Skip to main content
Device Global Header

Subscribe
or Renew

Advanced Search

This article is available to subscribers. Subscribe now. Already have an account? Sign in

Original ArticleFree PreviewArchive

Early Vidarabine Therapy to Control the Complications of Herpes Zoster in Immunosuppressed Patients

List of authors.
  • Richard J. Whitley, M.D.,
  • Seng-Jaw Soong, Ph.D.,
  • Raphael Dolin, M.D.,
  • Robert Betts, M.D.,
  • Calvin Linnemann, Jr., M.D.,
  • Charles A. Alford, Jr., M.D.,
  • and the NIAID Collaborative Antiviral Study Group*

Abstract

We conducted a double-blind, placebo-controlled trial to assess the value of vidarabine therapy for the prevention of complications from herpes zoster in immunocompromised patients. Of 121 patients with localized herpes zoster of 72 hours' duration or less, 63 received vidarabine and 58 received the placebo. Populations were matched for pertinent characteristics. Therapy accelerated cutaneous healing and decreased the rates of cutaneous dissemination (from 24 per cent [14 patients] to 8 per cent [5 patients]) (P = 0.014); and of zoster-related visceral complications (from 19 per cent [11 patients] to 5 per cent [3 patients]) (P = 0.015). Therapy also decreased the total duration of post-herpetic neuralgia (P = 0.047). Patients with lymphoproliferative cancers and those 38 years of age or older were at greatest risk for complications and benefited most from therapy. There was no serious drug toxicity.

We conclude that vidarabine therapy, when started within the first three days, is valuable for the reduction of complications related to herpes zoster. (N Engl J Med. 1982; 307:971–5.)

Funding and Disclosures

Supported by a contract (NO1-AI-12667) from the National Institute of Allergy and Infectious Diseases, by grants (CA 13148) from the National Cancer Institute and (RR-032) from the General Clinical Research Centers Programs, National Institutes of Health, and by the Robert Meyer Foundation.

Author Affiliations

From the Division of Virology, Departments of Pediatrics, Microbiology, and Biostatistics, the University of Alabama in Birmingham; the Division of Infectious Diseases, Department of Medicine, University of Vermont College of Medicine, Burlington; the Division of Infectious Diseases, Department of Medicine, University of Rochester, Rochester, N.Y.; and the Division of Infectious Diseases, Department of Medicine, University of Cincinnati, Cincinnati, Ohio. Address reprint requests to Dr. Whitley at the Department of Pediatrics, Rm. 609, CDLD Bldg., University of Alabama in Birmingham, University Station, Birmingham, AL 35294.

* Members of the Collaborative Antiviral Study Group participating in this trial were G. Galasso and M. Myers (project officers), S. Straus, NIAID, NIH; R. Whitley, C. Alford, N. Barton, and C. G. Cobbs, Central Unit; S. Soong and P. Kartus, Department of Biostatistics, University of Alabama in Birmingham; J. Overall, University of Utah College of Medicine; F. Hayden and J. Gwaltney, University of Virginia; M. Hilty, R. Glaser, and R. Turner, Ohio State University College of Medicine; C. Linnemann, Jr., University of Cincinnati; C. Liu, D. Hinthorn, C. T. Cho, and G. R. Hodges, University of Kansas Medical Center; J. Luby and K. Murphy, University of Texas, Southwestern; S. Schwartzman and A. Nahmias, Emory University; J. Connor, D. Richman, M. Oxman, and S. Spector, University of California, San Diego; Y. Bryson, University of California, Los Angeles; M. Ho, G. Pazin, and J. Dowling, University of Pittsburgh; M. Hirsch and A. Karchmer, Massachusetts General Hospital, Boston; J. Tilles, University of California, Irvine; R. Betts and R. G. Douglas, University of Rochester; A. Chow, University of British Columbia; R. Haynes, Wayne State University, Dayton; R. Dolin and R. C. Reichman, University of Vermont; R. Buchanan and S. Thornton, Parke-Davis and Company, Ann Arbor, Mich.

Print Subscriber? Activate your online access.