acyclovir and Vaginal-Diseases

Two cases of conjugal contact transfer vaccinia are described. Each patient had intimate contact after their respective partners, active-duty military personnel, received the smallpox vaccination.

Topics: Acyclovir; Adult; Female; Herpes Genitalis; Humans; Keratinocytes; Male; Military Personnel; Patient Education as Topic; Sexual Partners; Sexually Transmitted Diseases, Viral; Smallpox; Smallpox Vaccine; Spouses; Vaccination; Vaginal Diseases; Valacyclovir; Valine

Substantial advances have been made in our understanding of HSV and genital herpes. The molecular biology of viral structure and function and the pathogenesis of infection have been elucidated to a large degree, and epidemiologic investigations, based on reliable type-specific assays, have been done. Diagnostic techniques have been refined, and the value of therapy has been defined. Currently, management strategies for pregnant women and their neonates are based on data rather than hypothesis, and rational counseling is feasible. The next major advance in the field would be the availability of a safe and effective vaccine, the development and investigation of which is being pursued vigorously.

Topics: Acyclovir; Condoms; Diagnosis, Differential; Female; Gynecology; Herpes Genitalis; Humans; Incidence; Mass Screening; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Outcome; Prevalence; Primary Prevention; Recurrence; Risk Factors; Vaginal Diseases; Virus Shedding; Vulvar Diseases

The nucleoside analogue (S)-1-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine (HPMPC) inhibited the replication of herpes simplex virus (HSV) types 1 and 2 in tissue culture cells at about 1.0 micrograms/ml, whereas Acyclovir (ACV) had an EC50 of about 0.10-0.50 micrograms/ml. The purpose of these studies was to evaluate the efficacy of topically applied HPMPC in animal models of primary and recurrent genital HSV-2 infections. Mice treated with 5%, 1% or 0.5% HPMPC three times daily, beginning 6 or 24 h after virus inoculation had reduced vaginal viral replication regardless of time of initiation of therapy. ACV at 5% also reduced vaginal viral replication, but not as effectively as HPMPC. In primary infection of guinea pigs, therapy with 5% or 1% HPMPC beginning at 24 h but not 72 h significantly altered lesion development. However, 5% HPMPC was highly toxic to guinea pigs. Vaginal viral replication was reduced significantly with either 1% or 0.3% HPMPC initiated at 24 h. In these studies, HPMPC was also more efficacious than 5% ACV. Topical treatment with 1% HPMPC did not reduce the incidence or severity of spontaneous or UV-induced recurrent genital lesions. These results indicate that topical therapy with 1%, 0.5% or 0.3% HPMPC was more effective than 5% ACV in the treatment of primary genital HSV-2 infections of guinea pigs and mice and suggest that HPMPC should be considered for topical use in humans.

Topics: Acyclovir; Administration, Topical; Animals; Antiviral Agents; Cidofovir; Cytosine; Disease Models, Animal; Female; Guinea Pigs; Herpes Genitalis; Mice; Organophosphonates; Organophosphorus Compounds; Simplexvirus; Ultraviolet Rays; Vagina; Vaginal Diseases; Virus Replication