FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 308:1448-1453 June 16, 1983 Number 24 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

We conducted a placebo-controlled, double-blind study of acyclovir therapy for acute herpes zoster in immunocompromised patients. Of the 94 patients enrolled in the study, 52 had localized skin lesions at entry, and 42 had disseminated cutaneous zoster. A one-week course of intravenous acyclovir (1500 mg per square meter of body-surface area per day) halted progression of zoster in both groups, as determined by development or progression of cutaneous dissemination, development of visceral zoster, or proportion of cases deemed treatment failures. Significantly fewer patients treated with acyclovir within the first three days after the onset of exanthem had complications of zoster, as compared with patients treated with placebo (P = 0.02 by Fisher's exact test), but acyclovir also stopped progression of zoster in patients treated after three days of rash (P = 0.05 by Fisher's exact test). Acyclovir recipients with disseminated cutaneous zoster had a significantly accelerated rate of clearance of virus from vesicles, as compared with placebo recipients (P = 0.05 by the Breslow test).

This article has been cited by other articles:

• Saez-Llorens, X., Yogev, R., Arguedas, A., Rodriguez, A., Spigarelli, M. G., De Leon Castrejon, T., Bomgaars, L., Roberts, M., Abrams, B., Zhou, W., Looby, M., Kaiser, G., Hamed, K. (2009). Pharmacokinetics and Safety of Famciclovir in Children with Herpes Simplex or Varicella-Zoster Virus Infection. Antimicrob. Agents Chemother. 53: 1912-1920 [Abstract] [Full Text]  
• Nogueira, R. G., Traynor, B. (2004). The Neurology of Varicella-Zoster Virus: A Historical Perspective. Arch Neurol 61: 1974-1977 [Full Text]  
• Severson, E. A., Baratz, K. H., Hodge, D. O., Burke, J. P. (2003). Herpes Zoster Ophthalmicus in Olmsted County, Minnesota: Have Systemic Antivirals Made a Difference?. Arch Ophthalmol 121: 386-390 [Abstract] [Full Text]  
• Acosta, E. P., Balfour, H. H. Jr. (2001). Acyclovir for Treatment of Postherpetic Neuralgia: Efficacy and Pharmacokinetics. Antimicrob. Agents Chemother. 45: 2771-2774 [Abstract] [Full Text]  
• (2000). Management of herpes virus infections following transplantation. J Antimicrob Chemother 45: 729-748 [Full Text]  
• Balfour, H. H. (1999). Antiviral Drugs. NEJM 340: 1255-1268 [Full Text]  
• Eysenbach, G., Diepgen, T. L. (1998). Responses to Unsolicited Patient E-mail Requests for Medical Advice on the World Wide Web. JAMA 280: 1333-1335 [Abstract] [Full Text]  
• Gnann, J. W. Jr., Crumpacker, C. S., Lalezari, J. P., Smith, J. A., Tyring, S. K., Baum, K. F., Borucki, M. J., Joseph, W. P., Mertz, G. J., Steigbigel, R. T., Cloud, G. A., Soong, S.-j., Sherrill, L. C., DeHertogh, D. A., Whitley, R. J. (1998). Sorivudine versus Acyclovir for Treatment of Dermatomal Herpes Zoster in Human Immunodeficiency Virus-Infected Patients: Results from a Randomized, Controlled Clinical Trial. Antimicrob. Agents Chemother. 42: 1139-1145 [Abstract] [Full Text]  
• ASKIN, F. B., WESTRA, W. H. (1996). RESIDENT'S PAGE: PATHOLOGY. Arch Otolaryngol Head Neck Surg 122: 194-198 [Abstract]  
• Wallace, M. R., Bowler, W. A., Murray, N. B., Brodine, S. K., Oldfield, E. C. III (1992). Treatment of Adult Varicella with Oral Acyclovir: A Randomized, Placebo-controlled Trial. ANN INTERN MED 117: 358-363 [Abstract]  
• Feder, H. M. Jr (1990). Treatment of Adult Chickenpox With Oral Acyclovir. Arch Intern Med 150: 2061-2065 [Abstract]  
• Jacobson, M. A., Berger, T. G., Fikrig, S., Becherer, P., Moohr, J. W., Stanat, S. C., Biron, K. K. (1990). Acyclovir-Resistant Varicella Zoster Virus Infection after Chronic Oral Acyclovir Therapy in Patients with the Acquired Immunodeficiency Syndrome (AIDS). ANN INTERN MED 112: 187-191 [Abstract]  
• Balfour, H. H. Jr, Englund, J. A. (1989). Antiviral Drugs in Pediatrics. Arch Pediatr Adolesc Med 143: 1307-1316 [Abstract]  
• Pavan-Langston, D., Dunkel, E. C. (1989). Ocular Varicella-Zoster Virus Infection in the Guinea Pig: A New In Vivo Model. Arch Ophthalmol 107: 1068-1072 [Abstract]  
• Pahwa, S., Biron, K., Lim, W., Swenson, P., Kaplan, M. H., Sadick, N., Pahwa, R. (1988). Continuous Varicella-Zoster Infection Associated With Acyclovir Resistance in a Child With AIDS. JAMA 260: 2879-2882 [Abstract]  
• Rusthoven, J. J., Ahlgren, P., Elhakim, T., Pinfold, P., Reid, J., Stewart, L., Feld, R. (1988). Varicella-Zoster Infection in Adult Cancer Patients: A Population Study. Arch Intern Med 148: 1561-1566 [Abstract]  
• WHITLEY, R. J. (1988). Ganciclovir--Have We Established Clinical Value in the Treatment of Cytomegalovirus Infections?. ANN INTERN MED 108: 452-454 [Abstract]  
• STRAUS, S. E., OSTROVE, J. M., INCHAUSPE, G., FELSER, J. M., FREIFELD, A., CROEN, K. D., SAWYER, M. H. (1988). Varicella-Zoster Virus Infections: Biology, Natural History, Treatment, and Prevention. ANN INTERN MED 108: 221-237 [Abstract]  
• DORSKY, D. I., CRUMPACKER, C. S. (1987). Drugs Five Years Later: Acyclovir. ANN INTERN MED 107: 859-874 [Abstract]  
• Kaplan, L. D., Wofsy, C. B., Volberding, P. A. (1987). Treatment of Patients With Acquired Immunodeficiency Syndrome and Associated Manifestations. JAMA 257: 1367-1374 [Abstract]  
• Hammond, E. (1987). Herpes-Zoster Infections in Children with Hodgkin's Disease. Journal of Pediatric Oncology Nursing 4: 23-29  
• Sylvester, R. K., Ogden, W. B., Draxler, C. A., Lewis, F. B. (1986). Vesicular Eruption: A Local Complication of Concentrated Acyclovir Infusions. JAMA 255: 385-386 [Abstract]  
• Balfour, H. H. Jr (1986). Acyclovir Therapy for Herpes Zoster: Advantages and Adverse Effects. JAMA 255: 387-388 [Abstract]  
• HIRSCH, M. S., KAPLAN, J. C. (1985). Prospects of Therapy for Infections with Human T-Lymphotropic Virus Type III. ANN INTERN MED 103: 750-755 [Abstract]  
• Dolin, R (1985). Antiviral chemotherapy and chemoprophylaxis. Science 227: 1296-1303 [Abstract]  
• Cole, E. L., Meisler, D. M., Calabrese, L. H., Holland, G. N., Mondino, B. J., Conant, M. A. (1984). Herpes Zoster Ophthalmicus and Acquired Immune Deficiency Syndrome. Arch Ophthalmol 102: 1027-1029 [Abstract]  
• JORDAN, M. C., JORDAN, G. W., STEVENS, J. G., MILLER, G. (1984). Latent Herpesviruses of Humans. ANN INTERN MED 100: 866-880 [Abstract]  
• Laskin, O. L. (1984). Acyclovir: Pharmacology and Clinical Experience. Arch Intern Med 144: 1241-1246 [Abstract]