阿昔洛韦治疗眼部带状疱疹35例疗效观察

目的: 观察阿昔洛韦治疗眼部带状疱疹的疗效。方法: 阿昔洛韦0.5 g加入0.9%氯化钠250 ml静脉滴注,每天2次,维持8 h。结果: 35例均治愈,病程缩短一半以上,35岁以下5~6天痊愈,36~49岁5~8天痊愈,50~74岁8~9天痊愈,有并发症1~2周痊愈。结论: 阿昔洛韦治疗眼部带状疱疹主要是通过与病毒竞争受体而发挥作用。延长输液时间等于延长了阿昔洛韦与病毒竞争受体的时间,输液要维持足够时间才能提高疗效。     

固体分散无环鸟苷胶囊剂溶出度及人体内生物利用度

目的：用固体分散技术制得无环鸟苷胶囊剂以提高无环鸟苷体外溶出度和体内生物利用度。方法：8名HBsAg阳性受试者分别单次口服400 mg两种剂型后,用HPLC方法测定血清中无环鸟苷浓度,进行固体分散无环鸟苷胶囊剂与市售片剂的药代动力学和生物利用度研究。结果：两剂型血清药物浓度有显著差异,曲线下面积(AUC)固体分散无环鸟苷胶囊剂为6271.33 h.ng.mL^-1,市售片为4101.00 h.ng.mL^-1。固体分散无环鸟苷胶囊剂相对市售片剂的相对生物利用度为152.92%。30 min溶出度在不同的溶出介质中固体分散无环鸟苷胶囊剂也明显快于市售片剂。结论：经固体分散的无环鸟苷胶囊剂能显著地提高无环鸟苷的生物利用度。     

盐酸万乃洛韦人血浆浓度的HPLC-荧光法测定及其药物动力学

建立了盐酸万乃洛韦 (1)体内活性代谢物阿昔洛韦 (2 )浓度的蛋白沉淀 -荧光检测 HPL C法。采用 Genesis C1 8柱 (10 0× 3mm ,3μm ) ,流动相为 0 .1m ol/ L磷酸 (0 .6 m l/ m in,恒流速 )和乙腈 (0 .0 0 5～ 0 .1m l/ m in,变速 ) ;柱温35°C;荧光激发波长 2 85 nm,发射波长 370 nm。最低检测浓度 10 ng/ ml,最低定量浓度 (L OQ) 2 0 ng/ m l,2 0～ 15 0 0ng/ m l浓度范围线性良好。 8名志愿者口服 30 0 m g 1片后 ,t1 /2 为 3.19± 0 .36 h,AUC为 95 73.37± 16 40 .0 9h· ng· m l- 1 ,Cmax为 2 5 87.0 4± 710 .16 ng/ ml,Tmax为 1.2 5± 0 .46 h     

Advances in the antiviral therapy of herpes virus infection in children

Herpes viruses are ubiquitous, and primary infection with many of these viruses is common during childhood. In general, children tolerate primary infection well, with only mild symptoms, but in the immunocompromised, including the newborn, infection can be associated with serious morbidity and mortality. Drug treatment for many of the herpes infections is available but is often associated with serious side effects. In the pediatric age group, treatment is further hindered by a lack of information on suitable dosing regimes, unavailability of oral solutions and a lack of clinical trials specifically investigating response to treatment in this group of patients. This article will review current evidence regarding the pharmacokinetics and dosing of the most commonly used antiherpetic agents and will look specifically at the treatment of the more common herpes virus infections in children.     

Successful treatment of aciclovir and foscarnet resistant Herpes simplex virus lesions with topical imiquimod in patients infected with human immunodeficiency virus type 1

Aciclovir (ACV)-resistant Herpes simplex virus type-2 (HSV-2) infections are observed commonly in patients also infected with HIV-1. The use of foscarnet (FOS) in these patients may also lead to resistance. This situation can become a difficult therapeutic challenge. Four cases of patients infected with HIV and with mucocutaneous HSV-2 resistant to ACV and FOS are reported. These patients were treated successfully with topical 5% imiquimod. Imiquimod treatment also appeared to delay the time to recurrence of HSV lesions.     

Famciclovir vs. aciclovir in immunocompetent patients with recurrent genital herpes infections: a parallel-groups, randomized, double-blind clinical trial

BACKGROUND: Twice-daily therapy with famciclovir (FCV) was shown to be effective for episodic therapy for recurrent genital herpes in a large placebo-controlled trial. However, no study has been published to date comparing FCV and aciclovir (ACV). OBJECTIVES: We have evaluated the effectiveness of FCV vs. ACV in the treatment of recurrent genital herpes infection. METHODS: A multicentre, double-blind, double-placebo, randomized, parallel-design study, assessed for equivalence, was conducted. As the analysis was based on confidence intervals, a difference of lesion healing time between ACV and FCV (Delta) of 1.05 days with a standard deviation of 2.30 days was chosen. Two hundred and four outpatients were included. Patients self-initiated oral therapy with 125 mg of FCV twice daily or ACV 200 mg five times daily for 5 days. The principal end-point of the study was the complete healing of lesions. Duration of the complete resolution of all symptoms, and safety were also considered. RESULTS: The mean healing time was 5.1 days and 5.4 days for FCV and ACV, respectively, with a crude value of Delta = 0.25 days (CI 95%: -0.32; 0.82) in the intent-to-treat population. Therefore, the confidence interval for the difference between the two treatments lies entirely within the equivalence range (-1.05-1.05). The value of Delta in the per-protocol population [0.35 day (CI 95%: -0.24; 0.93)] was comparable between the two groups. No differences were detected in the proportion of patients having complete healing at the different days of evaluation as well as in the duration until the complete resolution of all the symptoms. The frequency, nature and severity of adverse events did not differ among the two treatment groups. CONCLUSIONS: Twice-daily FCV was as effective and safe in the treatment of recurrent genital herpes simplex virus infection as five times daily ACV.     

Herpes simplex vegetans: atypical genital herpes infection with prominent plasma cell infiltration in B‐cell chronic lymphocytic leukemia

Herpes simplex vegetans is a rare disorder even in immunocompromised patients. It typically affects patients with HIV or myeloproliferative diseases.The atypical cutaneous lesions show papillomatous vegetations in varying locations. Histologically the lesions show pseudoepitheliomatous hyperplasia of squamous epithelium, plasma cell infiltration and are positive for HSV 1 and/or HSV 2. Herpes simplex vegetans often responds poorly to treatment in immunocom‐promised patients.     

万乃洛韦毫微粒对肝脏和肝细胞胞内靶向性的研究

目的：测定静注万乃洛韦聚氰基丙烯酸正丁酯毫微粒（ＶＡＣＶＰＢＣＡＮＰ）冻干剂和万乃洛韦小鼠体内的分布。方法：用体外肝细胞培养及摄取实验研究ＶＡＣＶＰＢＣＡＮＰ对肝细胞的胞内靶向性。结果：ＶＡＣＶＰＢＣＡＮＰ静注后１５ｍｉｎ即有７４．４９％的ＶＡＣＶ集中在肝脏，比ＶＡＣＶ注射液提高了２．９９倍，肾脏分布量降低了５．４６倍。结论：ＶＡＣＶ制成毫微粒后可明显增加肝细胞的摄取量     

更昔洛韦治疗老年带状疱疹疗效分析

目的:评价更昔洛韦治疗老年带状疱疹的疗效及安全性。方法:126例老年带状疱疹患者分为两组,更昔洛韦组静脉滴注更昔洛韦0.25g,每日1次;阿昔洛韦组静脉滴注阿昔洛韦0.5g,每日2次。两组疗程均为7d。结果:更昔洛韦组有效率为93.8%,阿昔洛韦组有效率为78.7%,两组比较差异有显著性(P<0.05),在减轻症状和体征方面,更昔洛韦比阿昔洛韦组疗效更显著(P<0.01)。两组均无严重的不良反应发生。结论:更昔洛韦治疗老年带状疱疹安全,速效。     

小儿病毒性脑炎42例临床特点及治疗体会

目的:探讨小儿病毒性脑炎(病脑)临床特点及治疗体会.方法:对确诊为病脑的42例住院息儿进行临床观察,并采用阿昔洛韦治疗,观察其疗效.结果:42例病脑患儿均在病毒感染的基础上出现神经系统症状及体征.经阿昔洛韦加综合治疗10～30天,治愈25例(59.5%),好转13例(31.0%),无效4例(9.5%),总有效率90.5%.结论:阿昔洛韦是治疗小儿病脑安全有效的抗病毒药物.