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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In recent years, the antiviral armamentarium has expanded considerably. Currently available agents are virustatic, inhibiting specific steps in the process of viral replication. No agent is active against nonreplicating or latent viruses. Acyclovir is useful in the treatment of genital herpes, herpes simplex encephalitis, mucocutaneous herpetic infection, varicella infection in the immunosuppressed host, and herpes zoster infection in the normal and the immunosuppressed host. It can also be used for prevention of herpesvirus infection in immunocompromised patients. Ganciclovir is indicated for the treatment of cytomegalovirus retinitis in patients with acquired immunodeficiency syndrome (AIDS) and is effective in the management of organ-specific cytomegalovirus infection in other immunocompromised patients. Chronic hepatitis C and condyloma acuminatum due to human papillomavirus respond to therapy with interferon alfa-2b. Patients with human immunodeficiency virus infection and CD4 lymphocyte counts of less than 500 cells/mm3 should be treated with zidovudine. Amantadine is useful in a therapeutic and prophylactic role in the management of influenza A virus infection. With the expanded use of and indications for antiviral therapy, clinically significant resistance to these agents has been encountered with increasing frequency.
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PMID:Antiviral agents. 134 78

Antiviral agents are less numerous and often more toxic than antibacterial agents. Acyclovir is commonly used for suppression and treatment of recurrent genital herpes simplex virus and may be indicated for pregnant women with disseminated herpes. Zidovudine is indicated for pregnant women with human immunodeficiency virus infection who have low CD4 lymphocyte counts. Ganciclovir, vidarabine, ribavirin, amantadine, didanosine, and foscarnet are rarely indicated in gynecology and are not recommended for use in pregnancy.
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PMID:Antiviral agents. 143 33

Human Herpesvirus-6 is the etiological agent of Roseola infantum and approximately 12% of heterophile antibody negative infectious mononucleosis. HHV-6 is T-lymphotropic, and readily infects and lyses CD4+ cells. The prevalence rate of HHV-6 in the general population is about 80% (as measured by IFA) with an IgG antibody titer of 1:80. A lower prevalence, however, is observed in some countries. HHV-6 is reactivated in various malignant and non-malignant diseases as well as in Chronic Fatigue Syndrome and transplant patients. Furthermore, elevated antibody titers were also observed in lymphoproliferative disorders, auto-immune diseases and HIV-1 positive AIDS patients. There appears to be some strain variability in HHV-6 isolates. The GS isolates of HHV-6 (prototype) was resistant to Acyclovir, Gancyclovir, but its replication was inhibited by Phosphonoacetic acid and Phosphoformic acid. HHV-7 isolated from healthy individuals showed, by restriction analysis, that 6 out of 11 probes derived from two strains of HHV-6, cross-hybridized with DNA fragments, derived from HHV-7.
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PMID:Human herpesvirus-6 (HHV-6) (short review). 165 46

A 50 year old patient with non-diagnosed HIV-infection at onset of his illness developed impairment of vision and temporary double vision combined with severe hemianopsia. With normal fundus and suspicious Herpes simplex iritis therapy with Acyclovir was started. Primarily the patient showed a good response to the therapy and loss of vision could be prevented. After 4 weeks CMV-retinitis developed. In spite of Gancyclovir therapy manifestation of total loss of vision after 6 weeks. Autopsy demonstrated signs of simultaneous a CMV-infection of the retina and a herpes simplex-infection of the optic nerve combined with a Non-Hodgkin-Lymphoma of the optic tract.
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PMID:[Sudden blindness in an AIDS patient. Simultaneous infection with cytomegalovirus and herpes simplex viruses and development of malignant non-Hodgkin lymphoma]. 165 79

Acyclovir and zidovudine are the two most widely used antiviral drugs. Acyclovir is efficacious against all infections caused by herpes simplex virus, but treatment must start early to be effective. Herpes zoster virus is less susceptible to acyclovir, but high doses shorten the duration of skin lesions, although the effect on post-herpetic neuralgia is uncertain. Zidovudine diminishes short-term mortality in patients with HIV infection and serious opportunistic infections. In those patients, the average increase in life expectancy is about one year. Because of myelotoxicity, frequent monitoring of blood counts is necessary. Recent results in patients who have few or no symptoms of HIV infection indicate that the drug decreases the chance of progressing to AIDS. Therefore, indications for treatment now include asymptomatic patients with unfavourable laboratory parameters.
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PMID:[Antiviral substances: against what? For whom?]. 221 67

There has been a dramatic increase in patient visits to physicians for evaluation and treatment of genital herpes infections. This has resulted in part from an increase in genital herpes infections, particularly severe, first-episode genital herpes infections in adults without prior HSV-1 infection. Virus culture remains the most sensitive and specific method for diagnosis, and use of viral cultures is encouraged. Type-specific antibody tests have been employed in studies documenting the role of asymptomatic shedding of HSV in transmission of genital infections, the role of genital HSV in transmission of HIV, the predominance of asymptomatic and unrecognized infections in those infected with HSV-2, and the presence of past asymptomatic or unrecognized acquisition of HSV-2 in 25% of persons presenting with first-episode genital herpes. Unfortunately, commercially available serologic tests do not reliably differentiate between antibody to HSV-1 and HSV-2. Recent studies suggest that the annual risk of transmission from a sexual partner with genital herpes is about 10% in heterosexual couples. Currently, promotion of "safe sex" is the only available approach for prevention of transmission. However, ongoing research is focused on the development of an effective vaccine. Acyclovir should be used routinely in persons with first-episode genital herpes, but careful evaluation is needed in persons with recurrent genital herpes to determine whether episodic or suppressive treatment is indicated. Acyclovir should also be used routinely for episodic or suppressive treatment of HSV infections in persons with AIDS. Additional antiviral agents are needed for more effective suppressive therapy and for treatment of ACV-resistant HSV infections in the immunocompromised host.
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PMID:Genital herpes simplex virus infections. 224 48

We present the case of an ulcerative lesion of the nasal mucous membrane and of the cutis surrounding the nose, starting six months ago, in a 26 year-old woman. From the histological picture a necrotic Herpes-virus infection was diagnosed. This suggested the existence of a deficiency of cell-mediated immunity. In fact a selective quantitative defect in the helper/inducer subset of T lymphocytes, as observed in AIDS, was noticed. HIV infection was confirmed by the ELISA test and the Western Blot test. Viral cultures grew HSV I from the skin lesion, which rapidly recovered after treatment with Acyclovir. We emphasize the absence of other signs and symptoms that could make us suspect an HIV infection and the rarity in the literature of the occurrence of HSV infections in that particular location as an initial manifestation of AIDS.
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PMID:[Ulcerative herpes simplex as the first manifestation of AIDS]. 227 60

A 43-year-old homosexual man was hospitalized in April 1988 because of acute epigastric pain. It was known that he had had a HIV infection for a year, and in April 1988 it was defined as stage Walter Reed I. Acute, exudative, nonspecific pancreatitis was diagnosed. Three weeks later cerebral symptoms (disturbances of consciousness), hypoacusis, and impaired vision developed. The ocular fundus displayed areas of edema and whitish clouding in the retina, first in the left eye and later also in the right. These were initially assumed to be anemic infarctions until the differential diagnosis of acute retinal necrosis with possible herpesvirus infection was made. On the basis of ophthalmoscopic findings cytomegalovirus retinitis appeared improbable. Serologic examinations showed increased levels of IgG antibody titers of cytomegalovirus and herpes simplex virus (both 1:20,000). Therapy with intravenous infusions of Acyclovir was instituted (1500 mg/d). After a few days the patient regained consciousness as well as his hearing and vision. There was complete resolution of the retinal exudates. This excellent therapeutic result of Acyclovir therapy confirmed the diagnosis of acute retinal necrosis syndrome, identified the cerebral symptoms as herpes encephalitis, and explained the entire disease process as the first opportunistic infection in HIV infection, i.e., by that time the patient had developed stage Walter Reed 6 (AIDS). Problems of differential diagnosis and the therapeutic schedule with Acyclovir are discussed.
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PMID:[Acute retinal necrosis and herpes encephalitis. The key role of the ophthalmologist in diagnosing opportunistic infections in AIDS, successful therapy with acyclovir (Zovirax)]. 234 17

Infections caused by herpes simplex virus (HSV) are a significant source of morbidity in immunocompromised patients. Acyclovir is often used prophylactically and therapeutically in patients with human immunodeficiency virus infection. The emergence of acyclovir-resistant strains of HSV capable of causing disease has been recognized. We report a case in which a thymidine kinase-deficient mutant of HSV caused extensive disease in a patient with AIDS. This case emphasizes that virus recovered from nonhealing lesions should be submitted for further study, which may advance our understanding of the interaction between host defense and drug-resistant strains.
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PMID:Mucocutaneous dissemination of acyclovir-resistant herpes simplex virus in a patient with AIDS. 254 44

Acyclovir (Zovirax) and zidovudine (Retrovir) dominate antiviral therapy. They interfere with the multiplication of herpes viruses (acyclovir) and HIV (zidovudine) by incorporation into nascent DNA chains and interruption of the further linking of nucleotides. All types of infection caused by herpes simplex virus are potentially treatable by acyclovir, but treatment has to start to be effective. It is especially important to treat immunosuppressed patients because their infections are more prolonged and severe. A typical attack of herpes zoster in an immunocompetent patient is shortened by about 2 days if high doses of acyclovir are given within 3 days of the start of the skin lesions, but unfortunately the incidence of post-herpetic neuralgia is not diminished. Zidovudine lowers early mortality in patients with AIDS and pneumocystis carinii pneumonia. However, much of the effectiveness of zidovudine is lost later; the average prolongation of life in treated patients is estimated to be about 1 year. Some two thirds of patients with AIDS can be treated with zidovudine; in the others the drug is ineffective (Kaposi's sarcoma) or contraindicated. Frequent blood counts are necessary to monitor myelotoxicity.
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PMID:[Antiviral drugs--1988]. 285 Nov 67


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