Herpesvirus medications

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Herpesvirus medications


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Herpesvirus medications

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Acyclovir p. 198

Immunocompromised patients

acyclovir/famciclovir/valacyclovir p. 198


Anti-herpes medications are a group of antiviral agents that treat herpes infections including herpes simplex virus, or HSV, but they can also treat other viral infections like varicella zoster virus, or VZV, and cytomegalovirus, or CMV.

They act by inhibiting viral DNA synthesis and thus, inhibiting viral proliferation.

Alright, now let’s start with HSV, which infects skin and mucosal epithelial cells.

There are two types of HSV, HSV1 and HSV2.

Generally speaking, HSV1 tends to cause infections “above the waist” mostly involving the lips, or labia, which is referred to as herpes labialis, and the mouth and the gingiva, which is called gingivostomatitis.

In rare cases, HSV1 can spread to the esophagus, causing esophagitis, or to the central nervous system, causing meningitis or encephalitis, typically affecting the temporal lobe.

On the other hand, HSV2 tends to cause infections “below the waist” affecting the genital organs, which is referred to as herpes genitalis.

HSV can also pass from a mother to a baby usually when the baby passes through the infected maternal vaginal secretions and can cause severe neonatal infections.

The typical presentation of a herpes infection is clusters of small, painful, fluid-filled blisters, that ooze and ulcerate. They eventually heal after a few weeks.

However, HSV also infects the nearby sensory neurons, which aren’t destroyed, but instead, they become a permanent home for the herpes virus. This is referred to as the latent phase of the infection and is typically asymptomatic.

From time to time, the herpes virus from the sensory neurons make a few viral copies of itself which can get released and infect the epithelial cells.

Alright, now let’s move on to varicella zoster virus. VZV causes a primary infection called varicella or chickenpox, which is characterized by a rash on the scalp, face, and trunk that contains macules, papules, vesicles, and scabs at the same time.


Herpes medications are antiviral agents used to treat herpes infection. They mainly work by interfering with DNA replication of Herpes simplex viruses. Commonly prescribed herpes medications include acyclovir, cidofovir, foscarnet, and valacyclovir. Side effects include nephrotoxicity, electrolyte imbalances, headaches, hallucinations, and seizures.


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  2. "Rang and Dale's Pharmacology" Elsevier (2019)
  3. "Goodman and Gilman's The Pharmacological Basis of Therapeutics, 13th Edition" McGraw-Hill Education / Medical (2017)
  4. "Mode of action, toxicity, pharmacokinetics, and efficacy of some new antiherpesvirus guanosine analogs related to buciclovir." Antimicrobial Agents and Chemotherapy (1986)
  5. "Clinical study in genital herpes: natural Gene-Eden-VIR/Novirin versus acyclovir, valacyclovir, and famciclovir" Drug Design, Development and Therapy (2016)
  6. "Efficacy of brincidofovir as prophylaxis against HSV and VZV in hematopoietic cell transplant recipients" Transplant Infectious Disease (2018)
  7. "Antiviral Drug Resistance of Human Cytomegalovirus" Clinical Microbiology Reviews (2010)

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