A; Cordoba-Diaz, D

    2013-01-23

    Acyclovir (ACV) is one of the drugs of choice for the treatment of epidermal, ocular or systemic herpetic infections. Nevertheless, its trans-mucosal limited absorption and the scarce contact time of the formulation with the mucosal surface - especially in the ocular mucosa - constitute a big limitation of the antiviral efficiency. The most effective way to solve these problems is to increase the quantity and the residence time of the drug over the ocular surface. In order to cope with all these requirements, micro-particles (MPs) and nano-particles (NPs) containing ACV have been developed using cross-linked chitosan with tripolyphosphate (TPP) due to the biocompatibility, bio-adhesion ability and the potential power as penetration enhancer of this polymer. Particles were characterized by Fourier-transformed infrared (FTIR) spectroscopy, X-ray diffraction, SEM, Zeta potential and particle size. Encapsulation efficiency and release profiles in flow through diffusion cells were also determined. Besides the Slug Mucosal Irritation (SMI) assay has been applied as an alternative to the Draize test to predict the mucosal irritation of the selected formulation. FTIR and X-ray results suggested an electrostatic interaction ACV-Chitosan that made ACV be molecularly dispersed within the polymer matrix. Encapsulation efficiency was 75% for MP and 16% for NP. Release profiles in flow through diffusion cells were also determined. From the diffusion profiles, it was found that the amounts of ACV effectively diffused in 24h were 30, 430 and 80 μg for the ACV solution, MP and NP respectively. SMI results showed that chitosan-based particles induced moderate irritation and mild tissue damage, what supposes that ACV-MP constitute a promising alternative for further development of an antiviral formulation.

  12. Visualizing Compound Distribution during Zebrafish Embryo Development: The Effects of Lipophilicity and DMSO.

    Science.gov (United States)

    de Koning, Coco; Beekhuijzen, Manon; Tobor-Kapłon, Marysia; de Vries-Buitenweg, Selinda; Schoutsen, Dick; Leeijen, Nico; van de Waart, Beppy; Emmen, Harry

    2015-12-01

    The predictability of the zebrafish embryo model is highly influenced by internal exposure of the embryo/larva. As compound uptake is likely to be influenced by factors such as lipophilicity, solvent use, and chorion presence, this article focuses on investigating their effects on compound distribution within the zebrafish embryo. To visualize compound uptake and distribution, zebrafish embryos were exposed for 96 hr, starting at 4 hr postfertilization, to water-soluble dyes: Schiff's reagent (logP -4.63), Giemsa stain (logP -0.77), Van Gierson stain (logP 1.64), Cresyl fast violet (logP 3.5), Eosine Y (logP 4.8), Sudan III (logP 7.5), and Oil red O (logP 9.81), with and without 1% dimethyl-sulfoxide (DMSO). Three additional compounds were used to analytically determine the uptake and distribution: Acyclovir (logP -1.56), Zidovudine (logP 0.05), and Metoprolol Tartrate Salt (logP 1.8). Examinations were performed every 24 hr. Both methods (visualization and specific analysis) showed that exposure to higher logP values results in higher compound uptake. Specific analysis showed that for lipophilic compounds >90% of compound is taken up by the embryo. For hydrophilic compounds, >90% of compound within the complete egg could not be associated to embryo or chorion and is probably distributed into the perivitelline space. Overall, internal exposure analyses on at least two occasions (i.e., before and after hatching) is crucial for interpretation of zebrafish embryotoxicity data, especially for compounds with extreme logP values. DMSO did not affect exposure when examined with the visualization method, however, this method might be not sensitive enough to draw hard conclusions.

  13. The FMCA-GM assays, high throughput non-clonogenic alternatives to CFU-GM in preclinical hematotoxicity testing.

    Science.gov (United States)

    Haglund, Caroline; Aleskog, Anna; Håkansson, Lena Douhan; Höglund, Martin; Jacobsson, Stefan; Larsson, Rolf; Lindhagen, Elin

    2010-05-04

    One of the most common dose limiting adverse effects in cancer treatment is myelotoxicity. The aim of this study was to develop an in vitro method for measuring potential myelotoxic properties of a drug candidate in a high throughput setting. Human CD34(+) progenitor cells from umbilical cord blood were plated in 384-well microplates with drugs in liquid culture, supplemented with specific cytokines for the granulocytopoietic-macrophage lineage. After 7 or 14 days of proliferation and differentiation the cells were analyzed using the automated non-clonogenic fluorometric microculture cytotoxicity assay (FMCA). Two types of assays setups were evaluated, the FMCA-GM7 where cells were exposed to drugs directly after thawing and cytotoxicity measured on day 7 in contrast to the FMCA-GM14 where the cells were cultured 7 days prior to plating and drug exposure, with viability analysis on day 14 of differentiation. Drug sensitivity was similar in both assays and method validation was performed using 24 drugs with known myelotoxic profile (acyclovir, bortezomib, busulfan, carboplatin, chloramphenicol, chlorpromazine, cisplatin, cytarabine, clozapine, doxorubicin, erlotinib, etoposide, 5-fluorouracil, fludarabine, gefitinib, gemcitabine, hydroxyurea, imatinib, lomustine, melphalan, sorafenib, sunitinib, taxol and 6-thioguanine). The 50% inhibitory concentrations (IC(50)) from the FMCA-GM7 and the FMCA-GM14 correlated highly (r = 0.83) and (r = 0.82), respectively, with IC(50) from the established clonogenic assay (CFU-GM), obtained from the literature. The current data suggests that the FMCA-GM could offer a simple and robust alternative to the CFU-GM assay in preclinical hematotoxicity studies.

  14. Antiviral drugs for viruses other than human immunodeficiency virus.

    Science.gov (United States)

    Razonable, Raymund R

    2011-10-01

    Most viral diseases, with the exception of those caused by human immunodeficiency virus, are self-limited illnesses that do not require specific antiviral therapy. The currently available antiviral drugs target 3 main groups of viruses: herpes, hepatitis, and influenza viruses. With the exception of the antisense molecule fomivirsen, all antiherpes drugs inhibit viral replication by serving as competitive substrates for viral DNA polymerase. Drugs for the treatment of influenza inhibit the ion channel M(2) protein or the enzyme neuraminidase. Combination therapy with Interferon-α and ribavirin remains the backbone treatment for chronic hepatitis C; the addition of serine protease inhibitors improves the treatment outcome of patients infected with hepatitis C virus genotype 1. Chronic hepatitis B can be treated with interferon or a combination of nucleos(t)ide analogues. Notably, almost all the nucleos(t) ide analogues for the treatment of chronic hepatitis B possess anti-human immunodeficiency virus properties, and they inhibit replication of hepatitis B virus by serving as competitive substrates for its DNA polymerase. Some antiviral drugs possess multiple potential clinical applications, such as ribavirin for the treatment of chronic hepatitis C and respiratory syncytial virus and cidofovir for the treatment of cytomegalovirus and other DNA viruses. Drug resistance is an emerging threat to the clinical utility of antiviral drugs. The major mechanisms for drug resistance are mutations in the viral DNA polymerase gene or in genes that encode for the viral kinases required for the activation of certain drugs such as acyclovir and ganciclovir. Widespread antiviral resistance has limited the clinical utility of M(2) inhibitors for the prevention and treatment of influenza infections. This article provides an overview of clinically available antiviral drugs for the primary care physician, with a special focus on pharmacology, clinical uses, and adverse effects.

  15. Effect of ASP2151, a herpesvirus helicase-primase inhibitor, in a guinea pig model of genital herpes.

    Science.gov (United States)

    Katsumata, Kiyomitsu; Chono, Koji; Sudo, Kenji; Shimizu, Yasuaki; Kontani, Toru; Suzuki, Hiroshi

    2011-08-25

    ASP2151 is a herpesvirus helicase-primase inhibitor with antiviral activity against varicella zoster virus and herpes simplex virus types 1 (HSV-1) and 2 (HSV-2). Here, we examined the potency and efficacy of ASP2151 against HSV in vitro and in vivo. We found that ASP2151 was more potent in inhibiting the replication of HSV-1 and HSV-2 in Vero cells in the plaque reduction assay and had greater anti-HSV activity in a guinea pig model of genital herpes than did acyclovir and valacyclovir (VACV), respectively. Oral ASP2151 given from the day of infection reduced peak and overall disease scores in a dose-dependent manner, resulting in complete prevention of symptoms at the dose of 30 mg/kg. The 50% effective dose (ED(50)) values for ASP2151 and VACV were 0.37 and 68 mg/kg, respectively, indicating that ASP2151 was 184-fold more potent than VACV. When ASP2151 was administered after the onset of symptoms, the disease course of genital herpes was suppressed more effectively than by VACV, with a significant reduction in disease score observed one day after starting ASP2151 at 30 mg/kg, whereas the therapeutic effect of VACV was only evident three days after treatment at the highest dose tested (300 mg/kg). This indicated that ASP2151 possesses a faster onset of action and wider therapeutic time window than VACV. Further, virus shedding from the genital mucosa was significantly reduced with ASP2151 at 10 and 30 mg/kg but not with VACV, even at 300 mg/kg. Taken together, our present findings demonstrated the superior potency and efficacy of ASP2151 against HSV.

  16. Effect of ASP2151, a Herpesvirus Helicase-Primase Inhibitor, in a Guinea Pig Model of Genital Herpes

    Directory of Open Access Journals (Sweden)

    Toru Kontani

    2011-08-01

    Full Text Available ASP2151 is a herpesvirus helicase-primase inhibitor with antiviral activity against varicella zoster virus and herpes simplex virus types 1 (HSV-1 and 2 (HSV-2. Here, we examined the potency and efficacy of ASP2151 against HSV in vitro and in vivo. We found that ASP2151 was more potent in inhibiting the replication of HSV-1 and HSV-2 in Vero cells in the plaque reduction assay and had greater anti-HSV activity in a guinea pig model of genital herpes than did acyclovir and valacyclovir (VACV, respectively. Oral ASP2151 given from the day of infection reduced peak and overall disease scores in a dose-dependent manner, resulting in complete prevention of symptoms at the dose of 30 mg/kg. The 50% effective dose (ED50 values for ASP2151 and VACV were 0.37 and 68 mg/kg, respectively, indicating that ASP2151 was 184-fold more potent than VACV. When ASP2151 was administered after the onset of symptoms, the disease course of genital herpes was suppressed more effectively than by VACV, with a significant reduction in disease score observed one day after starting ASP2151 at 30 mg/kg, whereas the therapeutic effect of VACV was only evident three days after treatment at the highest dose tested (300 mg/kg. This indicated that ASP2151 possesses a faster onset of action and wider therapeutic time window than VACV. Further, virus shedding from the genital mucosa was significantly reduced with ASP2151 at 10 and 30 mg/kg but not with VACV, even at 300 mg/kg. Taken together, our present findings demonstrated the superior potency and efficacy of ASP2151 against HSV.

  17. Anaphylactic shock due to mecobalamin injection%甲钴胺注射液致过敏性休克

    Institute of Scientific and Technical Information of China (English)

    赵静; 张仲

    2016-01-01

    A 73-Year-old male with unilateral sKull sKin herpes simplex virus infection received an Iv infusion of acYclovir 500 mg. One and half hours later he received intramuscular injection of mecobalamin injection 0. 5 mg. About 15 minutes after intramuscular injection of mecobalamin,the patient suddenlY developed dizziness,sweat,paleness,obnubilation,no response to voice stimuli,and blood pressure was undetectable. He received the treatments with oxYgen inhalation,sufficient fluid resuscitation,and regimens to raise blood pressure. The patient became conscious graduallY,pulse rate was 63 beats/min,blood pressure was 140/73mmHg(1 mmHg =0. 133 KPa),respiratorY rate was 20 times/min. After replacing mecobalamin with muscular amino acids,peptides and nucleotide,the similar adverse reactions did not recur.%1例73岁男性患者因单纯疱疹病毒感染,给予阿昔洛韦500 mg静脉滴注,1.5 h后肌内注射甲钴胺注射液0.5 mg。注射甲钴胺后约15 min患者突然出现头晕、大汗、面色苍白,神志不清,呼之不应,测不到血压,经吸氧、充分液体复苏和升压治疗后,患者神志逐渐清楚,脉搏63次/min,血压140/73 mmHg(1 mmHg=0.133 KPa),呼吸20次/min。将甲钴胺换为肌氨肽苷后,未再发生类似不良反应。

  18. Anti-HSV-1 and HSV-2 Flavonoids and a New Kaempferol Triglycoside from the Medicinal Plant Kalanchoe daigremontiana.

    Science.gov (United States)

    Ürményi, Fernanda Gouvêa Gomes; Saraiva, Georgia do Nascimento; Casanova, Livia Marques; Matos, Amanda Dos Santos; de Magalhães Camargo, Luiza Maria; Romanos, Maria Teresa Villela; Costa, Sônia Soares

    2016-12-01

    Kalanchoe daigremontiana (Crassulaceae) is a medicinal plant native to Madagascar. The aim of this study was to investigate the flavonoid content of an aqueous leaf extract from K. daigremontiana (Kd), and assess its antiherpetic potential. The major flavonoid, kaempferol 3-O-β-d-xylopyranosyl-(1 → 2)-α-l-rhamnopyranoside (1), was isolated from the AcOEt fraction (Kd-AC). The BuOH-soluble fraction afforded quercetin 3-O-β-d-xylopyranosyl-(1 → 2)-α-l-rhamnopyranoside (2) and the new kaempferol 3-O-β-d-xylopyranosyl-(1 → 2)-α-l-rhamnopyranoside-7-O-β-d-glucopyranoside (3), named daigremontrioside. The crude extract, Kd-AC fraction, flavonoids 1 and 2 were evaluated using acyclovir-sensitive strains of HSV-1 and HSV-2. Kd-AC was highly active against HSV-1 (EC50  = 0.97 μg/ml, SI > 206.1) and HSV-2 (EC50  = 0.72 μg/ml, SI > 277.7). Flavonoids 1 and 2 showed anti-HSV-1 (EC50  = 7.4 μg/ml; SI > 27 and EC50  = 5.8 μg/ml; SI > 8.6, respectively) and anti-HSV-2 (EC50  = 9.0 μg/ml; SI > 22.2 and EC50  = 36.2 μg/ml; SI > 5.5, respectively) activities, suggesting the contribution of additional substances to the antiviral activity.

  19. Is the drug-induced hypersensitivity syndrome (DIHS due to human herpesvirus 6 infection or to allergy-mediated viral reactivation? Report of a case and literature review

    Directory of Open Access Journals (Sweden)

    Borgia Guglielmo

    2010-03-01

    Full Text Available Abstract Background Drug-Induced Hypersensitivity Syndrome (DIHS is a severe and rare systemic reaction triggered by a drug (usually an antiepileptic drug. We present a case of DISH and we review studies on the clinical features and treatment of DIHS, and on its pathogenesis in which two elements (Herpesvirus infection and the drug interact with the immune system to trigger such a syndrome that can lead to death in about 20% of cases. Case presentation We report the case of a 26-year old woman with fever, systemic maculopapular rash, lymphadenopathy, hepatitis and eosinophilic leukocytosis. She had been treated with antibiotics that gave no benefit. She was taking escitalopram and lamotrigine for a bipolar disease 30 days before fever onset. Because the patient's general condition deteriorated, betamethasone and acyclovir were started. This treatment resulted in a mild improvement of symptoms. Steroids were rapidly tapered and this was followed with a relapse of fever and a worsening of laboratory parameters. Human herpesvirus 6 (HHV-6 DNA was positive as shown by PCR. Drug-Induced Hypersensitivity Syndrome (DIHS was diagnosed. Symptoms regressed on prednisone (at a dose of 50 mg/die that was tapered very slowly. The patient recovered completely. Conclusions The search for rare causes of fever led to complete resolution of a very difficult case. As DIHS is a rare disease the most relevant issue is to suspect and include it in differential diagnosis of fevers of unknown origin. Once diagnosed, the therapy is easy (steroidal administration and often successful. However our case strongly confirms that attention should be paid on the steroidal tapering that should be very slow to avoid a relapse.

  20. SP-303, an antiviral oligomeric proanthocyanidin from the latex of Croton lechleri (Sangre de Drago).

    Science.gov (United States)

    Ubillas, R; Jolad, S D; Bruening, R C; Kernan, M R; King, S R; Sesin, D F; Barrett, M; Stoddart, C A; Flaster, T; Kuo, J; Ayala, F; Meza, E; Castañel, M; McMeekin, D; Rozhon, E; Tempesta, M S; Barnard, D; Huffman, J; Smee, D; Sidwell, R; Soike, K; Brazier, A; Safrin, S; Orlando, R; Kenny, P T; Berova, N; Nakanishi, K

    1994-09-01

    SP-303, a large proanthocyanidin oligomer isolated from the latex of the plant species Croton lechleri (Eupborbiaceae) has demonstrated broad activity against a variety of DNA and RNA viruses. In cell culture, SP-303 exhibits potent activity against isolates and laboratory strains of respiratory syncytial virus (RSV), influenza A virus (FLU-A) and parainfluenza virus (PIV). Parallel assays of SP-303 and ribavirin showed comparable activity against these viruses. SP-303 also exhibits significant inhibitory activity against herpesvirus (HSV) types 1 and 2, including herpesviruses resistant to acyclovir and foscarnet. Inhibition was also observed against hepatitis A and B viruses. The antiviral mechanism of SP-303 seems to derive from its direct binding to components of the viral envelope, resulting in inhibition of viral attachment and penetration of the plasma membrane. Antiviral effects of SP-303 were measured by three distinct methods: CPE, MTT and precursor uptake/incorporation. Cytotoxicity endpoints were markedly greater than the respective antiviral endpoints. SP-303 exhibited activity in RSV-infected cotton rats and African green monkeys, PIV-3-infected cotton rats, HSV-2 infected mice and guinea pigs and FLU-A-infected mice. The most successful routes of SP-303 administration for producing efficacy were: topical application to HSV-2- genital lesions in mice and guinea pigs, aerosol inhalation to FLU-A-infected mice and PIV-3-infected cotton rats, and oral dosage to RSV-infected cotton rats. A variety of toxicological evaluations demonstrated the safety of SP-303, particularly orally, which was predictable, since condensed tannins are a common dietary component. It is notable that the larger proanthocyanidins as a class have high antiviral activity, whereas most of the monomers are inactive. Clinical trials are ongoing to evaluate SP-303 as a therapeutic antiviral agent.

  1. Exposure-response relationships and drug interactions of sirolimus.

    Science.gov (United States)

    Zimmerman, James J

    2004-10-15

    Sirolimus (rapamycin, RAPAMUNE, RAPA) is an immunosuppressive agent used for the prophylaxis of renal allograft rejection and exhibits an immunosuppressive mechanism that is distinct from that for cyclosporine and tacrolimus. The purpose of this manuscript is to discuss the exposure-response relationships and drug interactions of sirolimus. The various factors affecting sirolimus whole blood exposure included first-pass extraction, formulation, food, demographics, liver disease, assay method, and interacting drugs. Clinically significant effects caused by food, pediatric age, hepatic impairment, and interacting drugs require recommendations for the safe and efficacious use of sirolimus in renal allograft patients. An exposure-response model based on multivariate logistic regression was developed using the interstudy data from 1832 renal allograft patients. The analysis revealed an increased probability of acute rejection for sirolimus troughs or =4, and females. The outcomes suggested that individualization of sirolimus doses immediately after transplantation, based on HLA mismatch and sex, would likely decrease the probability of acute rejections in renal allograft recipients who receive concomitant sirolimus, cyclosporine (full-dose), and corticosteroid therapy. Sirolimus is a substrate for both Cytochrome P450 3A (CYP3A) and P-glycoprotein (P-gp) and undergoes extensive first-pass extraction. Drugs that are known to inhibit or induce these proteins may potentially affect sirolimus whole blood exposure. In healthy volunteers, cyclosporine, diltiazem, erythromycin, ketoconazole, and verapamil significantly increased sirolimus whole blood exposure, and rifampin significantly decreased sirolimus exposure. However, sirolimus whole blood exposure was not affected by acyclovir, atorvastatin, digoxin, ethinyl estradiol/norgestrel, glyburide, nifedipine, or tacrolimus. Among the 15 drugs studied, sirolimus significantly increased the exposures of only erythromycin and S-(-)verapamil.

  2. Herpes simplex virus type 1 and Alzheimer's disease: increasing evidence for a major role of the virus

    Directory of Open Access Journals (Sweden)

    Ruth Frances Itzhaki

    2014-08-01

    Full Text Available AbstractHSV1, when present in brain of carriers of the type 4 allele of the apolipoprotein E gene (APOE, has been implicated as a major factor in AD. It is proposed that virus is normally latent in many elderly brains but reactivates periodically (as in the peripheral nervous system under certain conditions, for example stress, immunosuppression, and peripheral infection, causing cumulative damage and eventually development of AD. Diverse approaches have provided data that explicitly support, directly or indirectly, these concepts. Several have confirmed HSV1 DNA presence in human brains, and the HSV1-APOE-ε4 association in AD. Further, studies on HSV1-infected APOE-transgenic mice have shown that APOE-e4 animals display a greater potential for viral damage. Reactivated HSV1 can cause direct and inflammatory damage, probably involving increased formation of beta amyloid (Aβ and of AD-like tau (P-tau - changes found to occur in HSV1-infected cell cultures. Implicating HSV1 further in AD is the discovery that HSV1 DNA is specifically localised in amyloid plaques in AD. Other relevant, harmful effects of infection include the following: dynamic interactions between HSV1 and amyloid precursor protein (APP, which would affect both viral and APP transport; induction of toll-like receptors in HSV1-infected astrocyte cultures, which has been linked to the likely effects of reactivation of the virus in brain. Several epidemiological studies have shown, using serological data, an association between systemic infections and cognitive decline, with HSV1 particularly implicated. Genetic studies too have linked various pathways in AD with those occurring on HSV1 infection. In relation to the potential usage of antivirals to treat AD patients, acyclovir (ACV is effective in reducing HSV1-induced AD-like changes in cell cultures, and valacyclovir, the bioactive form of ACV, might be most effective if combined with an antiviral that acts by a different

  3. 常用抗生素在体外环境中对血清肿瘤标志物检测的影响%Effects of commonly used antibiotics in vitro environment on detection of serum tumor markers

    Institute of Scientific and Technical Information of China (English)

    孔梅; 邢长永; 甄君

    2011-01-01

    Objeetive To discuss the effects of 11 commonly used antibiotics in vitro environment on the detection of serum tumor markers. Methods To select 50 samples of serum tumor markers and 20 normal serum samples respectively,and to join in the serum of eleven commonly used antibiotics, and to detect AFP, CEA, CA125, CA153 and CA199 five types of tumor markers before and after the content changes by chemiluminescence immunoassay and to analyse the result by using the t-test. Results Joined the penicillin lactic acid sodium, acyclovir, ciprofloxacin and sodium chloride, ceftazidime, cefuroxime sodium, ornidazole tablets, ceph radine, the value of AFP was different after detection (P<0.05). Accession of chloride, ceftazidime, cefuroxime sodium, cephradine, azithromycin dihydrogen phosphate after CEA value differences (P<0. 05). Joined acyclovir, cefuroxime sodium, cephradine, imide cilasatin sodium CA125 after testing was different (P<0.05). In joining the penicillin sodium, cefuroxime sodium, piperacillin sodium and sulbactam sodium(2 : 1),ornidazole tablets,acyclovir CA199 detection value when there was a difference(P<0.05). In joining the penicillin sodium, cefuroxime sodium, piperacillin sodium and sulbactam sodium (2 : 1),ornidazole films, polyimide cilasatin sodium, ceftazidime CA153 detection value after differences ( P< 0. 05 ). Conclusion In most of the 11 commonly used antibiotics on tumor markers except gentamicin sulfate, they have clinical significance to improve the accuracy of tumor markers by exclude drug interference factors.%目的 探讨十一种常用抗生素在体外环境中对血清肿瘤标志物含量的影响.方法 50份肿瘤患者血清和20份正常血清中分别加入11种常用抗生素,采用免疫化学发光法检测AFP、CEA、CA125、CA153和CA199五种肿瘤标志物前后含量的变化,采用 T检验进行统计学分析.结果 加入青霉素钠、阿昔洛韦、乳酸环丙沙星氯化钠、头孢他啶、头孢呋辛

  4. Otoacoustic emissions and auditory brainstem responses in patients with sudden sensorineural hearing loss. Do otoacoustic emissions have prognostic value?

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    Manoochehr Amiridavan

    2006-11-01

    Full Text Available BACKGROUND: Sudden sensorineural hearing loss (SSNHL is a perplexing condition for patients and there are many controversies about its etiology, audiologic characteristics, prognostic factors, and treatment. METHODS: In this prospective study, we performed some audiologic tests, including PTA, IA, ABR, and OAE (TEOAE before beginning treatment of 53 patients with SSNHL. We assigned the patients randomly to two treatment groups: oral steroids + acyclovir vs. intravenous urographin. Twenty-eight patients underwent Magnetic Resonance Imaging (MRI of the Brain. RESULTS: Of 53 patients (22 female and 31 male, 22 (41.5% had negative or no signal to noise ratio and overall correlation in TEOAE. Twenty-six patients (49% had positive overall correlations less than 50%, and 5 patients (4.4% had overall correlations >50%. Fifteen patients (28. 3% responded completely or well, 20 (37.7% responded partially, and 18 (33.9% had poor or no response to the treatment. The mean values for overall correlation in 3 subgroups of patients (no response, partial response, and complete response were – 3. 5% (+ 1/16%, +11% (+ 1/99%, and +36.6% (+3/07%, respectively (P = 0.01. Twenty out of 52 patients had no reproducible wave in ABR (38.5%, and waves I, III, and V were absent in 40 (77%, 31 (59.6% and 21 (40% patients, respectively. There were some limitations (false positive and false negative results in ABR use in our cases, but it may be useful in detecting site of lesion in SSNHL. Overall, according to the results of OAE, ABR, and brain MRI of these patients, 3 were affected by acoustic neurinomas, at least 1 had auditory neuropathy, and the site of lesion was cochlear in 6, and cochlear + retrocochlear in 13 patients. CONCLUSIONS: ABR has limitations for use in SSNHL and seems not to obviate the need for brain MRI, but may help in determining the site of lesions such as ischemia or neuropathy. Overall correlation (and S/N ratio in TEOAE is a valuable

  5. Diagnostic dilemma: crusted scabies superimposed on psoriatic erythroderma in a patient with acquired immunodeficiency syndrome.

    Science.gov (United States)

    Fuchs, Brian S; Sapadin, Allen N; Phelps, Robert G; Rudikoff, Donald

    2007-01-01

    A 45-year-old man with AIDS presented with extensive erythema and scaling involving the face, trunk, and upper and lower extremities, and mild nail dystrophy. The patient had been diagnosed with psoriasis 2 years previously, and at the time of presentation was using emollients and topical corticosteroid creams with little improvement. He was receiving zidovudine, lamivudine, trimethoprim/sulfamethoxazole, acyclovir, rifabutin, and hydroxyzine. Pertinent laboratory data included CD4 lymphocytes (10 cells/mm(3)), viral load (32,000 copies per mL) white blood cell count (3.4 x 10(3)/microL), hemoglobin (13.5 g/dL), and platelets (204 x 10(3)/microL). Because of the extensive eruption and lack of response to topical agents, the patient was started on acitretin 25 mg daily. The patient had shown no signs of improvement 4 weeks later and was noted to have brownish gray crusted plaques involving the beard area, neck, upper part of the back, arms, trunk, genitals, and thighs in addition to his erythroderma (Figure 1 and Figure 2). Microscopic examination of scales from the upper part of the back revealed numerous scabies mites and eggs. He was then treated with lindane shampoo on the scalp and beard area and permethrin 5% cream to the body. The patient returned 2 weeks later with some improvement after thrice-weekly applications of this regimen; however, scrapings from the trunk once again revealed live scabies mites. Microscopic examination of scales that had fallen on the examination table revealed multiple mites and eggs. The patient was then given permethrin 5% cream, which he applied 3 times a week for 2 weeks, and 1 dose of oral ivermectin, 200 micro/kg. This resulted in a marked decrease in crusting and scaling. With resolution of the scabies lesions, the patient displayed marked erythema and scaling of the trunk and extremities consistent with generalized psoriasis (Figure 3). Treatment with acitretin resulted in gradual resolution of the erythroderma. A few months

  6. An indole alkaloid from a tribal folklore inhibits immediate early event in HSV-2 infected cells with therapeutic efficacy in vaginally infected mice.

    Directory of Open Access Journals (Sweden)

    Paromita Bag

    Full Text Available Herpes genitalis, caused by HSV-2, is an incurable genital ulcerative disease transmitted by sexual intercourse. The virus establishes life-long latency in sacral root ganglia and reported to have synergistic relationship with HIV-1 transmission. Till date no effective vaccine is available, while the existing therapy frequently yielded drug resistance, toxicity and treatment failure. Thus, there is a pressing need for non-nucleotide antiviral agent from traditional source. Based on ethnomedicinal use we have isolated a compound 7-methoxy-1-methyl-4,9-dihydro-3H-pyrido[3,4-b]indole (HM from the traditional herb Ophiorrhiza nicobarica Balkr, and evaluated its efficacy on isolates of HSV-2 in vitro and in vivo. The cytotoxicity (CC50, effective concentrations (EC50 and the mode of action of HM was determined by MTT, plaque reduction, time-of-addition, immunofluorescence (IFA, Western blot, qRT-PCR, EMSA, supershift and co-immunoprecipitation assays; while the in vivo toxicity and efficacy was evaluated in BALB/c mice. The results revealed that HM possesses significant anti-HSV-2 activity with EC50 of 1.1-2.8 µg/ml, and selectivity index of >20. The time kinetics and IFA demonstrated that HM dose dependently inhibited 50-99% of HSV-2 infection at 1.5-5.0 µg/ml at 2-4 h post-infection. Further, HM was unable to inhibit viral attachment or penetration and had no synergistic interaction with acyclovir. Moreover, Western blot and qRT-PCR assays demonstrated that HM suppressed viral IE gene expression, while the EMSA and co-immunoprecipitation studies showed that HM interfered with the recruitment of LSD-1 by HCF-1. The in vivo studies revealed that HM at its virucidal concentration was nontoxic and reduced virus yield in the brain of HSV-2 infected mice in a concentration dependent manner, compared to vaginal tissues. Thus, our results suggest that HM can serve as a prototype to develop non-nucleotide antiviral lead targeting the viral IE

  7. Esclerose lateral amiotrófica e herpes vírus. Relato de um caso curioso: uma associação casual ou causal? Amyotrophic lateral sclerosis and herpes virus. A curious case report: a cause or casual association?

    Directory of Open Access Journals (Sweden)

    JOÃO ELIEZER FERRI-DE-BARROS

    1998-06-01

    Full Text Available OBJETIVO: Apresentar o relato de um caso curioso de esclerose lateral amiotrófica (ELA. CASO: Homem de 47 anos que apresentava déficit de força nos membros superiores evoluindo há 4 anos. A eletroneuromiografia era compatível a ELA, forma de Vulpian-Bernardt. O estudo do líquido cefalorraqueano (LCR mostrava processo inflamatório e positividade das reações para Herpes vírus I e II. O estudo do LCR, do soro sanguíneo e da barreira hemato-encefálica sugeria imunoprodução local para Herpes vírus tipo I. A ressonância nuclear magnética sugeria mielopatia cística ou seringomielia em medula cervical estendendo-se nos espaços C2 a C4. O paciente foi tratado com aciclovir endovenoso por 21 dias. Até dois meses após, o paciente não foi submetido a novos exames subsidiários para controle. DISCUSSÃO: Até o momento atual, a doença ELA não tem tratamento medicamentoso específico. A noção da existência de "síndrome esclerose lateral amiotrófica" associada a etiologias diversas pode contribuir para o tratamento de alguns doentes.OBJECTIVE: To present a curious case of amyotrophic lateral sclerosis (ALS. CASE: A forty-seven year old man claimed of paresis in the arms since four years. The electrical study of the muscles and nerves diagnosis was ALS, type Vulpian-Bernardt. The cerebrospinal fluid study revealed an inflammatory process and the positivity of immulogical reactions for Herpes simplex I. The blood-brain barrier study showed the possibility that immulogical response for Herpes simplex I was produced in the spinal fluid space. A magnetic resonance suggested cystic myelopathy of cervical spinal cord expanding from C2 to C4. The patient received endovenous acyclovir for 21 days. Until two months after the medication we did not submit the patient to other subsidiary examinations. DISCUSSION: Until now there is no specific drug treatment for ALS. The notion that there is a "syndrome of ALS" related with various causes may

  8. Chickenpox pneumonia. Case presentation. Dora Ngiza hospital, Port Elizabeth, South Africa. Neumonia varicelosa. Presentacion de caso.

    Directory of Open Access Journals (Sweden)

    Ilen Ochoa Tamayo

    2009-03-01

    Full Text Available Chickenpox is an exanthematic highly infectious disease produced by the Varicella zoster virus (VZV, commonly occurs in childhood, 90% of cases occurred in children under 12 years of age, 10% of the population over 15 years is susceptible to suffer it. It is an airborne illness, the inhale virus cause an infection in the initial respiratory epithelium, the virus spreads to distant cells of the reticuloendothelial system, finally, there is a state of viremia with skin lesions, although the spread can also be extended to the viscera. The deterioration of the cell-mediated immunity caused by coexisting diseases, HIV infection, cancer, hemato-oncology illnesses, steroid use, as well as advanced age, smoking, chronic obstructive pulmonary disease and hemorrhagic nature of the Skin lesions, are risk factors for developing Varicella-Zoster pneumonia. In this article we describe a case of chickenpox in a young HIV positive patient complicated with Varicella-Zoster pneumonia. Despite of the treatment with acyclovir, prednisone and supportive measures had a fatal outcome.La varicela es una infección exantemática producida por el virus Varicela zoster (VZV que comúnmente ocurre en la infancia. Se reporta el 90 % de los casos en niños menores de 12 años, el 10 % de la población mayor de 15 años es susceptible a padecerla. La enfermedad se adquiere por inhalación de partículas que contienen el virus y que son expulsadas por la nasofaringe de individuos infectados. Esto causa una infección inicial en el epitelio respiratorio. El virus se disemina a células distantes del sistema retículo endotelial y, finalmente, se produce un estado de viremia con manifestaciones en la piel, aunque la diseminación también se puede extender a las vísceras. El deterioro de la inmunidad celular ocasionado por enfermedades coexistentes, infección por VIH, cáncer, enfermedad hemato-oncológica, uso de esteroides, así como, la edad avanzada, el hábito de fumar

  9. HIV positive patient with HSV-2 encephalitis: case report.

    Science.gov (United States)

    Pagliano, Pasquale; Ascione, Tiziana; Carleo, Maria Aurora; Boccia, Giovanni; De Caro, Francesco; Tortora, Fabio

    2016-09-01

    Incidence of brain infections in Human Immunodeficiency Virus (HIV) positive patients is reduced after the availability of current high active antiretroviral therapy (HAART). Herpes Simplex Virus type 2 (HSV-2) is an infrequent cause of encephalitis in HIV patients despite it is frequently involved in sexual transmitted infections. Here, we report a case of HSV-2 encephalitis occurring in a patient without full suppression of HIV replication within the brain. A 38 year-old HIV infected man was admitted to our department because of recurrent generalized seizure and fever during the previous 24 hours. Eight months before our observation the patient was switched from a protease inhibitor based regimen to a rilpivirine-based regimen without any evidence of HIV-RNA replication in the plasma. When the patient was admitted in our hospital, he was febrile and moderately confused, no deficit of cranial nerves was reported, motility was conserved, but he was unable to walk. Laboratory examinations performed at admission demonstrated an increase of cerebrospinal fluid (CSF) protein and cells with lymphocyte prevalence, and normal CSF glucose. HSV-2-DNA and HIV-RNA were present within CSF at admission. Nuclear Magnetic Resonance imaging of the brain revealed lesions of the medial part of both temporal lobes including hippocampus without any sign of bleeding. A 21-day course of acyclovir therapy was administered with consistent improvement of clinical findings and disappearance of HSV-2-DNA within CSF. After the episode, HAART was switched to a regimen with high CSF penetrability containing abacavir, lamivudine, darunavir and ritonavir. Twelve months after HSV-2 encephalitis neurologic evaluation was normal, but symptoms of depression were reported, HIV-RNA remained undetectable both in the plasma and CSF, and CD4+ lymphocytes were above 500/μL. No opportunistic infection was reported. Patients switched to regimen well tolerated such those containing rilpivirine, that have

  10. Treatment of sexually transmitted diseases.

    Science.gov (United States)

    1982-03-19

    treated with erythromycin. Pyrethrins with piperonyl butoxide offer effective topical treatment for pubic lice and are less toxic than lindane. Podophyllin is the most widely used treatment for veneral warts. Patients with genital herpes should be told to avoid emollient creams and ointments, for these may delay healing and promote local spread of lesions by autoinoculation; acyclovir may soon be available for topical treatment.

  11. Construction of a novel oncolytic adenoviral vector and its biological characteristics.

    Science.gov (United States)

    Zhang, Mingzhi; Zhang, Xudong; Han, Zhiqiang; Chen, Xinfeng; Yang, Li; Sheng, Yuqiao; Wen, Jianguo

    2013-02-01

    In this study, we aimed to construct an effective and safe oncolytic adenoviral vector for cancer treatment with gene therapy. First, the promoter of the catalytic subunit of human telomerase (hTERTp), adenovirus early region 1a gene (E1A) and thymidine kinase gene of human herpes virus type 1 (HSV-1-TK) were amplified by using PCR from genomic DNA of 293A cells and wild-type HSV-1 (wHSV-1). These specially-prepared elements were inserted into an adenoviral shuttle vector in the opposite and the same directions of left inverted terminal repeat (L-ITR), respectively, to construct pENTR-E1A-IRES-TK-hTERTp (pEITH) and pENTR-hTERTp-E1A-IRES-TK (pHEIT). LR reaction between adenoviral shuttle vectors (pEITH and pHEIT) and the backbone vector DEST was carried out to establish adenoviral expression vectors pAd-E1A-IRES-TK-hTERTp (pAd-EITH) and pAd-hTERTp-E1A-IRES-TK (pAd-HEIT). Recombinant adenovirus Ad-EITH and Ad-HEIT were produced by transfecting 293A cells and purified for the subsequent studies of titer measurement, replication capability with and without acyclovir (ACV) and antitumor ability with and without ganciclovir (GCV) to evaluate the biological characteristics. Adenoviral shuttle vectors pEITH and pHEIT and expression vectors pAd-EITH and pAd-HEIT were successfully constructed, and recombinant adenoviruses Ad-EITH and Ad-HEIT with high titer were produced. The results of replication and cytotoxicity assays showed that Ad-EITH and Ad-HEIT replicated in the hTERTp (+) human nasopharyngeal carcinoma cell line CNE and expressed the TK gene effectively leading to the death of tumor cells. In addition, there were still some Ad-HEIT particles replicating in the hTERTp (-) human osteosarcoma U-2OS cells and human lung HFL-1 fibroblasts compared to Ad-EITH which was hardly able to replicate in U-2OS and HFL-1 cells. In addition, we also observed an interesting phenomenon, that the replication of Ad-EITH could be inhibited by antiviral drug ACV on account of the

  12. Pneumonia por varicela associada com síndrome da angústia respiratória aguda: relato de dois casos Varicella pneumonia complicated with acute respiratory distress syndrome: two cases report

    Directory of Open Access Journals (Sweden)

    Marcelo Moreno

    2007-03-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A varicela é uma doença exantemática causada pela infecção primária do vírus varicela zoster (VVZ. A pneumonia pelo VVZ complicada com a síndrome da angústia respiratória aguda (SARA é rara e associa-se a altas taxas de morbimortalidade. O objetivo deste estudo foi apresentar dois casos de pneumonia por varicela que evoluíram com SARA e outras disfunções orgânicas. RELATO DOS CASOS: Paciente de 15 anos, imunocomprometido com a síndrome da imunodeficiência adquirida (SIDA e uma paciente do sexo feminino imunocompetente, foram admitidos na UTI com quadro clínico de varicela, SARA, trombocitopenia e acidose graves. Além disso, disfunção cardiovascular e falência renal ocorreram no primeiro e segundo casos, respectivamente. Foram tratados com aciclovir além de ventilação mecânica protetora. CONCLUSÕES: Os dois casos de pneumonia por varicela, que apresentaram SARA e disfunções de múltiplos órgãos, obtiveram boa evolução clínica.BACKGROUNG AND OBJECTIVES: Varicella is an exantematic disease caused by varicella-zoster virus. Varicella pneumonia complicated with acute respiratory distress syndrome (ARDS is very rare in adults and is associated with high morbimortality. We report two cases of ARDS secondary to varicella-zoster virus pneumonia. CASES REPORT: We report two cases of ARDS and multiple organ dysfunction syndrome (MODS secondary to varicella-zoster virus pneumonia. A 15-year-old man with human immunodeficiency virus (HIV infection and a 29-year-old immunocompetent female were admitted in the ICU with primary varicella infection and pneumonia. Both cases progressed towards ARDS, severe thrombocytopenia and acidosis. In addition cardiovascular and renal failure occurred in the first and second patients, respectively. Treatment consisted of immediate administration of intravenous acyclovir and a lung-protective ventilation strategy. CONCLUSIONS: Both cases of varicella

  13. Common cutaneous disorders in athletes.

    Science.gov (United States)

    Conklin, R J

    1990-02-01

    Athletic activity may cause or aggravate skin disorders, which in turn may diminish athletic performance. Since many sporting activities necessitate prolonged exposure to the sun, athletes must avoid painful sunburn which will adversely affect their performance. Drugs and chemicals also may cause photoallergic and/or phototoxic reactions, including polymorphous light eruption and athletes should thus avoid photosensitising drugs and chemicals. The effects of chronic ultraviolet exposure include ageing, pigmentation and skin cancers. The most effective protection against excessive exposure to sunlight is the use of sunscreens, although inadequate application and poor protection in the UVA spectrum may diminish their effectiveness and contact allergies may create other problems. Viral, bacterial and fungal infections are common in athletes due to heat, friction and contact with others. Herpes simplex may be treated with any drying agents (e.g. alcohol) as they are as effective as more expensive topical agents such as acyclovir. Molluscum contagiosum may be spread by close contact or water contact and is treated by superficial incision, cryotherapy or standard wart varnishes. Plantar wart infection is transmitted by swimming pool decks, changing rooms and hand-to-hand from weights in gymnasiums. Plantar warts presenting with pain may be aggressively treated, by blunt dissection, but painless ones are best treated conservatively. Impetigo and folliculitis often develop after trauma. Antibiotics are effective against mild infections while abrasions and lacerations should be cleansed and dressed with occlusive dressings. Diphtheroid bacteria in moist footwear may produce pitted keratolysis and erythrasma. Tinea pedis is common in athletes and probably originates in swimming pools, gymnasium floors and locker rooms. Interdigital, dry-moccasin and pustular-midsole forms can be distinguished. The latter two forms respond to topical antifungal agents, while the interdigital

  14. Preparation and ocular retention of aciclovir chitosan eye-drops%阿昔洛韦壳聚糖滴眼液的制备及眼部滞留性考察

    Institute of Scientific and Technical Information of China (English)

    田鹏程; 王军

    2013-01-01

    Objective To study acyclovir (ACV) eye-drops by using chitosan (CS) as the adhesive to prolong the ocular retention.Methods The formula and preparation process of the eye-drops were made,and the quality including appearance,viscosity,pH,concentration and stability was studied.Rabbits as the testing animals,the eye irritation and retention were also observed.Results Compared with that of common ACV eye-drops,the viscosity of ACV-CS eye-drops increased significantly (1.8 × 10-2 Pa · s),and the ocular retention was prolonged (above 60 min)without any irritation (irritation score of 0.25).Conclusion ACV-CS eye-drops are promising with the properties of easy preparation,safe application and prolonged ocular retention.%目的 研制阿昔洛韦(ACV)-壳聚糖(CS)滴眼液,以延长阿昔洛韦的眼部滞留性.方法 以CS为增黏剂制备ACV-CS滴眼液,并对其性状、黏度、pH值、含量、稳定性等进行检测;以家兔为实验动物,分别考察ACV-CS滴眼液的眼部滞留性和眼部刺激性.结果 ACV-CS滴眼液的性状、黏度、pH值、含量、稳定性等均符合要求;与普通ACV滴眼液相比,ACV-CS滴眼液的黏性(1.8×10-2 Pa·s)显著增加,对兔眼部无明显刺激性,刺激反应评分为0.25,并显著延长眼部滞留时间(60 min以上).结论 本品制备简单,使用安全,具有较好的眼部滞留作用,值得进一步研究.

  15. Bone marrow transplantation for chronic myeloid leukemia (CML) from unrelated and sibling donors: single center experience.

    Science.gov (United States)

    Lamparelli, T; Van Lint, M T; Gualandi, F; Occhini, D; Barbanti, M; Sacchi, N; Ficai, G; Ghinatti, C; Ferrara, G B; Delfino, L; Pozzi, S; Morabito, A; Zikos, P; Vitale, V; Corvo, R; Frassoni, F; Bacigalupo, A

    1997-12-01

    This is a report on 60 consecutive patients with chronic myeloid leukemia (CML) who received an allogeneic bone marrow transplant (BMT) in this Unit. Donors were HLA-identical siblings (SIB) (n = 36) or unrelated donors (MUD) (n = 24) matched by serology for HLA A and B and by molecular biology for HLA DR. All patients were prepared with cyclophosphamide 120 mg/kg and fractionated total body irradiation 10-12 Gy. GVHD prophylaxis consisted of cyclosporin A (CsA) starting on day -7 and short-course methotrexate. Bone marrow was unmanipulated in all cases. Cytomegalovirus prophylaxis consisted of acyclovir for SIBs and foscarnet for MUDs. When compared to SIB transplants, MUD patients were younger (29 vs 36 years; P = 0.002), had younger donors (31 vs 39; P = 0.001), had a longer interval between diagnosis and BMT (1459 vs 263 days; P < 0.001) and received a smaller number of nucleated cells at transplant (3.3 vs 4.4 x 10(8)/kg; P = 0.003). More MUDs had advanced disease (50 vs 17%, P = 0.005). The median day to 0.5 x 10(9)/l neutrophils was similar in both groups (18 days for SIBs vs 17 days for MUDs; P = 0.06); the median platelet count on days +30, +50, +100 was significantly (P < 0.01) higher in SIB than in MUD patients (122 vs 38, 113 vs 50 and 97 vs 45 x 10(9)/l, respectively). Acute GVHD was scored as absent-mild, moderate, or severe, in 36, 58 and 6% of SIBs vs 25, 42 and 33% in MUD patients (P = 0.01). Chronic GVHD was comparable (P = 0.1). The actuarial risk of CMV antigenemia at 1 year was 60% in both groups. There were six deaths in SIB patients (two leukemia, two infections, one GVHD, one pneumonitis) and four deaths in MUD patients (three acute GVHD and one infection). Fifty patients survive with a median follow-up of 656 days for SIBs and 485 for MUDs. The actuarial 3-year transplant-related mortality is 12% in SIBs and 17% in MUDs (P = 0.5); the actuarial relapse is 18% in SIBs vs 6% in MUDs (P = 0.4) and 3-year survival 78% in SIBs vs 82% in MUDs (P

  16. An indole alkaloid from a tribal folklore inhibits immediate early event in HSV-2 infected cells with therapeutic efficacy in vaginally infected mice.

    Science.gov (United States)

    Bag, Paromita; Ojha, Durbadal; Mukherjee, Hemanta; Halder, Umesh Chandra; Mondal, Supriya; Chandra, Nidhi S; Nandi, Suman; Sharon, Ashoke; Sarkar, Mamta Chawla; Chakrabarti, Sekhar; Chattopadhyay, Debprasad

    2013-01-01

    Herpes genitalis, caused by HSV-2, is an incurable genital ulcerative disease transmitted by sexual intercourse. The virus establishes life-long latency in sacral root ganglia and reported to have synergistic relationship with HIV-1 transmission. Till date no effective vaccine is available, while the existing therapy frequently yielded drug resistance, toxicity and treatment failure. Thus, there is a pressing need for non-nucleotide antiviral agent from traditional source. Based on ethnomedicinal use we have isolated a compound 7-methoxy-1-methyl-4,9-dihydro-3H-pyrido[3,4-b]indole (HM) from the traditional herb Ophiorrhiza nicobarica Balkr, and evaluated its efficacy on isolates of HSV-2 in vitro and in vivo. The cytotoxicity (CC50), effective concentrations (EC50) and the mode of action of HM was determined by MTT, plaque reduction, time-of-addition, immunofluorescence (IFA), Western blot, qRT-PCR, EMSA, supershift and co-immunoprecipitation assays; while the in vivo toxicity and efficacy was evaluated in BALB/c mice. The results revealed that HM possesses significant anti-HSV-2 activity with EC50 of 1.1-2.8 µg/ml, and selectivity index of >20. The time kinetics and IFA demonstrated that HM dose dependently inhibited 50-99% of HSV-2 infection at 1.5-5.0 µg/ml at 2-4 h post-infection. Further, HM was unable to inhibit viral attachment or penetration and had no synergistic interaction with acyclovir. Moreover, Western blot and qRT-PCR assays demonstrated that HM suppressed viral IE gene expression, while the EMSA and co-immunoprecipitation studies showed that HM interfered with the recruitment of LSD-1 by HCF-1. The in vivo studies revealed that HM at its virucidal concentration was nontoxic and reduced virus yield in the brain of HSV-2 infected mice in a concentration dependent manner, compared to vaginal tissues. Thus, our results suggest that HM can serve as a prototype to develop non-nucleotide antiviral lead targeting the viral IE transcription for the

  17. [Meningoencephalitis caused by West Nile virus in a renal transplant recipient].

    Science.gov (United States)

    Ertilav, Muhittin; Ozkul, Aykut; Zeytinoğlu, Ayşın; Sen, Sait; Sipahi, Savaş; Töz, Hüseyin; Kitiş, Omer; Eraslan, Cenk

    2014-10-01

    -RNA positivity in CSF. This time cyclosporin was stopped, MMF was given in low dose (1 g/day), and high dose parenteral acyclovir and intravenous immunoglobulin (400 mg/kg/day, 7 days) were initiated. The patient recovered completely after 10 days without any neurological abnormalities. In conclusion, especially in endemic areas, WNV should be considered in the differential diagnosis of CNS infections develop in solid organ transplant cases and patients with other immunodeficiencies who present with fever, generalized myalgia, gastrointestinal symptoms and/or neurological disorders.

  18. Latent Virus Reactivation: From Space to Earth

    Science.gov (United States)

    Mehta, Satish K.; Cohrs, Randall J.; Gilden, Donald H.; Tyring, Stephen K.; Castro, Victoria A.; Ott, C. Mark; Pierson, Duane L.

    2010-01-01

    Reactivation of latent viruses is a recognized consequence of decreased immunity. More recently viral reactivation has been identified as an important in vivo indicator of clinically relevant immune changes. Viral reactivation can be determined quickly and easily by the presence of virus in saliva and other body fluids. Real-time polymerase chain reaction (PCR) is a highly sensitive and specific molecular method to detect the presence of specific viral DNA. Studies in astronauts demonstrated that herpes simplex virus type 1(HSV-1), Epstein-Barr Virus (EBV), cytomegalovirus (CMV), and varicella zoster virus (VZV) reactivate at rates above normal during and after spaceflight in response to moderately decreased T-cell immunity. This technology was expanded to patients on Earth beginning with human immune deficiency virus (HIV) immuno-compromised patients. The HIV patients shed EBV in saliva at rates 9-fold higher than observed in astronauts demonstrating that the level of EBV shedding reflects the severity of impaired immunity. Whereas EBV reactivation is not expected to produce serious effects in astronauts on missions of 6 months or less, VZV reactivation in astronauts could produce shingles. Reactivation of live, infectious VZV in astronauts with no symptoms was demonstrated in astronauts during and after spaceflight. We applied our technology to study VZV-induced shingles in patients. In a study of 54 shingles patients, we showed salivary VZV was present in every patient on the day antiviral (acyclovir) treatment was initiated. Pain and skin lesions decreased with antiviral treatment. Corresponding decreases in levels of VZV were also observed and accompanied recovery. Although the level of VZV in shingles patients before the treatment was generally higher than those found in astronauts, lower range of VZV numbers in shingles patients overlapped with astronaut s levels. This suggests a potential risk of shingles to astronauts resulting from reactivation of VZV. In

  19. Effects of Various Prophylactic Solutions on Postoperative Cytomegalovirus Infection in Liver Transplant Recipients%不同预防方案对肝移植受者术后巨细胞病毒感染率的影响

    Institute of Scientific and Technical Information of China (English)

    王葆青; 张洁; 张含之; 周俭; 何礼贤

    2013-01-01

    Objective:To investigate the status of postoperative cytomegalovirus (CMV) infection among the liver transplant recipients and to evaluate the effects of prophylactic solutions on CMV infection after liver transplantation in China.Methods:All the clinical and follow-up data was retrospectively investigated in 309 liver transplantation patients from January 2004 to March 2007 in Liver Transplantation Center,Zhongshan Hospital,Fudan university.Results:In the preoperative CMV-seropositive recipients,the CMV infection rates in the three prophylactic groups (PG group) who have been treated with intravenous ganciclovir (GCV),acyclovir (ACV),GCV + ACV were 10.5 %,15.9% and 7.9 %,respectively.The incidences of the CMV disease were 10.5%,8.3% and 3.2%,which showed significant differences compared to those in the non-prophylactic group (NPG group,42.3% and 15.4%,P<0.01).One-year overall survival rates of the three PG groups were 86.8%,78.0% and 88.9%,respectively.There was statistical difference in one-year survival rate between GCV+ ACV group and the NPG group (P<0.05).Conclusions:In the preoperative CMV-seropositive recipients,all the three different prophylactic methods [GCV 2.5 mg/(kg · d) ; ACV (0.2 g); and GCV 2.5 mg/(kg · d) + ACV 0.2 mg/(kg · d),3 times perday] can lower the incidence of CMV infection and CMV disease.Moreover,GCV + ACV prophylactic treatment can significantly increase one-year survival rate of liver transplantation patients.%目的:了解肝移植受者术后巨细胞病毒(cytomegalovirus,CMV)感染情况,探讨预防方案对肝移植受者术后CMV感染的预防作用.方法:回顾分析复旦大学附属中山医院肝移植中心2004年1月-2007年3月309例肝移植患者术后1年内的临床资料.结果:术前受体CMV-IgG阳性的肝移植患者中,3个预防组(PG组)分别采用更昔洛韦(ganciclovir,GCV)、阿昔洛韦(acyclovir,ACV)和GCV+ ACV预防后,CMV隐性感染发生率分别为10.5%、15.9

  20. Clinical analysis of 15 cases with vaginal intraepithelial neoplasia and vaginal cancer after operations of cervical cancer or cervical intraepithelial neoplasia%子宫颈癌或癌前病变术后再发阴道癌或癌前病变的临床分析

    Institute of Scientific and Technical Information of China (English)

    刘琦; 施雅; 张秦; 税迎春; 管群; 石群立

    2014-01-01

    Objective Although the correlation between high risk human papilloma virus (hrHPV) infection and cervical cancer ( CC ) or cervical intraepithelial neoplasia ( CIN ) is well known , vaginal cancer ( VC ) or vaginal intraepithelial neoplasia ( VAIN) also caused by hrHPV has not received enough attention .This article aims to explore the clinical characteristics of VC or VAIN after operations of CC or CIN in order to provide evidence for the treatment of these diseases . Methods The clinical charac-teristics and treatment of 15 cases with VC or VAIN after operations of CC or CIN were reviewed from Jan 2010 to May 2013 in our hos-pital. Results The mean age was (53.6 ±10.82) years, ranged from 39 to 73 years.The duration from the first operation to devel-oped VAIN or VC was (25.07 ±18.31) months, ranged from 1 to 60 months.There are 4 cases developed VC, 4 cases VAINⅢand 2 cases VINⅡfrom 10 CC patients;and 3 cases developed VC , 2 cases VAINⅢfrom 5 CINⅢpatients.hrHPV test were positive in all 15 patients.Treatment in these series were performed including total vaginectomy in 8 patients (3 VC, 4 VAINⅢ and 1 VAINⅡpatients), pelvic lymphonectomy in 1;upper vaginectomy in 2 patients (1 VC, 1 VAINⅢ), radiation or chemo-radiation therapy in 3 (3 VC), interferon muscle injection combined with topical application of estrogen and acyclovir gel in 2 (1 VC, 1 VAINⅡ). Conclusion Careful follow-up after CC or CIN operations are very important because continued hrHPV infection may result VC and VAIN lesions.Vaginectomy may be the best therapy .Interferon muscle injection combined with topical application of estrogen and acyclovir gel are also alternatively therapy , especially for hard to operate patients . Radiation therapy seems to be not very adaptable for VAIN patients .%目的:高危型人乳头瘤病毒( high risk human papilloma virus , hrHPV)与子宫颈癌及宫颈上皮内瘤样病变( cervical intraepithelial neoplasia , CIN)的相关性

  1. Analgesic therapy in postherpetic neuralgia: a quantitative systematic review.

    Directory of Open Access Journals (Sweden)

    Kathleen Hempenstall

    2005-07-01

    receptor antagonists (e.g., oral memantine, oral dextromethorphan, intravenous ketamine, codeine, ibuprofen, lorazepam, certain 5HT1 receptor agonists, and acyclovir. Topical administration of benzydamine, diclofenac/diethyl ether, and vincristine (iontophoresis are similarly not associated with efficacy, nor are intrathecal administration of lidocaine alone or epidural administration of lidocaine and methylprednisolone, intravenous therapy with lidocaine, subcutaneous injection of Cronassial, or acupuncture. However, many of the trials that demonstrated a lack of efficacy represented comparatively low numbers of patient episodes or were single-dose studies, so it may be appropriate to regard such interventions as "not yet adequately tested" rather than demonstrating "no evidence of efficacy." Topical aspirin/diethyl ether has not been adequately tested. CONCLUSION: The evidence base supports the oral use of tricyclic antidepressants, certain opioids, and gabapentinoids in PHN. Topical therapy with lidocaine patches and capsaicin is similarly supported. Intrathecal administration of methylprednisolone appears to be associated with high efficacy, but its safety requires further evaluation.

  2. Cytomegalovirus and other herpesviruses infections in heart and bone marrow transplant recipients Infecções causadas por citomegalovírus e outros vírus do grupo herpes em transplantados cardíacos e de medula óssea

    Directory of Open Access Journals (Sweden)

    Adriana Weinberg

    1990-10-01

    Full Text Available From January 1988 to January 1989 all the heart transplant and bone marrow recipients at the Instituto do Coração of the Hospital das Clínicas of the University of São Paulo Medical School were studied for the incidence and morbidity associated with herpesviruses infections after transplantation. Five bone marrow and 5 heart transplant recipients were followed for a mean of 4.2 months post-transplantation. All the patients were seropositive for cytomegalovirus (CMV before admission and 80% experienced one or more recurrences during the observation period. Of the 12 episodes of CMV infection, that were identified in this study, 83% were accompanied by clinical or laboratory abnormalities. However, there was only one case of severe disease. The overall incidence of infection for herpes simplex (HSV was 50%. Although most of HSV reactivations were oral or genital, one case of HSV hepatitis occurred. One of the 6 episodes of HSV infections that were treated with acyclovir showed an unsatisfactory response and was successfully managed with ganciclovir. All the individuals had anti-varicella zoster virus antibodies, but none of them developed infection. The study emphasizes the importance of active diagnostic surveillance of herpesvirus infections in transplant patients. Both CMV and HSV reactivations showed high incidence and important morbidity and thus, deserve prophylactic therapy.De janeiro de 1988 a janeiro de 1989 todos os pacientes submetidos a transplante de coração ou de medula óssea no Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo foram estudados quanto à incidência e morbidade das infecções pós-transplante causadas por vírus do grupo herpes. Cinco recipientes de medula óssea e 5 transplantados cardíacos foram observados por um período médio de 4.2 meses após o transplante. Todos os pacientes tinham sorologia positiva para citomegalovírus (CMV antes do transplante

  3. Prevention of vaginal and rectal herpes simplex virus type 2 transmission in mice: mechanism of antiviral action

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    Ceña-Diez R

    2016-05-01

    important position for affecting transition of gB trimer from G1-S4 prefusion to final postfusion state and in several positions where G1-S4 could interfere with gB/gH–gL interaction. We demonstrated that these polyanionic carbosilan dendrimers have a synergistic activity with acyclovir and tenofovir against HSV-2, in vitro. Topical vaginal or rectal administration of G1-S4 or G2-S16 prevents HSV-2 transmission in BALB/c mice in values close to 100%. This research represents the first demonstration that transmission of HSV-2 can be blocked by vaginal/rectal application of G1-S4 or G2-S16, providing a step forward to prevent HSV-2 transmission in humans.Keywords: nanotechnology, dendrimers, G1-S4, G2-S16, HSV-2, microbicide

  4. 诺卡式菌性角膜炎表现为盘状角膜炎1例%Nocardia keratitis presenting as viral disciform keratitis, a case report

    Institute of Scientific and Technical Information of China (English)

    Nor-Sharina Y; Lee KF; Siti Hawa H; Zunaina E

    2011-01-01

    目的:报告诺卡式菌属感染引起的盘状角膜炎病例1例.方法:病例报告.结果:患者,男,13岁,无角膜接触镜使用史,在小溪里游泳后,右眼疼痛伴视力下降2wk.最佳矫正视力:右眼6/30(0.2).检查发现角膜基质存在形态规则的旁中心盘状浸润伴炎症反应.角膜敏感度下降.最初角膜刮片镜检行革兰氏染色阴性,棘阿米巴角膜刮片和培养阴性.诊断为病毒性盘状角膜炎,给予口服阿昔洛韦和局部使用激素眼药水.2wk后患者视力恶化伴角膜损伤加重,再次角膜取材刮片行革兰氏染色提示诺卡式菌属感染,按经验局部给予3g/L加替沙星眼药水后,临床效果明显.治疗6mo后,视力达到6/6仅在角膜中心留有少量角膜混浊.结论:诺卡式菌属感染延误诊断可以导致病情恶化.如果采用正确的治疗,诺卡式菌属感染引起的角膜炎可以恢复良好,仅留少量瘢痕,获得较好的视力.%keratitisreduced vision of the right eye after following history of swimming in the stream for two weeks duration.Best-corrected visual acuity of the right eye was 6/30.There was a well-defined para-central disciform stromal infiltration with inflammatory reactions.A corneal sensation was diminished.Initial corneal scrapping for gram stain,Acanthamoeba smear and culture and sensitivity was found to be negative.He was diagnosed as presumed viral disciform keratitis and treated with oral acyclovir and topical steroid.Two weeks later,his vision became deteriorated associated with worsening of the corneal lesion.Re-scrapping corneal specimen for gram stain showed features of Nocardia sp.Topical Gatifloxacin 3g/L was commenced empirically and it showed rapid clinical response.His visual acuity was improved to 6/6 six months after treatment with minimal corneal opacity sparing the visual axis.the condition.If proper treatment is initiated,Nocardia keratitis resolves with minimal scarring and good visual recovery.

  5. An Analysis of 15 Cases of Ramsay-Hunt Syndrome with Intracranial Structure Involvement%伴颅内结构受累的Ramsay-Hunt综合征15例分析

    Institute of Scientific and Technical Information of China (English)

    王特; 杨晓苏

    2013-01-01

    manifestations and is easy to be misdiagnosed. The most common manifestations are facial palsy, herpes zoster oticus and hearing loss. Involvement of any structure or system in the central nervous system(meningeal, brainstem) are also be necessary. The early diagnosis and intravenous acyclovir will achieve a better curative effect.

  6. 频谱治疗仪治疗病毒性肝炎并发带状疱疹的护理%Nursing for Viral Hepatitis and Shingles by Spectrum Instrument

    Institute of Scientific and Technical Information of China (English)

    王秀娟

    2012-01-01

    Objective To observe the effect and nursing of patients with viral hepatitis and shingles hy spectrum instrument. Methods From January 2009 to June 2011, 44 patients with viral hepatitis B and shingles divide 44 patients with hepatitis h virus sex hepatitis in the hospital were randomly into observational group(n =22) and control group(n =22). All the patients were treated with acyclovir antivirus, in-surahle and vitamin B1 needle etc nutrition nerve. The observational group received additional radiation therapy of the WS-301 spectrum upon the shingles site. The skin blisters healed and pain were observed of the two groups. Results Comparison of skin blisters healed and the effect of pain between the two groups showed that the total effective rate was 95. 45% in the observation group and total effectiveness of the control group was 72.73%,and the difference was statistically significant(P<0.05). Conclusion spectrum therapeutic radiation therapy is more quick and effective for viral hepatitis and shingles. During the treatment, insecurity factors should be prevented and psychological counseling should be conducted for the patients.%目的 探讨应用频谱治疗仪治疗病毒性肝炎并发带状疱疹的效果及其护理.方法 方便性抽样选择嘉兴市第一医院2009年1月至2011年6月收治的44例乙型病毒性肝炎并发带状疱疹患者,按随机数字表法将其分观察组和对照组各22例.两组患者均予阿昔洛韦抗病毒、甲钴胺和维生素B1营养神经治疗,观察组在此基础上采用WS-301频谱治疗仪照射治疗带状疱疹部位.观察两组患者皮肤水疱愈合及疼痛情况.结果 两组患者皮肤水疱愈合及疼痛情况的疗效比较,观察组总有效率为95.45%,对照组总有效率为72.73%,差异有统计学意义(P<0.05).结论 常规治疗基础上采用频谱治疗仪照射治疗病毒性肝炎并发带状疱疹可促进水疱愈合,减轻患者疼痛.治疗过程中,要避免不安全因素

  7. Insuficiência renal aguda nefrotóxica: prevalência, evolução clínica e desfecho Nephrotoxic acute renal failure: prevalence, clinical course and outcome

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    Patrícia S. Pinto

    2009-09-01

    nephrotoxic ARF. PATIENTS AND METHODS: Historical cohort carried out in a tertiary school hospital from February to November, 1997. Patients over 12 years of age, diagnosed with ARF, and followed up by a team of nephrologists were included. The exclusion criteria were as follows: renal transplantation, chronic renal failure, dialysis due to exogenous poisoning, and those transferred to hospital during treatment. RESULTS: Of the 234 patients followed up, 12% had nephrotoxic ARF and 24% multifactorial ARF associated with the use of nephrotoxic drugs. The most prevalent comorbidities were as follows: hypertension, hepatopathy, neoplasias, congestive heart failure, and diabetes mellitus. Fifteen percent of the patients required dialysis, and the most commonly used type was continuous venovenous hemodialysis; 42% of the patients were oliguric; 44.7% died; and 33% recovered renal function. The most prevalent nephrotoxic drugs were antibiotics, nonsteroidal anti-inflammatory drugs, and radiographical contrast media. In order of frequency, the nephrotoxic drugs were as follows: vancomycin, aminoglycosides, acyclovir, chemotherapy agents, and radiographical contrast media. In multivariate analysis, hepatopathy was the only statistically significant variable (p = 0.03, CI = 1.08 to 6.49. The comparison of non-nephrotoxic and nephrotoxic ARF showed an increase in mortality proportional to the length of hospitalization. CONCLUSION: Nephrotoxic ARF is common, serious, and must be continuously monitored both in hospital and on an outpatient basis.

  8. Clinical Efficacy of Oral Ganciclovir for Prophylaxis and Treatment of Recurrent Herpes Simplex Keratitis

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    Xin Wang

    2015-01-01

    Full Text Available Background: Herpes simplex keratitis (HSK caused by herpes simplex virus 1 (HSV-1, which has high recurrent rate and incidence of severe vision loss, is the leading cause of infectious blindness in the world. The aim was to explore the clinical efficacy of oral ganciclovir (GCV in the prevention of recurrent HSK. Methods: A multicenter, prospective, randomized, single-blind, and controlled clinical trial was conducted from April 2010 to June 2013. One hundred seventy-three patients (173 eyes involved who were diagnosed as recurrent HSK definitely, including stromal keratitis and corneal endotheliitis, were divided into three groups randomly: negative control (placebo group was topically administered with 0.15% GCV ophthalmic gel, 4 times per day and 0.1% fluorometholone eye drops, 3 times per day until resolution of HSK; positive control acyclovir (ACV group was topically adopted the same ophthalmic gel and eye drops and additionally received oral ACV 400 mg 5 times a day for 10 weeks and followed by 400 mg 2 times per day for 6 months; test GCV group was topically adopted the same treatment as negative control group and additionally received oral GCV 1000 mg 3 times per day for 8 weeks. The symptoms and signs were evaluated before and after the therapy 1 st week, 2 nd week and then followed up every 2 weeks until recovery. Furthermore, we followed up recurrence of HSK for every 3 months after recovery and then assessed the cure time, recurrent rate and adverse reactions. Results: One hundred and seventy-three patients were followed up 7-48 months (mean 32.1 ± 12.3 months, but 34 patients were failed to follow-up. The cure time was 12.1 ± 4.3, 11.9 ± 4.0 weeks in negative control (placebo group and positive control ACV group respectively (P = 0.991, which was longer than that in test GCV group (8.6 ± 2.8 weeks and there was a significant difference between test GCV group and negative control (placebo group or positive control ACV group (P

  9. HPLC法测定人尿液中奥拉西坦的浓度%Determination of Oxiracetam in Human Urine by HPLC

    Institute of Scientific and Technical Information of China (English)

    刘秀菊; 张志清; 孙倩; 亢泽坤

    2013-01-01

    OBJECTIVE: To establish the method for the determination of oxiracetam in human urine, and to provide reference for the study of metabolic pathways of oxiracetam. METHODS: After precipitated with methanol, HPLC method was adopted for the content determination. With acyclovir as an internal standard, a Symmetry shied? RP18 column was used with mobile phase consisted of acetonitrile-water (5:95) at the flow rate of 0.5 ml/min. The column temperature was 40 ℃ and the detection wavelength was set at 210 nm. The injection volume was 20 μl. RESULTS: The linear ranges of oxiracetam were 20-2 400 mg/L. Absolute recoveries of urine at low, middle and high concentrations were (90.38 ± 4.93)% , (93.71 ± 3.54)% and (95.04 ± 2.31)% , and the method recoveries were (98.32 ± 1.96)% , (104.99 ± 1.74)% and (103.4 ± 2.43)%. The intra-day RSDs of urine at three concentrations were 3.40% , 4.76% and 1.04% , and inter-day RSDs were 2.82% , 3.64% and 1.90% , respectively. Trial data showed that 32.89% original drug discharged in 24 h after oral administration of Oxiracetam capsules (1600 mg). CONCLUSION: The method is simple, accurate, sensitive, and can be used for the pharmacokinetic study of oxiracetam in urine.%目的:建立测定人尿液中奥拉西坦浓度的方法,为奥拉西坦代谢途径的研究提供参考.方法:尿液以甲醇沉淀蛋白后,以高效液相色谱法进样测定,其中色谱柱为Symmetry shiedTMRP18柱,流动相为乙腈-水(5∶95),流速为0.5 ml/min,检测波长为210nm,柱温为40℃,进样量为20μl,内标为阿昔洛韦.结果:奥拉西坦尿药浓度在20~2400mg/L范围内线性关系良好;低、中、高3种浓度尿液样品的绝对回收率分别为(90.38±4.93)%、(93.71±3.54)%、(95.04±2.31)%,方法回收率分别为(98.32±1.96)%、(104.99±1.74)%、(103.4±2.43)%;日内RSD分别为3.40%、4.76%、1.04%,日间RSD分别为2.82%、3.64%、1.90%;试验数据显示人口服奥拉西坦胶囊(1600mg

  10. The role of medications and their management in acute kidney injury

    Directory of Open Access Journals (Sweden)

    McDaniel BL

    2015-05-01

    injury has several drugs that are implicated as a possible cause, with antiinfectives being the most common. Postrenal injuries that result from obstruction block the flow of urine, leading to hydronephrosis and subsequent damage to the renal parenchyma. Drugs associated with tubular obstruction include acyclovir, methotrexate, and several antiretrovirals. Renal recovery from drug-induced AKI begins once the offending agent has been removed, if clinically possible, and is complete in most cases. It is uncommon that renal replacement therapy will be needed while recovery occurs. Pharmacists can play a pivotal role in identifying possible causes of drug-induced AKI and limit their toxic effect by identifying those most likely to cause or contribute to injury. Dose adjustment is critical during changes in renal function, and the pharmacist can ensure that optimal therapy is provided during this critical time. Keywords: acute kidney injury, acute renal failure, acute tubular necrosis, drug-induced kidney injury, renal insufficiency

  11. Effect of Flos Lonicerae Extracts on Herpes Simplex Keratitis%金银花提取物对单纯疱疹病毒性角膜炎的作用

    Institute of Scientific and Technical Information of China (English)

    刘莹; 王国丽

    2011-01-01

    目的 考察金银花提取物对单纯性疱疹病毒性角膜炎的疗效.方法 建立单纯性疱疹病毒Ⅰ型(herpes simplex virus-Ⅰ,HSV-Ⅰ)感染Vero细胞的体外模型,以细胞病变效应、治疗指数为观察指标,了解不同浓度金银花提取物体外抗病毒效果;采用HSV-Ⅰ感染家兔角膜建立体内病毒感染模型,分别用金银花提取物、阿昔洛韦、0.9%氯化钠溶液治疗15 d,每天经荧光素钠染色角膜后在裂隙灯下观察药物对病毒性角膜炎模型的治疗作用.结果 体外实验表明,金银花提取物对感染HSV-Ⅰ病毒的Vero细胞具有明显的抗病毒作用,最大无毒浓度为384 mg·L-1,治疗指数为26.56;体内实验结果显示,与模型组相比,金银花提取物和阿昔洛韦均能有效治疗单纯疱疹病毒性角膜炎,减轻角膜病变程度,缩短平均治愈时间,金银花提取物疗效与阿昔洛韦相似.结论 金银花提取物对单纯疱疹病毒性角膜炎有显著的疗效.%Objective To study therapeutic efficacy of Flos Lonicerae extracts on herpes simplex keratitis. Methods A model of Vero cells infected with herpes simplex virus-I( HSV-I) was established. The in vitro anti-virus effect of different doses of Flos Lonicerae extracts was evaluated by using cytopathic effect ( CPE ) and therapeutic index ( TI ) .In vivo model of rabbit corner keratitis induced with herpes simplex ( HSK ) were established. Rabbits were treated with Flos Lonicerae extracts, Acyclovir ( ACV ) and normal saline for 15 days, respectively. The rabbit cornea was checked after dyeing with flourescein-natrium under slitlamp. Results It was showed that the Flos Lonicerae extracts possessed distinct anti-HSV-I effect on Vero cells,TC0 of which was 384 mg ? L-1and TI was 26. 56. Compared with the model group in vivo,both Flos Lonicerae extracts and ACV significantly reduced severity of HSV-I dendritic keratitis, shortened healing time of HSK. There was no statistical significance

  12. 单纯疱疹病毒性脑炎60例临床分析%Clinical analysis of 60 cases with herpes simplex virus encephalitis

    Institute of Scientific and Technical Information of China (English)

    王学义; 邹卿; 蒲涛

    2012-01-01

    , accompanied by lips or genital skin or mucosal herpes. The patients firstly appears headache, nausea, vomiting, fever, some with psychiatric symptoms (auditory hallucinations, visual hallucinations, speech disorders, personality changes, dysphoria or lack of facial expression) , repeated partial seizures and epilepsy stale, central facial paralysis, paralysis of limbs, disturbance of consciousness ( delirium, lethargy, drowsiness, shallow, middle, deep coma). The state of illness reached a peak from a few hours to several days. The detection of virus-specific antibody of cerebrospinal fluid: HSV-specific IgM was positive with 54 cases in a week, remained six cases were positive in 2 weeks. There were 20 cases whose HSV specific antibody IgG and IgE of paired cerebrospinal fluid in convalescence was more than 4 times. Other check of cerebrospinal fluid; most of cerebrospinal fluid was abnormal,such as increased pressure ( >200mmH2O) , leukocytosis. Some showed increase in red blood cells and light-moderate increase in protein, sugar and chloride were normal, without bacterial growth by smearing and culturing, and without cancer cells and malignant cells by pathological examination. Head CT and MRI: 60 patients with head CT scan in the onset of two weeks, most of the CT examination revealed abnormal. The most of patients with normal head CT had anomalistic head MRI. EEG: Most of them is abnormal. Diffuse abnormalities was in the majority, including severe abnormal in 18 cases, moderately abnormal in 20 cases, mildly abnormal in 20 cases. Prognosis: most of them is good, except six cases with death. Conclusion Herpes simplex virus encephalitis by clinical diagnostic criteria easily is diagnosed, the state of an illness is usually critical by anti-virus with using acyclovir and symptomatic treatment, the prognosis is good in the majority of the HSE patients, donot left over after-effects, but some have very poor prognosis, with different degrees of sequela and even death.

  13. Atividade de três drogas antivirais sobre os herpesvírus bovino tipos 1, 2 e 5 em cultivo celular Activity of three antiviral drugs against bovine herpesviruses 1, 2 and 5 in cell culture

    Directory of Open Access Journals (Sweden)

    Renata Dezengrini

    2010-10-01

    Full Text Available A atividade de três fármacos antivirais (Aciclovir [ACV], Ganciclovir [GCV] e Foscarnet [PFA] foi testada in vitro frente aos herpesvírus bovino tipos 1 (BoHV-1, 2 (BoHV-2 e 5 (BoHV-5. Para isso, utilizou-se o teste de reducao de placas virais em cultivo celular, testando-se diferentes concentracoes dos farmacos frente a 100 doses infectantes para 50% dos cultivos celulares (DICC50 dos respectivos virus. Pelo teste de MTT (3-(4,5-Dimethylthiazol- 2-yl-2,5-diphenyltetrazolium bromide, verificou-se que concentracoes inferiores a 200ƒÊg/mL dos tres antivirais resultaram em indices de viabilidade de celulas MDBK e Hep2 superiores a 80%. Com base na concentracao citotoxica para 50% das celulas (CC50 e na concentracao dos farmacos efetiva para inibir em 50% o numero de placas virais (EC50, calculou-se o indice de seletividade (IS dos antivirais para os tres herpesvirus. Assim, o ACV demonstrou ser moderadamente ativo frente ao BoHV-1 (EC50: 112,9ƒÊg/mL e IS: 4,5, ao BoHV-2 (EC50: 114,2 ƒÊg/mL e IS: 4,5 e BoHV-5 (EC50: 96,9ƒÊg/mL e IS: 5,3. O GCV apresentou atividade moderada frente ao BoHV-2 (EC50: 33,5ƒÊg/mL e IS: 16,6 e, em menor grau, contra o BoHV-5 (EC50: 123,2ƒÊg/mL e IS: 4,5, sendo ineficaz frente ao BoHV-1 (EC50: 335,8ƒÊg/mL e IS: 1,7. O PFA apresentou atividade antiviral mais pronunciada, sendo o unico farmaco que, na concentracao de 100ƒÊg/mL, inibiu completamente a producao de placas pelos tres virus testados. O PFA foi o mais efetivo in vitro frente ao BoHV-1 (EC50: 29,5ƒÊg/mL e IS: 42,2, ao BoHV-2 (EC50: 45,2ƒÊg/mL e IS: 27,6 e ao BoHV-5 (EC50: 7,8ƒÊg/mL e IS: 160,6. Portanto, os resultados obtidos indicam que o PFA pode se constituir em um candidato para terapia experimental de infeccoes pelos herpesvirus de bovinos in vivo.The activity of three anti-herpetic drugs (Acyclovir [ACV], Gancyclovir [GCV] and Foscarnet [PFA] was tested against bovine herpesvirus 1 (BoHV-1, 2 (BoHV-2 and 5 (BoHV-5 in vitro using the

  14. Primary hypogammaglobulinemia complicated with liver cirrhosis and literature review%抗体缺陷病并发肝硬化一例并文献复习

    Institute of Scientific and Technical Information of China (English)

    邓朝晖; 蒋丽蓉; 张斌; 徐亚珍; 沈丛欢; 周韬; 夏强; 张天遨

    2016-01-01

    child were analyzed in Shanghai Children's Medical Center.Using "primary hypogammaglobulinemia" and "liver cirrhosis" as keywords,literatures were searched from Pubmed and Chinese data of Weipu and Wanfang data from January 1988 to January 2015.Result The patient was a 12 years old boy with the chief complaint of 3 times hematemesis with diagnosis of XLA in the past 7 years.He received treatment with immunoglobulin (Ig) monthly for 6 years.He had no hepatitis C virus(HCV) infection and serologic tests for autoantibodies were negative.Anti-HBs,anti-HBe and anti-HBc were positive,which revealed previous hepatitis B virus(HBV) infection.Gastroscopy suggested esophageal gastric varices.Liver pathology showed liver cell degeneration,necrosis,fiber tissue hyperplasia and pseudolobuli.After hospitalization the boy underwent liver transplantation (LT).He was given tacrolimus (3 mg/d),prednisone (5 mg/d),lamivudine (150 mg/d) and acyclovir (900 mg/d) by oral administration after LT.After 3 months follow-up,the boy was alive and well with stable results of liver function tests.There were no report in Weipu and Wanfang data.A total of 19 cases,including 12 cases of common variable immunodeficiency,3 cases of XLA,2 cases of Hyper-IgM syndrome and 2 cases of congenital hypogammaglobulinemia were obtained from Pubmed published between Januau 1,1988 and January 1,2015.Seventeeu of the cases had HCV infection.Two cases had autoimmune hepatitis.Of the HCV infected patients,15 were given iutravenous gamma globulin.Seven of the 19 cases survived.Among 5 cases who received liver transplantation,3 cases died.Conclusion In addition to HCV infection and autoimmune hepatitis as causes of liver cirrhosis in primary hypogammaglobulinemia,chronic HBV infection is another cause.Intravenous gammaglobulin is an important way of transmittiug HCV and HBV infection.The effect of liver transplantation remains to be evaluated via further follow-up and studies.

  15. Vesicular Contact Reaction May Progress into Erythema Multiforme.

    Science.gov (United States)

    Czarnecka-Operacz, Magdalena; Jenerowicz, Dorota; Szulczyńska-Gabor, Joanna; Teresiak-Mikołajczak, Ewa; Szyfter-Harris, Joanna; Bowszyc-Dmochowska, Monika

    2016-12-01

    to be treated with acyclovir intravenously. Eight days after admission, we switched from intravenous metyloprednisolone to its oral formula. Diagnostic methods included: laboratory analyses (leukocytosis, neutrophilia, lymphopenia could be observed, and also serum CRP elevation). Pemphigoid gestationis was excluded on the basis of a direct immunofluorescence from perilesional skin and on the basis of indirect immunofluorescence and also serum analysis using ELISA for serum IgG antibodies to BP180-NC16A (courtesy of Prof. Marian Dmochowski). Histopathological examination revealed: massive edema of dermal papillae, leading to the formation of sub-epidermal vesicles; individual cell necrosis was observed in the upper epidermis. Within the dermis, a dense, perivascular inflammatory infiltrate was detected: the clinical picture suggested erythema multiforme. Another histopathological examination was performed at the University Clinic of Dermatology and Venereology in Magdeburg, courtesy of Prof. Dr. Harald Gollnick and Dr. Med. I. Franke; it also suggested the bullous form of erythema multiforme (dermal type). Three months after remission, the patient was hospitalized again to perform allergological diagnostics. Patch tests were performed with the European Baseline Series (Chemotechnique Diagnostics) supplemented with disinfectants and textiles used during surgical procedure. For patch testing, Finn Chambers on Scanpor were used. Results were recorded at 48 and 72 hour time points. According to the ICDRG (International Contact Dermatitis Research Group), reactions evaluated as ++ and +++ pluses were considered as positive and reaction evaluated as + plus was considered as doubtful. Patch testing revealed polyvalent contact allergy (Table I), (Figure 2a). The patient also reacted to Kodan Tinctur forte used as a skin disinfectant (contains brown dye LF 1889 - mixture of quinoline yellow, sunset yellow, brilliant black) (Figure 2b). It has to be emphasized, that patch test

  16. 小肠移植术后巨细胞病毒感染二例的治疗体会%Cytomegalovirus infection after small bowel transplantation

    Institute of Scientific and Technical Information of China (English)

    李元新; 李宁; 李幼生; 倪小冬; 吴波; 王剑; 李民; 黎介寿

    2011-01-01

    diagnosis of CMV graft enteritis was defined, and plasma diagnosis tools including CMV-IgM, CMV pp65 and CMV DNA with PCR were introduced. 2-3 weeks intravenous ganciclovir prophylaxis of CMV was underway, followed by 3 months oral acyclovir; In era Ⅲ, more precise real-time PCR technique was used to detect CMV DNA copies, and the schedule of the CMV surveillance was set up, antiviral prophylaxis therapy was modified to 2-3 weeks intravenous ganciclovir and 3 months oral ganciclovir, and preemptive therapy to halt the progression of asymptomatic infection to clinical disease was also introduced.Results Two of 15 SBTx recipients suffered from CMV with the occurrence rate of 13.3%. One recipient in era Ⅱ suffered from CMV graft enteritis on postoperative day 45, and CMV pneumonia on postoperative day 64, he received intravenous ganciclovir and thymus peptide, paused tacrolimus maintenance, and finally he died from severe acute cellular rejection. 94 100 copies/ml of CMV DNA in periphery blood of a recipient in era Ⅲ was detected with real-time PCR at 3rd month after SBTx, and a preemptive therapy successfully halted the CMV infection.Conclusion Antiviral prophylaxis therapy and close surveillance of CMV infection after SBTx should be performed, and preemptive therapy can also halt the CMV infection. When CMV disease occurs, the recipient should receive effective antiviral therapy, and acute cellular rejection also should be closely monitored at same time.

  17. The factors influencing the prognosis of herpes simplex virus encephalitis%儿童单纯疱疹病毒性脑炎的预后影响因素

    Institute of Scientific and Technical Information of China (English)

    彭炳蔚; 朱海霞; 李小晶; 高媛媛; 麦坚凝

    2014-01-01

    and HSV DNA-PCR positive in cerebrospinal fluid(CSF) from Jan.2012 to Oct.2013,among whom,19 patients were treated with intravenous Acyclovir,30 mg/(kg · d) 48 hours after onset and were followed up for 6 to 24 months.Clinical data were collected including Glasgow Coma Score,the brain magnetic resonance imaging(MRI),and electroencephalography(EEG).All MRI examinations including plain scan and contrast enhancement were carried out at the beginning of admission and 1 month after the onset of symptoms.The clinical outcomes were divided into two levels accoming to the severity of the neurological deficit,then the data were analyzed by using Logistic regression and Fisher's exact probability method.The OR value was calculated.Results Eighteen children survived,of whom 5 cases had no neurological deficit(27.8%),3 cases were left with mild impairment(16.7%),and the above 8 cases were thought to have better outcome.Six cases had moderate impairment (33.3%) and 4 cases had severe impairment(22.2%) and 1 child died,and these 11 cases were thought to have worse outcome.Patients aged between 1 month and 10 years,average (2.03 ± 2.23) years old.The mean GCS score was (9.68 ± 2.65) scores,the GCS of the patients were more than 7except for one death child with 3 scores.The multiple factor analysis showed that EEG,age,GCS and the range and character in MRI were significantly correlative to the prognosis(P < 0.05).The single factor analysis illustrated that age 1-4 years old(OR =30,95% CI 2.066-366.510,P =0.002),GCS ≤ 10 scores(OR =27.518,95% C1 2.066-366.510,P =0.004)and the wide necrosis existence involving diffuse white matter or deep nuclei of MRI findings (OR =12,95 % CI 1.294-111.323,P =0.017) indicated the worse outcome.Conclusions Age,GCS score,nature and damage degree of MRI lesions are the main important factors affecting the prognosis of children's HSE.HSE in children is apt to involve the cortex such as frontal lobe,parietal lobe even diffuse white