Vogt M, Huss R, Wunderli W
Departement für Innere Medizin, Universitätsspital Zürich.
Schweiz Med Wochenschr. 1992 Apr 18;122(16):569-75.
Herpes simplex virus type 1 and 2 may cause painful mucocutaneous lesions in both immunosuppressed and immunocompetent patients. Indications for the use of acyclovir (ACV) are reviewed. In the second part the management of infections caused by varicella-zoster virus are discussed. Primary varicella (chickenpox) in immunosuppressed children should be treated with i.v. ACV without delay. In healthy patients varicella pneumonia needs to be treated with ACV. Healthy patients with herpes zoster are not usually candidates for antiviral therapy. The only exception is herpes zoster ophthalmicus. In patients with severe immunosuppression, such as transplant recipients, ACV therapy is recommended in order to reduce the rate of dissemination. First reports and our own observations on the development of ACV-resistant HSV and VZV isolates stress the importance of discriminating use of ACV and other antiviral compounds in immunosuppressed patients.
单纯疱疹病毒1型和2型可在免疫抑制和免疫功能正常的患者中引起疼痛性黏膜皮肤病变。本文综述了阿昔洛韦(ACV)的使用指征。第二部分讨论了水痘-带状疱疹病毒感染的治疗。免疫抑制儿童的原发性水痘(水痘)应立即静脉注射ACV进行治疗。健康患者的水痘肺炎需要用ACV治疗。健康的带状疱疹患者通常不适合抗病毒治疗。唯一的例外是眼部带状疱疹。在严重免疫抑制的患者中,如移植受者,建议使用ACV治疗以降低播散率。关于ACV耐药HSV和VZV分离株出现的首次报道及我们自己的观察结果强调了在免疫抑制患者中谨慎使用ACV和其他抗病毒化合物的重要性。