Acute mucocutaneous HSV infections in immunocompromised patients Herpes of the eye and herpes simplex blepharitis a chronic long-term form of herpes eye infection Prevention of herpes viruses in immunocompromised people such as people undergoing cancer chemotherapy  Its effectiveness in treating Epstein-Barr virus EBV infections is less clear.
It is also effective in systemic or traumatic herpes infections, eczema herpeticum and Herpes simplex meningitis. Reviews of research dating from the s show there is some effect in reducing the number and duration of lesions if aciclovir is applied at an early stage of an outbreak. This finding emphasizes the importance of testing simple, inexpensive non-ART strategies, such as aciclovir and cotrimoxazole , in people with HIV.
It has been shown in limited test studies that the nursing infant is exposed to approximately 0. If nursing mothers have herpetic lesions near or on the breast, breast-feeding should be avoided. In high doses, hallucinations have been reported. Infrequent adverse effects 0. Aciclovir crystalline nephropathy is more common when aciclovir is given as a rapid infusion and in patients with dehydration and preexisting renal impairment.
Adequate hydration, a slower rate of infusion, and dosing based on renal function may reduce this risk. Infrequent adverse effects include erythema or itch. In-vitro replication studies have found a synergistic, dose-dependent antiviral activity against HSV-1 and HSV-2 when given with aciclovir. However, this effect has not been clinically established and more studies need to be done to evaluate the true potential of this synergy. Reports of increased half life of aciclovir, as well as decreased urinary excretion and renal clearance have been shown in studies where probenecid is given simultaneously with aciclovir.
Synergistic effects when administered with aciclovir and caution should be taken when administering aciclovir to patients receiving IV interferon. Although administered often with aciclovir in HIV patients, neurotoxicity has been reported in at least one patient who presented with extreme drowsiness and lethargy 30—60 days after receiving IV aciclovir; symptoms resolved when aciclovir was discontinued.
Mechanisms of resistance in HSV include deficient viral thymidine kinase; and mutations to viral thymidine kinase or DNA polymerase, altering substrate sensitivity.
When the virus was reproducing each well contained different amounts of the antiviral drug aciclovir. By counting the plaques holes formed by the virus in the layer of cells the potency of the aciclovir to the virus was calculated. Aciclovir is active against most species in the herpesvirus family. In descending order of activity: