ACYCLOVIR AND PREDNISOLONE TREATMENT OF ACUTE INFECTIOUS-MONONUCLEOSIS - A MULTICENTER, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY

Ninety-four patients with infectious mononucleosis and symptoms less t han or equal to 7 days were randomized to treatment with oral acyclovi r (800 mg 5 times/day) and prednisolone (0.7 mg/kg for the first 4 day s, which was reduced by 0.1 mg/kg on consecutive days for another 6 da ys; n = 48), or placebo (n = 46) for 10 days. Oropharyngeal Epstein-Ba rr virus (EBV) shedding was significantly inhibited during the treatme nt period (P = .02, Mann-Whitney rank test). No significant effect was observed for duration of general illness, sore throat, weight loss, o r absence from school or work. The frequency of latent EBV-infected B lymphocytes in peripheral blood and the HLA-restricted EBV-specific ce llular immunity, measured 6 months after onset of disease, was not aff ected by treatment. Thus, acyclovir combined with prednisolone inhibit ed oropharyngeal EBV replication without affecting duration of clinica l symptoms or development of EBV-specific cellular immunity.