Abstract
ACV, given intravenously, is effective in the treatment of herpesvirus infections in immunocompromised children. However, there are few data on the use and subsequent absorption of oral ACV. We have used oral ACV (600mg/m2/dose) given six hourly for ten days, to treat 12 children aged 6 weeks-14 years suffering from varicella-zoster (VZV) or herpes simplex virus (HSV) infections. All patients were at risk for disseminated disease (leukemia 4, eczema 2, cystic fibrosis 2, neuroblastoma 1, immunodeficiency 1, nephrotic 1, young infant 1). Plasma ACV levels (obtained on day 3 or 4) were compared when the drug was taken fasting and with food. Sampling was carried out prior to the morning dose (trough) and then after 1 1/2 hours (peak). Levels were repeated similarly in the evening, when the drug was given with the main meal. Plasma levels (peak) were considerably higher than ED50 for HSV (0.1-1.5μM) and VZV (3.75μM). The drug was well tolerated and its absorption was not significantly affected when taken with food. All patients recovered without disseminated disease. There was no evidence of renal hepatic or hematological side-effects.
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