Wade J C, Newton B, Flournoy N, Meyers J D
Ann Intern Med. 1984 Jun;100(6):823-8. doi: 10.7326/0003-4819-100-6-823.
Oral acyclovir was found to be safe and effective for the prevention of herpes simplex virus reactivation after marrow transplantation in a double-blind, placebo-controlled trial. Acyclovir or placebo was administered to 49 patients for 5 weeks beginning 1 week before transplantation: 5 of 24 patients receiving acyclovir developed herpes simplex virus infection during prophylaxis, compared to 17 of 25 patients receiving placebo (p less than 0.01). The median time to first virus reactivation was significantly longer among patients receiving acyclovir (78 days versus 9 days after transplant, p = 0.006). The effect was even more pronounced when the analysis was adjusted for drug compliance: Among patients taking a minimum of 40% of their prescribed drug, acyclovir was 96% virologically effective and 100% clinically effective during the period of administration. Acyclovir use was also associated with significantly more rapid marrow engraftment in patients receiving methotrexate. No virus resistant to acyclovir was isolated. Oral acyclovir provides effective prophylaxis against reactivation of herpes simplex virus among severely immunosuppressed patients able to take orally administered drugs.
在一项双盲、安慰剂对照试验中，发现口服阿昔洛韦对预防骨髓移植后单纯疱疹病毒再激活是安全有效的。在移植前1周开始，对49例患者给予阿昔洛韦或安慰剂，持续5周：接受阿昔洛韦治疗的24例患者中有5例在预防期间发生单纯疱疹病毒感染，而接受安慰剂治疗的25例患者中有17例发生感染（p<0.01）。接受阿昔洛韦治疗的患者首次病毒再激活的中位时间显著更长（移植后78天对9天，p = 0.006）。当对药物依从性进行分析调整时，效果更为明显：在服用至少40%规定药物的患者中，阿昔洛韦在给药期间病毒学有效率为96%，临床有效率为100%。接受甲氨蝶呤治疗的患者使用阿昔洛韦还与骨髓更快植入显著相关。未分离出对阿昔洛韦耐药的病毒。口服阿昔洛韦可为能够口服药物的严重免疫抑制患者提供有效的单纯疱疹病毒再激活预防。
