OBJECTIVETo study the value of antiviral therapy for infectious monocytosis (IM) in children by comparing the near-term therapeutic efficacies and long-term follow-up results in children with this disorder between receiving antiviral therapy or not.

METHODSThe medical data of IM children between 1999 and 2009 were retrospectively reviewed. A total of 172 cases with a follow-up visit period of 1 year and more were eligible. The children were classified into three groups according to the treatment protocol: ganciclovir treatment (n=49), acyclovir treatment (n=72) and symptomatic treatment (control; n=51). The children in the ganciclovir group received an intravenous drip of 10 mg/kg per day of ganciclovir, administered in twice-daily doses; Seven days later the drip volume was changed to 5 mg/kg, administered once each day; the total course lasting 10-14 days. The children in the acyclovir group received acyclovir orally at 20 mg/kg per day, administered in three times daily doses; the total course lasting 10-14 days. The children in the control group received symptomatic treatment only. In the three groups, indicators including fever course, improvement of isthmitis symptoms, lymph node retraction, hepatic and splenic lymph node retraction time, atypical lymphocyte fallback time and alteration of granulocyte amount after drug use were observed. The long-term follow-up visits covered such indicators as blood routine reexamination, hepatic function, liver and spleen B-ultrasonography, recovery rate, recurrence rate and mortality rate.

RESULTSIn the acute phase, there were no differences in terms of fever course, isthmitis improvement, hepatic and splenic lymph node retraction time and the time of atypical lymphocyte falling back to below 10% among the three groups (P>0.05). During the period of follow-up visits between 1 year and 8 years and 10 months, no significant differences were observed in the recovery rate, the recurrence rate and the mortality rate among the three groups (P>0.05).

CONCLUSIONSThe efficacies of antiviral therapy for IM children appear to be similar to non-antiviral therapy, suggesting that antiviral therapy fails to be beneficial for IM children.

Acyclovir ; therapeutic use ; Adolescent ; Antiviral Agents ; therapeutic use ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Ganciclovir ; therapeutic use ; Humans ; Infant ; Infectious Mononucleosis ; drug therapy ; Male ; Retrospective Studies

OBJECTIVETo study the therapeutic effect of integrative medicinal therapy with Qinzhu Liangxue Mixture (QLM) in combined with valaciclovir on herpes zoster (HZ) in middle and old aged patients.

METHODSNinety-seven HZ patients were randomly assigned to three groups and treated respectively with QLM alone (A), valaciclovir alone (B) and QLM plus valaciclovir (C). Times for stopping newly appeared blisters, scabbing relieving pain, and curing, as well as incidence rate of postherpetic neuralgia (PHN) after treatment were evaluated. Patients' symptoms and signs were scored before and after treatment.

RESULTSTime for appeaed newly blister and scabbing was shorter in Group B than in Group A; time for relieving pain and curing was shorter in Group C than in Group A; and the PHN incidence rate in Group C was the lowest.

CONCLUSIONValaciclovir can control the skin rash of HZ with quicker initiating time, and QLM can effectively relieve pain, the combined use with the two drugs can decrease the incidence rate of PHN availably.

Acyclovir ; analogs & derivatives ; therapeutic use ; Aged ; Analgesics ; therapeutic use ; Antiviral Agents ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Herpes Zoster ; drug therapy ; Humans ; Integrative Medicine ; Middle Aged ; Valine ; analogs & derivatives ; therapeutic use

Here we report a case of optic neuritis in the setting of herpes zoster ophthalmicus (HZO) in a child. A six-year-old girl presented with HZO in the right eye. During the hospitalization, her visual acuity decreased. Fluorescein angiography (FAG) and optical coherence tomography revealed optic neuritis in the affected eye. Visual acuity improved with one month of treatment with acyclovir and steroids. FAG analysis showed no evidence of leakage at the optic disc. At one year post treatment, the patient's fundus exam and vision were normal. Therapy with antivirals and steroids may be effective in patients with childhood HZO optic neuritis
Acyclovir/therapeutic use ; Child ; Drug Therapy, Combination ; Female ; Fluorescein Angiography ; Herpes Zoster Ophthalmicus/*complications/*drug therapy ; Humans ; Optic Neuritis/*drug therapy/*virology ; Steroids/therapeutic use ; Visual Acuity

OBJECTIVEUsing pharmacokinetics 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.

METHODSingle 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.

RESULTBoth 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.

CONCLUSIONHoney can significantly increase the ACV concentration and bioavailability in the eye, extend the action time of ACV in target cells and increase the retention capacity of ACV in the target tissue; thereby improving treatment success.

Acyclovir ; pharmacokinetics ; therapeutic use ; Animals ; Antiviral Agents ; pharmacokinetics ; therapeutic use ; Disease Models, Animal ; Eye ; drug effects ; metabolism ; Female ; Honey ; analysis ; Humans ; Keratitis, Herpetic ; drug therapy ; metabolism ; Male ; Rabbits

Acyclovir ; therapeutic use ; Antiviral Agents ; therapeutic use ; Dermatology ; Emergencies ; Female ; Herpesvirus 1, Human ; Humans ; Kaposi Varicelliform Eruption ; diagnosis ; drug therapy ; Skin Diseases ; diagnosis ; drug therapy ; Young Adult

OBJECTIVETo evaluate the role of acyclovir in treatment and prevention of herpes simplex keratitis (HSK).

METHODSA total of 105 patients with HSK were divided into 4 groups. Group 1 consisted of 79 patients with HSV epithelial keratitis. Group 2 consisted of 20 patients with interstitial keratitis. Group 3 consisted of 6 patients with necrotizing keratitis. Group 4 consisted of 4 necrotizing keratitis patients with corneal perforation treated with conjunctival flap and corneal transplantation. All patients were treated with acyclovir systemically and topically. After full recovery, the patients with epithelial HSK and stromal HSK were randomly divided into two groups individually. One group was constantly treated with oral acyclovir at 300 mg/day for 1 year as a prophylaxis group. The other group was designated as control.

RESULTSDuring the one-year treatment and follow-up, 5 cases with epithelial HSK recurred in the prophylaxis group and 14 cases in the control group, showing a statistically significant difference. One case of stromal HSK recurred in the prophylaxis group and 4 recurred in the control group.

CONCLUSIONLong term and low dose oral acyclovir for prophylaxis of recurrent epithelial herpes simplex infection and therapeutic doses of oral acyclovir reduce both the rate and duration of recurrences of infectious herpes simplex keratitis.

Acyclovir ; therapeutic use ; Adolescent ; Adult ; Antiviral Agents ; therapeutic use ; Child ; Female ; Humans ; Keratitis, Herpetic ; drug therapy ; prevention & control ; Male ; Middle Aged ; Recurrence

Acyclovir ; therapeutic use ; Aged, 80 and over ; Anti-Bacterial Agents ; therapeutic use ; Antiviral Agents ; therapeutic use ; Blister ; chemically induced ; etiology ; Female ; Floxacillin ; therapeutic use ; Herpes Zoster ; diagnosis ; drug therapy ; Humans ; Irritants ; adverse effects ; Shoulder Pain ; drug therapy ; etiology

OBJECTIVETo evaluate the clinical efficacy of intradermal injection of methylene blue for treatment of moderate to severe acute thoracic herpes zoster and prevention of postherpetica neuralgia in elderly patients.

METHODSSixty-four elderly patients with herpes zoster were randomized to receive a 10-day course of intradermal injection of methylene blue and lidocaine plus oral valaciclovir (group A, 32 cases) and intradermal injection of lidocaine plus oral valaciclovir (group B).Herpes evaluation index, pain rating index, incidence of postherpetic neuralgia, and comprehensive therapeutic effect were compared between the two groups at 11, 30 and 60 days after the treatment.

RESULTSThe baseline characteristics were comparable between the two groups (all P>0.05). Compared with that in group B, the time for no new blister formation, blister incrustation and decrustation, and pain relief was significantly shortened in group A (P<0.05) with also obviously lower pain intensity after the treatment. The incidence of postherpetic neuralgia was significantly lower in group A than in group B at 30 days (P<0.05), but not at 60 and 90 days after the treatment. The total clinical response rate was 93.8% in group A, much higher than that in group B (62.5%, P<0.05).

CONCLUSIONIntradermal injection of methylene blue can effectively shorten the disease course, reduce the pain intensity and prevent the development of postherpetic neuralgia in elderly patients with herpes zoster.

Acyclovir ; administration & dosage ; analogs & derivatives ; therapeutic use ; Aged ; Herpes Zoster ; complications ; Humans ; Incidence ; Injections, Intradermal ; Lidocaine ; administration & dosage ; therapeutic use ; Methylene Blue ; administration & dosage ; therapeutic use ; Neuralgia, Postherpetic ; therapy ; Pain Measurement ; Valine ; administration & dosage ; analogs & derivatives ; therapeutic use

OBJECTIVETo evaluate the efficacy and safety of hydrochloride valacyclovir in treatment of varicella in pediatric patients between April 2006 and March 2007.

METHODSA randomized controlled multi-center clinical trial was conducted in 5 pediatric centers, i.e., Children's Hospital of Fudan University, Children's Hospital of Zhejiang University, Children's Hospital of Nanjing Medical University, Pediatric Department of Tongji Hospital of Tongji Medical College, Huazhong University of Science & Technology and Children's Hospital, Chongqing University of Medical Sciences. Patients who were clinically diagnosed as varicella without any complications and were beyond 3 years of age were enrolled into the study from the out-patient clinics. The subjects were divided into two groups randomly, one was treated with hydrochloride valacyclovir, the other with ribavirin. There were 128 cases in the group treated with hydrochloride valacyclovir and 132 cases in control group treated with ribavirin. The treatment duration of two groups was five days. The clinical efficacy and safety were evaluated after the first day and the fourth day of the treatment and within three days after the end of the treatment. The clinical efficacy was assessed by efficacy index.

RESULTS(1) The efficacy index on the fourth day of the therapy (0.80 +/- 0.24) in the valacyclovir group was significantly higher than that of ribavirin control group (0.59 +/- 0.37) (t = 5.42, P < 0.01). The efficacy index at the end of the treatment (0.86 +/- 0.14) in the hydrochloride valacyclovir group was also significantly higher than that (0.70 +/- 0.30) of the ribavirin control group (t = 5.43, P < 0.01). (2) In the valacyclovir and ribavirin groups, the effective rates on the fourth day of the therapy were 94.53% and 72.7% respectively (chi2) = 22.38, P < 0.01). The effective rates at the end of the therapy were 99.2% and 88.6%, respectively (chi(2) = 12.60, P < 0.01). The rates of cure of the two groups were 33.6% and 25.0% (chi2) = 2.32, P > 0.05). (3) No severe adverse drug reactions were observed in any of the two groups.

CONCLUSIONSThe hydrochloride valacyclovir was safe, reliable and convenient in treatment of uncomplicated varicella in children.

Acyclovir ; adverse effects ; analogs & derivatives ; therapeutic use ; Antiviral Agents ; adverse effects ; therapeutic use ; Chickenpox ; drug therapy ; Child ; Child, Preschool ; Female ; Humans ; Male ; Valine ; adverse effects ; analogs & derivatives ; therapeutic use

One patient with bilateral acute retinal necrosis underwent encircling scleral buckle, vitrectomy, and intravitreal acyclovir on both eyes. This procedure was performed on the right eye while the retina was attached. The retina of the right eye was reattached by performing fluid-gas exchange and modified panretinal photocoagulation when the retina subsequently detached. Soon after the development of retinal detachment in the left eye, the above surgical procedures were performed on the left eye, and the retina was successfully reattached.Bilateral acute retinal necrosis with significant vitreous opacification, which is a devastating ocular disease causing possible blindness in both eyes, requires more aggressive, early surgical management.
Acute Disease ; Acyclovir/therapeutic use ; Adult ; Fundus Oculi ; Humans ; Light Coagulation ; Male ; Necrosis/surgery ; Retinal Detachment/surgery ; Retinal Diseases/drug therapy/pathology/*surgery ; Scleral Buckling ; Syndrome ; Vitrectomy