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Intravenous Acyclovir to Treat Mucocutaneous Herpes Simplex Virus Infection After Marrow Transplantation
A Double-Blind Trial
- JAMES C. WADE, M.D.;
- BARBARA NEWTON, R.N.;
- COLIN McLAREN, Ph.D.;
- NANCY FLOURNOY, M.S.;
- RONALD E. KEENEY, M.D.; and
- JOEL D. MEYERS, M.D.
Abstract
Acyclovir, a new antiviral agent, was compared to a placebo in a randomized double-blind trial of treatment for culture-proven herpes simplex virus infection after marrow transplantation. Patients received either intravenous acyclovir at 750 mg/m2 body surface area per day or a placebo for 7 days. Thirteen of 17 patients given acyclovir had a beneficial response as compared with two of 17 given the placebo (p < 0.01). The duration of positive cultures was shorter among acyclovir recipients (3 versus 17 days, p < 0.00005). Also shorter were the median days to resolution of pain (10 versus 16 days, p = 0.03), to crusting of lesions (7 versus 14 days, p = 0.01), and to total healing (14 versus 28 days, p = 0.03). No acyclovir toxicity was observed. Recurrent infection was common. Acyclovir provided significant antiviral and clinical efficacy without toxicity in highly immunosuppressed patients but had no effect on virus latency.
Article and Author Information
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▸From the Divisions of Infectious Diseases and Oncology, Department of Medicine, University of Washington School of Medicine, and the Fred Hutchinson Cancer Research Center; Seattle, Washington; and the Burroughs Wellcome Co.; Research Triangle Park, North Carolina.
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Grant support: in part by a grant from the Burroughs Wellcome Co. , and by grants CA 18029 and AI 07044 from the National Institutes of Health. Dr. Meyers is the recipient of Young Investigator Award AI 15689 from the National Institute of Allergy and Infectious Diseases.
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▸Requests for reprints should be addressed to Joel D. Meyers, M.D.; Fred Hutchinson Cancer Research Center, 1124 Columbia Street; Seattle, WA 98104.
- © 1982 American College of Physicians
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