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This is a patent i came across stating that the above antivirals have a substantial effect of lowering immune response to cmv, most like by their ability to reduce subclinical episodes of cmv reactivation.
So it appears that the above AV's can help with most of the herpes viruses, so using them before valcyte can reduce die of symptoms which has been noticed by those who have done this, as well as by those who have changed over to valtrex/famvir after doing a course of valcyte to keep these viruses supressed.
Certain antiviral drugs are known for the treatment of herpes virus infections. In particular, nucleoside analogues such as acyclovir (also known as aciclovir) (9-(2-hydroxyethoxymethyl)guanine-GB 1 523 865) are known for the treatment of human herpes viruses, being most effective against herpes simplex viruses (HSV-1 and HSV-2) and varicella zoster virus (VZV). Acyclovir has minimal activity against CMV replication in vitro, with an ID50 (the concentration at which the drug reduces viral plaque formation by 50% or more) of greater than 100 ?M, compared to values of 0.15 ?M, 1.62 ?M and 3.75 ?M against HSV-1, HSV-2 and VZV respectively (according to the assays of Crumpacker et al.). Valacyclovir is the L-valine ester of, and acts as a prodrug for, acyclovir, and hence has the same mechanism of action. Both drugs produce a number of side effects at common doses, including nausea, vomiting, diarrhoea and/or headaches.
Ganciclovir and valganciclovir are homologues of acyclovir and valatyclovir respectively, which have been developed for their markedly improved activity against CMV. These drugs are widely used in the management of CMV disease in immunosuppressed patients. However, ganciclovir is considered a potential human carcinogen, teratogen, and mutagen, and is considered likely to cause inhibition of spermatogenesis. Known side-effects include granulocytopenia, neutropenia, anaemia, thrombocytopenia, fever, nausea, vomiting, dyspepsia, diarrhoea, abdominal pain, flatulence, anorexia, raised liver enzymes, headache, confusion, hallucination, seizures, pain and phlebitis at injection site (due to high pH), sweating, rash, itch and increased serum creatinine and blood urea concentrations.
Penciclovir is an analogue of acyclovir which is able to treat herpesvirus infections with fewer side effects. The antiviral spectrum of penciclovir is similar to that of acyclovir, and it therefore has minimal activity against CMV. Famciclovir is a prodrug for penciclovir, having improved bioavailability.
There is therefore a prejudice in the art against treatment of CMV in immunocompetent patients, based on the following beliefs: most antiviral drugs are not able to effectively treat CMV; those drugs that are able to treat CMV have unacceptably high toxicity and level of side-effects; CMV infection is near-ubiquitous and has been considered to be asymptomatic in immunocompetent patients.
However, the inventors have discovered that CMV infection is not entirely asymptomatic, and that surprisingly there are in fact benefits in treating CMV infected patients with antiviral drugs which have low activity against cytomegalovirus as estimated by in vitro assays. When given to patients these drugs cause a substantial reduction in the immune response to cytomegalovirus, most likely by their ability to reduce subclinical episodes of CMV reactivation and hence limit recurrent stimulation of the CMV-specific immune response.
The dosage administered to a patient will normally be determined by the prescribing physician and will generally vary according to the age, weight and response of the individual patient, as well as the severity of the patient\'s symptoms. However, in most instances an effective therapeutic daily dosage will be in the range of 200-2000 mg and, preferably, of 400-1000 mg (e.g. for valacyclovir or acyclovir) administered in single or divided doses. In some cases, however, it may be necessary to use dosages outside these limits.
http://www.freshpatents.com/-dt20101104ptan20100280052.php
rest of the article is interesting too.
cheers!!!
So it appears that the above AV's can help with most of the herpes viruses, so using them before valcyte can reduce die of symptoms which has been noticed by those who have done this, as well as by those who have changed over to valtrex/famvir after doing a course of valcyte to keep these viruses supressed.
Certain antiviral drugs are known for the treatment of herpes virus infections. In particular, nucleoside analogues such as acyclovir (also known as aciclovir) (9-(2-hydroxyethoxymethyl)guanine-GB 1 523 865) are known for the treatment of human herpes viruses, being most effective against herpes simplex viruses (HSV-1 and HSV-2) and varicella zoster virus (VZV). Acyclovir has minimal activity against CMV replication in vitro, with an ID50 (the concentration at which the drug reduces viral plaque formation by 50% or more) of greater than 100 ?M, compared to values of 0.15 ?M, 1.62 ?M and 3.75 ?M against HSV-1, HSV-2 and VZV respectively (according to the assays of Crumpacker et al.). Valacyclovir is the L-valine ester of, and acts as a prodrug for, acyclovir, and hence has the same mechanism of action. Both drugs produce a number of side effects at common doses, including nausea, vomiting, diarrhoea and/or headaches.
Ganciclovir and valganciclovir are homologues of acyclovir and valatyclovir respectively, which have been developed for their markedly improved activity against CMV. These drugs are widely used in the management of CMV disease in immunosuppressed patients. However, ganciclovir is considered a potential human carcinogen, teratogen, and mutagen, and is considered likely to cause inhibition of spermatogenesis. Known side-effects include granulocytopenia, neutropenia, anaemia, thrombocytopenia, fever, nausea, vomiting, dyspepsia, diarrhoea, abdominal pain, flatulence, anorexia, raised liver enzymes, headache, confusion, hallucination, seizures, pain and phlebitis at injection site (due to high pH), sweating, rash, itch and increased serum creatinine and blood urea concentrations.
Penciclovir is an analogue of acyclovir which is able to treat herpesvirus infections with fewer side effects. The antiviral spectrum of penciclovir is similar to that of acyclovir, and it therefore has minimal activity against CMV. Famciclovir is a prodrug for penciclovir, having improved bioavailability.
There is therefore a prejudice in the art against treatment of CMV in immunocompetent patients, based on the following beliefs: most antiviral drugs are not able to effectively treat CMV; those drugs that are able to treat CMV have unacceptably high toxicity and level of side-effects; CMV infection is near-ubiquitous and has been considered to be asymptomatic in immunocompetent patients.
However, the inventors have discovered that CMV infection is not entirely asymptomatic, and that surprisingly there are in fact benefits in treating CMV infected patients with antiviral drugs which have low activity against cytomegalovirus as estimated by in vitro assays. When given to patients these drugs cause a substantial reduction in the immune response to cytomegalovirus, most likely by their ability to reduce subclinical episodes of CMV reactivation and hence limit recurrent stimulation of the CMV-specific immune response.
The dosage administered to a patient will normally be determined by the prescribing physician and will generally vary according to the age, weight and response of the individual patient, as well as the severity of the patient\'s symptoms. However, in most instances an effective therapeutic daily dosage will be in the range of 200-2000 mg and, preferably, of 400-1000 mg (e.g. for valacyclovir or acyclovir) administered in single or divided doses. In some cases, however, it may be necessary to use dosages outside these limits.
http://www.freshpatents.com/-dt20101104ptan20100280052.php
rest of the article is interesting too.
cheers!!!
