Ganciclovir Gel—A New Topical Treatment for Herpetic Keratitis

Abstract

Herpes simplex virus (HSV) infection of the eye is a major cause of corneal opacity in the US 1 and other developed countries. 2 Infection with either HSV-1 or HSV-2 is common. Data from the US National Health and Nutrition Examination Survey (NHANES) suggest an overall 58% seroprevalence rate for HSV-1—the predominant cause of herpes simplex keratitis 2 (HSK)—with rates in individual ethnic groups as high as 89%. 3 A three-month prospective epidemiological study conducted in France put the incidence of HSK at 31.5 cases per 100,000 per person-year. 4 Of these, 13.2 cases represented primary infections and 18.3 were recurrences. HSV infection is lifelong and recurrent, with the virus becoming latent in sensory nerves after the original outbreak. Estimates in the US indicate approximately 20,000 new cases of HSK each year with another 28,000 cases of recurrent disease. 5 The only currently available topical treatment for HSK in the US is trifluridine (TFT), a drug whose toxic effects highlight the need for more effective and less harmful treatments. This article will summarize HSV ocular infection and review current treatments approved both in the US and worldwide. It will also focus on efficacy and safety findings for ganciclovir 0.15% gel, an antiviral ophthalmic preparation available outside the US to treat HSK that is a promising new drug for the US market.