Cassady K A, Whitley R J
Ambulatory Care Center, The Children's Hospital of Alabama, Birmingham 35233, USA.
J Antimicrob Chemother. 1997 Feb;39(2):119-28. doi: 10.1093/jac/39.2.119.
The character of diseases caused by alphaherpesviruses has changed over the last decade. The severity of disease and the frequency of acyclovir resistance has increased with the increase in the number of immunocompromised patients. Compounding the trend towards more virulent herpes disease is the current emphasis towards outpatient management of many diseases. Much of the current antiviral research focuses on providing drugs with (i) improved oral bioavailability and pharmacokinetics which permit less frequent oral or topical dosing for suppressive treatment of herpes simplex virus (HSV) infections, (ii) different mechanisms of action for synergic effects in treating resistant HSV infections in the immunocompromised host and (iii) improved efficacy. Future antiviral agents will probably target enzymes or viral factors essential for infection or will inhibit other steps in the viral infection cycle, such as viral entry, protein synthesis or capsid assembly. Medications that augment the immune response constitute another pathway for combating herpes viral infections. Many of the newer experimental agents target essential processes unique to herpesvirus replication and, therefore, potentially have high selectivity.
在过去十年中，α疱疹病毒引起的疾病特征发生了变化。随着免疫功能低下患者数量的增加，疾病的严重程度和阿昔洛韦耐药性的频率也有所上升。许多疾病目前倾向于门诊治疗，这使得疱疹疾病的毒性增强趋势更加复杂。当前的抗病毒研究大多集中在提供具有以下特点的药物：（i）改善口服生物利用度和药代动力学，从而允许减少口服或局部给药频率以进行单纯疱疹病毒（HSV）感染的抑制治疗；（ii）具有不同的作用机制，以在免疫功能低下宿主中协同治疗耐药HSV感染；（iii）提高疗效。未来的抗病毒药物可能会靶向感染所必需的酶或病毒因子，或者会抑制病毒感染周期中的其他步骤，如病毒进入、蛋白质合成或衣壳组装。增强免疫反应的药物构成了对抗疱疹病毒感染的另一条途径。许多较新的实验药物靶向疱疹病毒复制特有的关键过程，因此可能具有高选择性。
