Clinical Use of Antiviral Drugs (Developments in Medical Virology, 3)

Antiviral chemotherapy has come of age, and, after an initial slow pro­ gress, the development of new antiviral agents has proceeded at a more rapid pace and the perspectives for their clinical use have increased considerably. Now, 25 years after the first antiviral assay (idoxuridine) was introduced in the clinic, it is fitting to commemorate the beginning of the antivirals' era. In its introductory chapter B.E. Juel-Jensen touches on what may be con­ sidered as five of the most fundamental requirements of an antiviral drug : efficacy, relative non-toxicity, easy solubility, ready availability and rea­ sonable cost. Surely, the antiviral drugs that have so far been used in the clinic could still be improved upon as one or more of these five essential demands are concerned. How is all began is narrated by W.H. Prusoff. The first antiviral drugs to be used in humans were methisazone and idoxuridine, the former, which is now of archival interest, in the prevention of smallpox, the latter, which was approved for clinical use in the United States in 1962, for the topical treatment of herpetic keratitis. In terms of potency, also because of solubility reasons, idoxuridine has been superseded by trifluridine in the topical treatment of herpes simplex epithelial keratitis. H.E. Kaufman did not find trifluridine or acyclovir ef­ fective in the treatment of deep stromal keratitis or iritis and he reckons that other antiviral drugs (i.e. bromovinyldeoxyuridine) would not be effec­ tive either. Front Matter....Pages i-xvii Clinical Use of Antiviral Drugs....Pages 1-13 Idoxuridine or How It All Began....Pages 15-24 The Treatment of Herpetic Eye Infections with Trifluridine and Other Anti-Virals....Pages 25-38 Treatment (Bromovinyldeoxyuridine) of Herpetic Eye Infections....Pages 39-48 Diagnosis and Treatment of Herpes Simplex Encephalitis....Pages 49-66 Treatment of Herpes Simplex Labialis....Pages 67-86 Treatment of Herpes Genitalis....Pages 87-114 Treatment of Herpes Simplex Virus Infections in Immunosuppressed Patients....Pages 115-125 Antiviral Therapy of Varicella-Zoster Virus Infections....Pages 127-143 Treatment (Bromovinyldeoxyuridine) of Varicella-Zoster Virus Infections....Pages 145-157 Therapy and Prevention of Cytomegalovirus Infections....Pages 159-194 The Prophylaxis of Herpes Group Infections in Patients with Haematological Malignancy....Pages 195-206 Resistance of Herpes Viruses to Nucleoside Analogues — Mechanisms and Clinical Importance....Pages 207-222 Clinical Use of Foscarnet (Phosphonoformate)....Pages 223-240 Prophylaxis and Treatment of Rhinovirus Infections....Pages 241-276 Rimantadine and Amantadine in the Prophylaxis and Therapy of Influenza A....Pages 277-287 Ribavirin Aerosol Treatment of Influenza, Respiratory Syncytial and Parainfluenza Virus Infections of Man....Pages 289-304 Antiviral Therapy of Highly Pathogenic Viral Diseases....Pages 305-315 Perspectives in the Use of Antiviral Agents for Prevention and Treatment of Respiratory Virus Infections....Pages 317-340 Perspectives for the Treatment of Gastrointestinal Tract Virus Infections....Pages 341-359 Principles of Antiretroviral Therapy for AIDS and Related Diseases....Pages 361-385 Promises to Keep: Clinical Use of Antiviral Drugs....Pages 387-403 Back Matter....Pages 405-413