Abstract
A range of diseases caused by herpetic viruses can be causally treated with antivirotics. The article brings an overview of the basic findings regarding the generally used antivirotics, explains the mechanisms of effects useful for understanding other related information, reviews the adverse effects of these drugs and highlights the factors important for choosing an antivirotic and its dosage.
Acyclovir is the basic drug used against all infections caused by the herpes simplex virus (HSV) and the varicella zoster and herpes zoster viruses (VZV). The doses vary according to the diagnosis; in general, infections caused by VZV require double the doses as infections caused by HSV.
The choice of the form of application is made on the basis of the seriousness of the patient’s condition; the length of the treatment depends mostly on immuno-competence. Acyclovir is well-tolerated.
Valacyclovir has a better biological availability and it is more beneficial in certain indications. Brivudin, famcyclovir and pencyclovir are used rarely.
Gancyclovir is the primary drug for cytomegalovirus (CMV) infections. Its main disadvantage is strong haematotoxicity.
Cidofovir and foscarnet are antivirotics used for treatment of CMV infections in immunosuppressed patients and they show efficacy against other viruses as well. Their use is limited by frequent adverse effects - nephrotoxicity, myelosuppression and ion disbalances.
Fomivirsen is a synthetic oligonucleotide designated for intravitreal application, as an alternative treatment of CMV retinitis.