Shepp D H, Dandliker P S, Flournoy N, Meyers J D
Transplantation. 1987 May;43(5):654-8. doi: 10.1097/00007890-198705000-00010.
To define an effective and convenient means for providing extended prophylaxis of herpes simplex virus (HSV) infection to chronically immunocompromised patients, we studied a two-part regimen of intravenous, followed by oral, acyclovir after marrow transplantation. Seropositive patients were first given intravenous acyclovir until day 30 after transplant. Intravenous acyclovir (250 mgm/m2) given twice daily to 34 patients during this period was 90% virologically effective among those completing the prophylactic course. A randomized, double-blind comparison of twice-daily oral acyclovir (800 mg) and placebo was then conducted from day 31 to day 75 after transplant in 51 patients. Oral acyclovir significantly delayed the median time to first excretion of HSV when compared with placebo (greater than 100 vs. 70 days after transplant, P = 0.0006) and was completely effective in all patients for the duration of drug administration. Patients receiving extended prophylaxis appeared to have less-severe HSV infection when later recurrences did occur. Sequential intravenous and oral acyclovir given twice daily is an effective and convenient regimen for extended prophylaxis of HSV infection following marrow transplantation, and should be useful in other transplant patients or other chronically immunosuppressed patients as well.
为确定一种为慢性免疫功能低下患者提供单纯疱疹病毒（HSV）感染延长预防的有效且便捷的方法，我们研究了骨髓移植后静脉注射随后口服阿昔洛韦的两部分治疗方案。血清学阳性患者在移植后第30天前先接受静脉注射阿昔洛韦。在此期间，34例患者每天两次静脉注射阿昔洛韦（250mg/m²），在完成预防疗程的患者中病毒学有效率为90%。然后对51例患者在移植后第31天至第75天进行了每天两次口服阿昔洛韦（800mg）与安慰剂的随机双盲比较。与安慰剂相比，口服阿昔洛韦显著延迟了HSV首次排出的中位时间（移植后大于100天对70天，P = 0.0006），并且在给药期间对所有患者完全有效。当后来确实发生复发时，接受延长预防的患者HSV感染似乎不太严重。每天两次序贯静脉注射和口服阿昔洛韦是骨髓移植后HSV感染延长预防的一种有效且便捷的治疗方案，并且在其他移植患者或其他慢性免疫抑制患者中也应有用。
