Prolonged continuous acyclovir treatment of normal adults with frequently recurring genital herpes simplex virus infection

Article Abstract:

Genital herpes, an infection usually transmitted by sexual intercourse, causes painful ulcers lasting for about a week, which recur often. The drug acyclovir has been shown to prevent recurrence for up to two years. This article is an interim three-year report of an ongoing, multicenter study of patients with recurring herpes outbreaks; these patients all suffered more than six recurrences per year prior to entry in the study. A total of 1,146 subjects were randomly assigned to received either a placebo or 400 milligrams of acyclovir twice daily. Five hundred twenty-five patients completed the study, and only three patients discontinued therapy because of adverse side effects; 571 patients were given a placebo. The experimental group was further divided into two groups; 289 were given suppressive therapy for three years, and 236 were given acute therapy for one year followed by two years of suppressive treatment. Over half of the patients had no recurrences at all during the third year of the study, and 25 percent of the patients receiving suppressive treatment only had no recurrences during the entire three-year period. Acyclovir did not appear to cause any toxic effects, and no one side effect involved more than 2 percent of the patients. The most common adverse reaction was nausea, reported by almost 1 in 20 during the first year, but only 1 in 200 during the third year. During the third year of the study the most common side effect, reported by 1.4 percent of patients, was weakness and lack of energy. A few patients seemed to require a larger dose to prevent a recurrence of herpes. The herpes simplex virus has developed resistance to acyclovir in patients with compromised immune systems, but not in healthy patients. Therapy should be reassessed annually because the frequency of recurrence varies. Acyclovir appears to be effective and safe when taken daily to suppress further outbreaks in patients with genital herpes. (Consumer Summary produced by Reliance Medical Information, Inc.)

Acyclovir

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Myocardial injury in critically ill patients: a frequently unrecognized complication

Article Abstract:

Myocardial injury appears to occur frequently in critically ill patients, but often is not detected. This injury to the heart tissue may be identified by measuring levels of cardiac troponin I, a protein found only in heart tissue. Of 209 hospital patients studied during an eight-week period, 32 (15%) had high blood levels of cardiac troponin I, indicating that their heart muscle was damaged. Mortality was considerably greater in ill patients with myocardial injury: 40.6% compared to 14.7%. Patients with myocardial injury were more likely to develop abnormally low blood pressure. Myocardial injury can occur in critically ill patients because of stresses caused by insufficient oxygen supply, reduced oxygenation of the blood, anemia, coronary artery disease, and hypotension.

Injuries, Physiological aspects, Critically ill, Heart muscle, Myocardium

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Oral Famciclovir for the Suppression of Recurrent Genital Herpes

Article Abstract:

The antiviral drug famciclovir may be effective in preventing recurrences of genital herpes. Researchers randomly assigned 455 people with a history of six or more episodes of genital herpes to take famciclovir or placebo for one year. At six months, about 80% of the people taking famciclovir had no recurrent episodes, compared to 27% of those taking a placebo. The average time to recurrence was about five to six times longer in the famciclovir group than in the placebo group. The drug was well-tolerated and had few side effects.

Famciclovir

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