A virologic pilot study of valacyclovir in infectious mononucleosis
A virologic pilot study of valacyclovir in infectious mononucleosis
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DOI：
10.1016/j.jcv.2007.02.002
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发表时间：
2007-05-01
影响因子：
8.8
通讯作者：
Brundage, Richard C.
中科院分区：
文献类型：
--
作者：
Balfour, Henry H., Jr.;Hokanson, Kristin M.;Brundage, Richard C.
背景：传染性单核细胞增多症降低了许多大学生的生产力，EB病毒感染可能导致长期的免疫损害。目的：评价万乃洛韦在EB病毒相关性急性传染性单核细胞增多症中的抗病毒作用，并探索潜在的临床益处。研究设计：将发病前7天出现症状的大学生随机分为服用万乃洛韦3g/d和不服用万乃洛韦14天。用荧光定量聚合酶链式反应(TaqMan)检测口腔和全血标本中EB病毒(EBV)DNA的含量。主要结果是，在治疗期间，经实验室证实的原发EBV感染的受试者口腔洗液中EBV拷贝数/毫升下降了2log(10)。次要结果包括临床效果。结果：20名受试者纳入研究。在口腔洗涤液来源的细胞颗粒(P=0.03)和上清液(P=0.001)样本中，接受万乃洛韦的受试者与对照组受试者相比，EB病毒拷贝-gt；=2log(10)下降的比例明显更大。治疗结束时，万乃洛韦组的症状数(P=0.03)和病情严重度(P=0.049)均低于对照组。结论：万乃洛韦治疗传染性单核细胞增多症可减少EB病毒的排泄。因为我们的研究规模很小，而且不是安慰剂对照，所以这些结果必须通过一项更大的安慰剂对照试验来证实。(C)2007 Elsevier B.V.保留所有权利。
Background: Infectious mononucleosis decreases the productivity of many college students and Epstein-Barr virus (EBV) infection may result in long-term immune damage.Objectives: Evaluate the antiviral effect of valacyclovir during EBV-related acute infectious mononucleosis and explore potential clinical benefits.Study design: University students who presented during the first 7 days of illness were randomized to receive valacyclovir 3 g/day for 14 days or not. The quantity of Epstein-Barr virus (EBV) DNA in oral and whole blood samples was determined by real-time (TaqMan) PCR. The primary outcome was the proportion of subjects with laboratory-con firmed primary EBV infection who had >= 2log(10) decrease in EBV copies/mL in oral washes during the treatment period. Secondary outcomes included clinical effects.Results: Twenty subjects were studied. The proportion of valacyclovir recipients versus control subjects who had >= 2log(10) decrease in EBV copies was significantly greater for both oral wash fluid-derived cell pellet (P = 0.03) and supernatant (P = 0.001) samples. At the end of the treatment period, the number of reported symptoms (P = 0.03) and the severity of illness (P = 0.049) were reduced among valacyclovir recipients as compared with controls.Conclusions: Valacyclovir therapy caused a reduction of EBV excretion and possibly produced a clinical benefit in infectious mononucleosis. Because our study was small and not placebo-controlled, these results must be confirmed by a larger, placebo-controlled trial. (c) 2007 Elsevier B.V. All rights reserved.