Clinical and Immunological Evaluation of Oral Ribavirin Administration in Recurrent Herpes simplex Infections

Abstract

A total of 38 out-patients with recurrent oral or genital Herpes simplex virus infections received either oral ribavirin (800–1600 mg/day for 7 days) or placebo following a randomized and balanced protocol. Clinical and laboratory parameters, including haematological, metabolic and immunological tests, were checked in order to estimate tolerance to and efficacy of ribavirin on recurrent Herpes simplex virus infection and on the number of recurrences during the 12 months following treatment. Ribavirin showed definite superiority in the treatment of recurrent Herpes simplex virus 1, when compared to placebo, its efficacy being enhanced if treatment is started as soon as possible after infection has started. No significant modification of the parameters used to assess tolerance was noted; moreover there was no modification of the immunological parameters evaluated.

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References

Nahmias

A.J.

, Roizman

: Infection with Herpes simplex viruses 1 and 2. N Engl J Med 1973; 289; 667–674, 719–725, 781–789.

Shore

S.L.

, Nahmias

A.J.

: Immunology of Herpes simplex viruses. In: Immunology of Human Infections: Part II: Viruses and Parasites; Immunodiagnosis and Prevention of Infectious Diseases ( Nahmias

A.J.

, O'Reilly

R.J.

, eds). New York: Plenum Press, 1981; pp 21–72.

Canonico

P.G.

: Ribavirin: a review of efficacy, toxicity and mechanism of antiviral activity. In: Antibiotics ( Hahn

F.E.

, ed). New York: Springer, 1983; Vol 3: pp 161–186.

Sidwell

E.R.

: Ribavirin in vitro antiviral activity. In: Ribavirin: a Broad Spectrum Antiviral Agent ( Smith

R.A.

, Kirkpatrick

, eds). New York: Academic Press, 1980; pp 23–42.

Goswami

D.B.

, Borek

, Sharma

O.K.

. The broad spectrum antiviral agent Ribavirin inhibits capping of RNA. Biochem Biophys Res Commun 1979; 89: 830–836.

Hall

C.B.

, McBride

J.T.

, Walsh

E.E.

. Aerosolized Ribavirin treatment of infants with respiratory syncytial viral infection. N Engl J Med 1983; 308: 1443–1447.

Fernandez

: Ribavirin: a summary of clinical trials: Herpes genitalis and measles. In: Ribavirin: a Broad Spectrum Antiviral Agent ( Smith

R.A.

, Kirkpatrick

, eds). New York: Academic Press, 1980; pp 215–230.

Minkoff

D.I.

, Connor

J.D.

: Clinical use of Ribavirin and the treatment of Herpes zoster in otherwise normal adults. In: Ribavirin: a Broad Spectrum Antiviral Agent ( Smith

, and Kirkpatrick

, eds). New York: Academic Press, 1980; pp 185–199.

McCormick

J.B.

, King

I.J.

, Webb

P.A.

. Lassa fever: effective therapy with Ribavirin. N Engl J Med 1986; 314: 20–26.

10.

Knight

, McClung

, Wilson

S.W.

. Ribavirin small-particle aerosol treatment of influenza. Lancet 1981; ii: 945–949.

11.

McCormick

J.B.

, Getchell

J.P.

, Mitchell

S.W.

. Ribavirin suppresses replication of lymphadenopathy-associated virus in cultures of human adult T lymphocytes. Lancet 1984; ii: 1367–1369.

12.

Solomon

A.R.

, Rasmussen

E.J.

, Varani

. The Tzanck smear in the diagnosis of cutaneous Herpes simplex. J Am Med Assoc 1984; 251: 633–635.

13.

Pocock

S.J.

: Clinical Trials; a Practical Approach. New York: John Wiley, 1983; Vol 95: pp 143–147.

14.

Boyun

: Isolation of mononuclear cells and granulocytes from human blood. Scand J Clin Lab Invest 1986; 21(suppl 97): 77–82.

15.

Jolley

W.B.

: Minimal effects of Ribavirin on the immune system. In: Ribavirin: a Broad Spectrum Antiviral Agent ( Smith

R.A.

, Kirkpatrick

, eds). New York: Academic Press, 1980; pp 59–71.

16.

Hirsch

M.S.

, Kaplan

J.C.

: Prospects of therapy for infections with HTLVIII. Ann Int Med 1985; 103: 750–755.