2′Fluoro-5-Iodo-Arabinosyl-Cytosine: A New Agent for Herpes Infections in the Immunosuppressed Patient

Abstract

Concurrent with our increased understanding of mechanisms of viral replication, new antiviral agents were developed with greater selectivity and sensitivity. Acyclovir was the first of these. We now present the initial compound of a series of 2′-Fluoro pyrimidine nucleosides with potent antiviral activity. This agent demonstrates both potency and sensitivity in vitro and in vivo against herpes simplex virus types I and II, and varicella zoster virus and is selective in vitro against cytomegalovirus. Initial clinical trials show the drug to be well tolerated and to be more effective than adenine arabinoside against varicella zoster in the immunosuppressed patient. Future developmental plans with the drug are outlined. FIAC (2′-Fluoro-5-iodo-aracytosine) is still at an early stage of clinical development and any comparison with acyclovir is premature; rather, therapy of severe viral infections in the future should consider combinations of such agents that show differential selectivity at multiple sites of action.