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New agent shortened HSV-2 shedding

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Possible alternative or addition to acyclovir

Pritelivir, and presumably other agents in this new class of anti–human simplex virus drugs, is active against viruses that develop resistance to drugs in the acyclovir class, making it an attractive alternative to the nucleoside agents for many patients, according to Dr. Richard J. Whitley and Mark Prichard, Ph.D.

"Resistance to the nucleoside analogues is encountered regularly in the immunocompromised host, particularly in recipients of stem-cell transplants and patients in whom antiviral therapy for AIDS has failed," they said.

And, as Dr. Wald and her associates reported, combination therapy with pritelivir and acyclovir may now be possible, especially for patients with life-threatening HSV infection. "Studies to assess this opportunity are under way," they added.

Dr. Whitley and Dr. Prichard are with the departments of pediatrics, microbiology, medicine, and neurosurgery at the University of Alabama at Birmingham. Dr. Whitley reported ties to N and N Scientific and Gilead; Dr. Prichard reported no relevant conflicts of interest. These remarks were taken from their editorial accompanying Dr. Wald’s report (N. Engl. J. Med. 2014 Jan. 15 [doi:10.1056/NEJMe1313982]).


 

FROM THE NEW ENGLAND JOURNAL OF MEDICINE

Although pritelivir markedly reduced the rate of viral shedding, some breakthrough shedding still occurred. "The question of whether further increases in the daily dose of pritelivir would completely abrogate viral shedding will have to be addressed in additional studies," they said.

Since pritelivir targets a different pathway than nucleoside analogues such as acyclovir, future studies also should investigate the effectiveness of combination therapy, the investigators added.

This study was funded by AiCuris. Dr. Wald reported ties to Agenus, Amgen, Genentech, Genocea, Gilead, and Vical. Her associates reported numerous relevant financial disclosures.

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