Haddad J, Langer B, Astruc D, Messer J, Lokiec F
Service de Néonatologie, Hospital University of Strasbourg, France.
Obstet Gynecol. 1993 Jul;82(1):102-4.
To assess plasma acyclovir levels in pregnant women given oral acyclovir during late gestation and to determine the role and effect of oral acyclovir on asymptomatic shedding of virus in cases of recurrent genital herpes.
Five pregnant women with proven genital herpes isolate (herpes simplex virus [HSV] 2) after 37 weeks' gestation were studied. Oral acyclovir was administered every 8 hours at dosages of 300, 400, and 300 mg in two subjects, and 200 mg five times daily in the other three until delivery. Plasma acyclovir peak and trough levels were determined. Viral cultures were obtained from both the mothers and neonates at delivery.
There was no difference in acyclovir plasma levels among the patients. Furthermore, acyclovir levels were comparable to those of nonpregnant adults. The drug failed to suppress asymptomatic shedding of virus and transmission of HSV 2 to the neonate in one of five of the patients.
Our study suggests that asymptomatic shedding of virus is not prevented by use of oral acyclovir during late gestation in proven recurrent genital herpes even though plasma acyclovir levels were within the normal range.
评估妊娠晚期口服阿昔洛韦的孕妇血浆阿昔洛韦水平，并确定口服阿昔洛韦在复发性生殖器疱疹病例中对病毒无症状排毒的作用和影响。
研究了5名妊娠37周后确诊为生殖器疱疹分离株（单纯疱疹病毒[HSV]2）的孕妇。两名受试者每8小时口服阿昔洛韦，剂量分别为300、400和300mg，另外三名受试者每天口服5次，每次200mg，直至分娩。测定血浆阿昔洛韦的峰浓度和谷浓度。分娩时从母亲和新生儿处采集病毒培养物。
患者之间的阿昔洛韦血浆水平没有差异。此外，阿昔洛韦水平与非妊娠成年人相当。该药物未能抑制5名患者中1名患者的病毒无症状排毒以及HSV 2向新生儿的传播。
我们的研究表明，在确诊的复发性生殖器疱疹妊娠晚期，即使血浆阿昔洛韦水平在正常范围内，使用口服阿昔洛韦也无法预防病毒的无症状排毒。
