Varicella in the immunocompetent adult is an infrequent but potentially serious
infection. Previous studies in immunocompetent hosts and normal adults have demonstrated the value of intravenous
acyclovir in the treatment of varicella-zoster virus
infections. Oral
acyclovir has also shown efficacy in both normal adults with
zoster (
shingles) and immunocompetent children with
varicella. A recently completed double-blind placebo-controlled study of oral
acyclovir in immunocompetent adults with uncomplicated
varicella also demonstrated efficacy.
Therapy within the first day reduced the time to 100% crusting of skin lesions from 7.4 to 5.6 days, and reduced the duration of
fever by one-half day. Symptoms were also diminished. These benefits were observed only when
therapy was initiated within 24 hours of the appearance of the
rash. Adults with complicated
varicella (usually symptomatic
varicella pneumonia) should receive intravenous
acyclovir. Several new agents for
varicella-
zoster therapy are being evaluated; brovavir is a new agent currently being compared to placebo in the treatment of adult
varicella.