Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven, 3000 Leuven, Belgium.
Molecules. 2021 Feb 20;26(4):1132. doi: 10.3390/molecules26041132.
Varicella-zoster virus (VZV), a common and ubiquitous human-restricted pathogen, causes a primary infection (varicella or chickenpox) followed by establishment of latency in sensory ganglia. The virus can reactivate, causing herpes zoster (HZ, shingles) and leading to significant morbidity but rarely mortality, although in immunocompromised hosts, VZV can cause severe disseminated and occasionally fatal disease. We discuss VZV diseases and the decrease in their incidence due to the introduction of live-attenuated vaccines to prevent varicella or HZ. We also focus on acyclovir, valacyclovir, and famciclovir (FDA approved drugs to treat VZV infections), brivudine (used in some European countries) and amenamevir (a helicase-primase inhibitor, approved in Japan) that augur the beginning of a new era of anti-VZV therapy. Valnivudine hydrochloride (FV-100) and valomaciclovir stearate (in advanced stage of development) and several new molecules potentially good as anti-VZV candidates described during the last year are examined. We reflect on the role of antiviral agents in the treatment of VZV-associated diseases, as a large percentage of the at-risk population is not immunized, and on the limitations of currently FDA-approved anti-VZV drugs. Their low efficacy in controlling HZ pain and post-herpetic neuralgia development, and the need of multiple dosing regimens requiring daily dose adaptation for patients with renal failure urges the development of novel anti-VZV drugs.
水痘带状疱疹病毒（VZV）是一种常见且普遍存在于人类中的病原体，会引起原发性感染（水痘或带状疱疹），随后在感觉神经节中潜伏。该病毒会重新激活，导致带状疱疹（HZ，带状疱疹），并导致严重的发病率，但很少有死亡率，尽管在免疫功能低下的宿主中，VZV 会导致严重的播散性和偶尔致命的疾病。我们讨论了 VZV 疾病以及由于引入活减毒疫苗来预防水痘或 HZ 而导致其发病率下降的情况。我们还重点介绍了阿昔洛韦、伐昔洛韦和泛昔洛韦（FDA 批准用于治疗 VZV 感染的药物）、溴夫定（在一些欧洲国家使用）和艾米那韦（一种解旋酶-引物酶抑制剂，在日本获得批准），这些药物预示着抗 VZV 治疗的新时代的开始。盐酸伐昔洛韦（FV-100）和硬脂酸伐昔洛韦（处于开发后期）以及过去一年中描述的几种可能作为抗 VZV 候选药物的新分子也进行了研究。我们反思了抗病毒药物在治疗 VZV 相关疾病中的作用，因为很大一部分高危人群未接种疫苗，以及目前 FDA 批准的抗 VZV 药物的局限性。它们在控制 HZ 疼痛和疱疹后神经痛发展方面的疗效有限，以及需要根据肾功能衰竭患者的情况进行每日剂量调整的多剂量方案，都促使开发新型抗 VZV 药物。
