THE EFFECTS OF CORTICOSTEROIDS ON ADENOVIRAL REPLICATION

Objective: To evaluate the effects of Pred Forte (prednisolone acetate ; Allergan Pharmaceutical, Irvine, Calif) on the replication of differ ent adenoviral serotypes in vitro and in the adenovirus type 5/New Zea land rabbit ocular model. Methods: The 50% inhibitory doses of Pred Fo rte and its components were determined for common ocular serotypes. Th e effects of continuous topical treatment with Pred Forte for 18 days were evaluated (eg, conjunctivitis, subepithelial immune infiltrates, and serial ocular viral titers) in the adenovirus 5/New Zealand rabbit ocular model. Results: Pred Forte and prednisolone acetate inhibited adenoviruses 1, 5, 8, and 19 in vitro. In vivo, 1% Pred Forte signific antly reduced conjunctivitis (P=.04) and subepithelial infiltrates (P= .02), but enhanced viral replication (P=.01) on days 9 to 21 and incre ased the duration of viral shedding (P<.001). Conclusions: Despite dem onstrated anti-inflammatory and anti-immune effects, prolonged treatme nt of acute adenoviral infections with topical Pred Forte is not recom mended because of the enhanced risks of viral transmission and communi ty epidemics.