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Viremia in acute herpes zoster.

AbstractBACKGROUND:
A phase 2 trial was conducted to evaluate the efficacy of a topical antiviral, sorivudine, as an adjuvant to valacyclovir for the treatment of acute herpes zoster.
METHODS:
In this randomized, placebo-controlled, double-blind trial, 25 patients were treated with either sorivudine or placebo cream. All patients began 7 days of valacyclovir treatment on day 3. Zoster lesion swab samples and samples of peripheral blood mononuclear cells were collected periodically throughout the study and were analyzed for varicella-zoster virus (VZV) DNA by use of both qualitative and real-time polymerase chain reaction. Serum samples collected periodically throughout the study were analyzed for VZV DNA by use of real-time polymerase chain reaction.
RESULTS:
VZV DNA was detected in all 3 sample types, and the number of viral copies correlated with the progression of herpes zoster. No statistically significant differences were seen between the placebo- and sorivudine-treated groups with respect to clinical characteristics or laboratory test results.
CONCLUSION:
The detection of VZV DNA in the serum and peripheral blood mononuclear cells of all 25 zoster patients documents that viremia is a common manifestation of herpes zoster. Sorivudine cream appears to be a safe and well-tolerated adjuvant therapy; however, further phase 2 studies are needed to determine its clinical efficacy for the treatment of herpes zoster. Trials registration. ClinicalTrials.gov identifier: NCT00652184.
AuthorsAnita K Satyaprakash, Anne Marie Tremaine, Arwen A Stelter, Rosella Creed, Parisa Ravanfar, Natalia Mendoza, Satish K Mehta, Peter L Rady, Duane L Pierson, Stephen K Tyring
JournalThe Journal of infectious diseases (J Infect Dis) Vol. 200 Issue 1 Pg. 26-32 (Jul 1 2009) ISSN: 0022-1899 [Print] United States
PMID19469706 (Publication Type: Clinical Trial, Phase II, Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, Non-P.H.S.)
Chemical References
  • Antiviral Agents
  • DNA, Viral
  • Placebos
  • Valine
  • valacyclovir
  • Acyclovir
Topics
  • Acyclovir (analogs & derivatives, therapeutic use)
  • Adult
  • Aged
  • Antiviral Agents (therapeutic use)
  • DNA, Viral (genetics, isolation & purification)
  • Double-Blind Method
  • Female
  • Herpes Zoster (drug therapy, genetics)
  • Herpesvirus 3, Human (genetics)
  • Humans
  • Male
  • Middle Aged
  • Patient Selection
  • Placebos
  • Valine (analogs & derivatives, therapeutic use)
  • Viremia (drug therapy)

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