Acyclovir and prednisolone treatment of acute infectious mononucleosis: a multicenter, double-blind, placebo-controlled study.
Ninety-four patients with infectious mononucleosis and symptoms < or = 7 days were randomized to treatment with oral acyclovir (800 mg 5 times/day) and prednisolone (0.7 mg/kg for the first 4 days, which was reduced by 0.1 mg/kg on consecutive days for another 6 days; n = 48), or placebo (n = 46) for 10 days. Oropharyngeal Epstein-Barr virus (EBV) shedding was significantly inhibited during the treatment period (P = .02, Mann-Whitney rank test). No significant effect was observed for duration of general illness, sore throat, weight loss, or absence from school or work. The frequency of latent EBV-infected B lymphocytes in peripheral blood and the HLA-restricted EBV-specific cellular immunity, measured 6 months after onset of disease, was not affected by treatment. Thus, acyclovir combined with prednisolone inhibited oropharyngeal EBV replication without affecting duration of clinical symptoms or development of EBV-specific cellular immunity.
Tynell
E
E
Department of Infectious Diseases, Karolinska Institutet, Danderyd, Sweden.
Aurelius
E
E
Brandell
A
A
Julander
I
I
Wood
M
M
Yao
Q Y
QY
Rickinson
A
A
Akerlund
B
B
Andersson
J
J
D000212:Acyclovir / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006680:HLA Antigens; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D007111:Immunity, Cellular; D007244:Infectious Mononucleosis / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D010612:Pharyngitis / Q000188:drug therapy; D010919:Placebos; D011239:Prednisolone / Q000627:therapeutic use*; D012449:Safety; D012463:Saliva / Q000821:virology; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology
D000914:Antibodies, Viral; D000998:Antiviral Agents; D005938:Glucocorticoids; D006680:HLA Antigens; D010919:Placebos; D011239:Prednisolone; D000212:Acyclovir