ANTIVIRAL THERAPY OF HERPES-SIMPLEX AND VARICELLA-ZOSTER VIRUS-INFECTIONS

Antiviral treatment of herpesvirus infections is rapidly changing sinc e the advent of new drugs with improved oral availability. The efficac y of valaciclovir, the prodrug of aciclovir, and famciclovir, the prod rug of penciclovir, in the treatment of herpes genitalis and acute her pes tester has been well documented in large clinical trials. Both dru gs are effective on tester-associated pain. Brivudin and sorivudine wh ich are the most active compounds against varicella-zoster virus (VZV) in cell culture have also been successful in the treatment of herpes tester. Aciclovir is still the standard therapy of severe herpes simpl ex virus (HSV) and varicella virus infections. In patients treated wit h aciclovir, the mortality of herpes encephalitis has been reduced to about 25 %. The development of resistance against aciclovir and the ot her nucleoside analogues has not been a problem to date in the treatme nt of immunocompetent individuals. However, in immunocompromised patie nts, aciclovir-resistant HSV strains often emerge. In such cases, intr avenous foscarnet is the current treatment of choice.