acyclovir and Colitis

A 58-year-old Japanese woman who had herpes zoster in association with colitis was successfully treated with intravenously administrated acyclovir. Vesicular lesions with red haloes ranged from the left side of her buttock to the left extremity, corresponding to the L4 to S2 dermatomes. Her colitis was considered to have been induced by varicella-zoster virus, based on the facts that the clinical courses were correlated and that the innervation of the affected site of the colon corresponded to an infected dermatome (S2).

Topics: Acyclovir; Antiviral Agents; Biopsy, Needle; Colitis; Female; Herpes Zoster; Humans; Middle Aged; Radiography

CMV disease is a major problem in AIDS, though with a different profile from that seen in other immunosuppressed patients. The novel treatments, ganciclovir and phosphonoformate, have a major role in the management of such infections, but maintenance therapy is often required. Optimal maintenance regimens have yet to be established, especially where zidovudine is also being used.

Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Addison Disease; Antiviral Agents; Colitis; Cytomegalovirus Infections; Encephalitis; Esophageal Diseases; Foscarnet; Ganciclovir; Humans; Phosphonoacetic Acid; Pneumonia, Viral; Retinitis

Topics: Acyclovir; Antiviral Agents; Azathioprine; Colitis; Cytomegalovirus Infections; Female; Ganciclovir; Humans; Immunosuppressive Agents; Valacyclovir; Valine; Young Adult

Topics: Acyclovir; Antibodies, Monoclonal; Antibodies, Monoclonal, Murine-Derived; Antineoplastic Combined Chemotherapy Protocols; Antiviral Agents; Carmustine; Cisplatin; Colitis; Combined Modality Therapy; Cyclophosphamide; Cytarabine; Dexamethasone; Doxorubicin; Etoposide; Hematopoietic Stem Cell Transplantation; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunocompromised Host; Immunoglobulins, Intravenous; Intestinal Pseudo-Obstruction; Lymphoma, Large B-Cell, Diffuse; Male; Melphalan; Middle Aged; Postoperative Complications; Prednisolone; Rituximab; Transplantation, Autologous; Vincristine; Virus Activation

The effect of colitis induced with dextran sodium sulfate (DSS) in rats on the bioavailability of drugs transported by the oligopeptide transporter PepT-1 was analyzed by studying the pharmacokinetics of PepT-1 substrates: cephalexin and valacyclovir, the prodrug of antiviral acyclovir. Western blot, immunohistochemistry, and real-time PCR were used to determine the PepT-1 protein and gene expression. We observed (1) no significant modification of PepT-1 expression in the duodenum and jejunum; (2) a slight decrease in both PepT-1 mRNA (50%) and protein expression (25%) in the ileum following DSS challenge; and (3) ectopic PepT-1 immunostaining in regenerative hyperplasia segments in the distal colon from DSS-treated rats where focal inflammation is localized. However, no modification of pharmacokinetic parameters (C (max), T (max), AUC) of cephalexin or acyclovir was detected. In conclusion, DSS-induced rat colitis did not alter PepT-1 substrate bioavailability despite certain modifications in PepT-1 expression profile.

Topics: Acyclovir; Animals; Anti-Bacterial Agents; Antiviral Agents; Biological Availability; Cephalexin; Colitis; Immunohistochemistry; Intestinal Mucosa; Male; Peptide Transporter 1; Rats; Rats, Wistar; RNA, Messenger; Symporters; Valacyclovir; Valine

Topics: Acyclovir; Antiviral Agents; Chickenpox; Colitis; Humans; Immunocompetence; Infant; Male

The spectrum of presentation of complications in patients with human immunodeficiency virus (HIV) disease is changing, in line with their improved survival. Infection of the colon with cytomegalovirus (CMV) is now more commonly encountered in clinical practice. We have reviewed the medical records of eleven patients with clinical and pathological evidence of CMV colitis. The clinical presentation, endoscopic and histological findings, and simultaneous infection of other organs with CMV are discussed. Diarrhoea in association with abdominal pain is the most frequent symptom complex in these patients and should raise the clinical index of suspicion for CMV colitis.

Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Adult; Colitis; Colon; Cytomegalovirus Infections; Diarrhea; Ganciclovir; Humans; Intestinal Mucosa; Male; Middle Aged; Rectum

Topics: Acute Disease; Acyclovir; Aged; Colitis; Colon; Herpes Zoster; Humans; Male

Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Adult; Antiviral Agents; Colitis; Cranial Nerve Diseases; Cytomegalovirus Infections; Ganciclovir; Hoarseness; Humans; Laryngeal Nerves; Male; Opportunistic Infections; Recurrent Laryngeal Nerve; Vocal Cord Paralysis

Cytomegalovirus (CMV) is an important cause of acalculous gangrenous cholecystitis in immunocompromised persons. We report a case of acalculous acute cholecystitis and active colitis associated with CMV in a patient suffering from the acquired immune deficiency syndrome. The condition was treated successfully with surgery and 9-(1,3,-dihydroxy-2-propoxymethyl)guanine intravenously.

Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Adult; Antiviral Agents; Cholecystectomy; Cholecystitis; Colitis; Cytomegalovirus; Cytomegalovirus Infections; Ganciclovir; Humans; Male

Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Adult; Antiviral Agents; Colitis; Cytomegalovirus Infections; Ganciclovir; Humans; Male; Retinitis

9-(1,3-dihydroxy-2-propoxymethyl) guanine (ganciclovir) was used to treat 41 patients (median age, 37 years) with the acquired immunodeficiency syndrome and cytomegalovirus gastrointestinal infection. Sites of infection were the colon in 31, the esophagus in 5, the rectum in 4, and the small bowel in 1. Patients received ganciclovir, 5 mg/kg body weight, intravenously every 12 hours for 14 days. Clinical improvement was seen in 30 patients and virologic response in 32. Mainly hematologic toxicity occurred: moderate leukopenia (1000 to 1900/mm3) was seen in 7 patients and severe (less than 1000/mm3) in 1, and moderate neutropenia (500 to 1000/mm3) in 5 and severe (less than 500/mm3) in 1. A cutaneous rash developed in 2 patients. Median overall survival was 16 weeks (range, 2 to 56). Cytomegalovirus recurred in 13 patients; median time to recurrence was 9 weeks from the start of treatment. Ganciclovir may be effective in treating cytomegalovirus gastrointestinal disease in patients with the acquired immunodeficiency syndrome.

Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Adult; Colitis; Cytomegalovirus Infections; Digestive System Diseases; Esophagitis; Ganciclovir; Hematologic Diseases; Hormones; Humans; Intestine, Small; Male; Middle Aged; Prospective Studies; Rectal Diseases; Recurrence; Ulcer

Topics: Acyclovir; Colitis; Enzyme-Linked Immunosorbent Assay; Herpes Simplex; Humans; Kidney Transplantation; Male; Middle Aged

Eight immunosuppressed homosexual men with cytomegalovirus viremia--seven with serious bilateral retinitis, one with colitis in addition to retinitis, and one with pneumonitis only--were treated with a new acyclovir derivative, 9-(1,3-dihydroxy-2-propoxymethyl) guanine, which has excellent in-vitro activity against cytomegalovirus. All patients had virologic and clinical improvement, but substantial leukopenia developed in three patients. Both clinical relapses and viral relapses occurred frequently, usually within 30 days after cessation of treatment. 9-(1,3-Dihydroxy-2-propoxymethyl) guanine represents the first clinically and virologically effective agent for the treatment of cytomegalovirus disease, but more effective and less toxic therapeutic regimens for both acute and chronic use must be developed.

Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Adult; Agranulocytosis; Antiviral Agents; Colitis; Cytomegalovirus Infections; Ganciclovir; Hodgkin Disease; Homosexuality; Humans; Male; Pneumonia, Viral; Retinitis

Topics: Acyclovir; Adult; Colitis; Crohn Disease; Cytomegalovirus Infections; Female; Ganciclovir; Hepatitis, Viral, Human; Humans