Vildé J L, Bricaire F, Leport C, Renaudie M, Brun-Vézinet F
J Med Virol. 1986 Oct;20(2):127-34. doi: 10.1002/jmv.1890200205.
A comparative assessment of vidarabine and acyclovir in the treatment of varicella and disseminated zoster in immunosuppressed patients was undertaken. Thirty-eight immunosuppressed patients with varicella (N = 18) or disseminated zoster (N = 20) were treated intravenously with 10 mg/kg/day of vidarabine or 30 mg/kg/day of acyclovir for 5 days according to a preestablished code within each diagnosis group--varicella and disseminated zoster. Two deaths, although not directly related to VZV infection, were observed in the vidarabine-treated varicella group. The times to cessation of formation of new lesions and to the disappearance of fever were similar for vidarabine and acyclovir in each group. In the varicella group, VZV was isolated on day 5 in four out of five vidarabine patients versus one out of five acyclovir patients. No severe adverse effects were observed with either drug. Neutropenia present in patients of both drug groups was transitory and most often related to previous cytolytic chemotherapy. These data suggest that either vidarabine or acyclovir could be used in the treatment of severe VZV infections in immunosuppressed patients, although a larger number of patients would be required for definitive conclusion. Because of the large amount of solute required for vidarabine administration, acyclovir may be preferred when the risk of cardiorespiratory failure is high.
对阿糖腺苷和阿昔洛韦治疗免疫抑制患者水痘和播散性带状疱疹进行了比较评估。38例患有水痘（N = 18）或播散性带状疱疹（N = 20）的免疫抑制患者，根据每个诊断组（水痘和播散性带状疱疹）预先设定的编码，静脉注射10mg/kg/天的阿糖腺苷或30mg/kg/天的阿昔洛韦，持续5天。在接受阿糖腺苷治疗的水痘组中观察到2例死亡，尽管与水痘带状疱疹病毒（VZV）感染无直接关系。每组中，阿糖腺苷和阿昔洛韦使新皮疹停止出现和发热消退的时间相似。在水痘组中，5例接受阿糖腺苷治疗的患者中有4例在第5天分离出VZV，而5例接受阿昔洛韦治疗的患者中有1例分离出VZV。两种药物均未观察到严重不良反应。两个药物组患者出现的中性粒细胞减少是暂时的，且大多与先前的溶细胞性化疗有关。这些数据表明，阿糖腺苷或阿昔洛韦均可用于治疗免疫抑制患者的严重VZV感染，尽管需要更多患者才能得出明确结论。由于阿糖腺苷给药需要大量溶质，在存在高心肺衰竭风险时，阿昔洛韦可能更受青睐。
