Treatment of herpesvirus infections in HIV-infected individuals.
OBJECTIVE
To discuss strategies available for the treatment of herpesvirus infections in individuals infected with HIV.


METHODS
Information was obtained from controlled and uncontrolled clinical trials, abstracts, conference proceedings, and review articles.


METHODS
Emphasis was placed on controlled investigations in subjects infected with HIV.


METHODS
Data from human studies were extracted by the author and evaluated according to the patient population studied, sample size, dosage regimen, and therapeutic response.


RESULTS
Herpes group viruses are common opportunistic pathogens in HIV-infected individuals. Zoster, caused by varicella-zoster virus (VZV), is an early indication of the loss of cell-mediated immunity and HIV disease progression. Anorectal mucocutaneous disease is the most common manifestation caused by herpes simplex virus (HSV). Acyclovir is the drug of choice for treatment of both VZV and HSV infections. Cytomegalovirus (CMV) is the most common life-threatening viral infection in patients with AIDS; retinitis is the most frequent clinical manifestation. The response rate of CMV retinitis to initial treatment with either ganciclovir or foscarnet is equivalent, approximately 60-90 percent. Recent data suggest that the survival benefit may be greater with foscarnet.


CONCLUSIONS
Advances in the development and application of antiviral drugs for herpes group viruses have made treatment and, in some cases, prevention of infections possible. Future efforts, aimed at earlier intervention and suppression of latent virus, may offer additional improvement in quality of life for the HIV-infected individual.
Fletcher
C V
CV
Department of Pharmacy Practice, College of Pharmacy, University of Minnesota, Minneapolis 55455.
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000212:Acyclovir / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D003586:Cytomegalovirus Infections / Q000150:complications / Q000188:drug therapy; D017245:Foscarnet; D015774:Ganciclovir / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications*; D006679:HIV Seropositivity; D006561:Herpes Simplex / Q000150:complications / Q000188:drug therapy; D006562:Herpes Zoster / Q000150:complications / Q000188:drug therapy; D006566:Herpesviridae Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D009894:Opportunistic Infections / Q000150:complications / Q000188:drug therapy; D010746:Phosphonoacetic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use
D000998:Antiviral Agents; D017245:Foscarnet; D010746:Phosphonoacetic Acid; D015774:Ganciclovir; D000212:Acyclovir