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Aciclovir
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'''Aciclovir''' (ACV), also known as '''acyclovir''' in the US, is an [[antiviral]] medication designed for [[herpesviruses]].<ref name="deClercq2005">{{Cite journal | last = de Clercq | first = Erik | last2 = Field | first2 = Hugh J| publication-date = January 2006 | date = 5 October 2005 | title = Antiviral prodrugs β the development of successful prodrug strategies for antiviral chemotherapy| periodical = British Journal of Pharmacology | publisher = Wiley-Blackwell| volume = 147 | issue = 1| pages = 1β11| url = | issn =| pmid= 16284630 | pmc= 1615839 | doi = 10.1038/sj.bjp.0706446}}</ref> It is mostly used to treat [[herpes simplex virus]] (cold sores or genital sores) and [[varicella zoster virus|varicella zoster virus]] (chickenpox or shingles). It also has weaker activity against [[cytomegalovirus]] and [[Epstein-Barr virus]].<ref name="AHFS2015" /> Aciclovir is a nucleic acid analogue derived from guanosine. It works by blocking the production of the viral [[DNA]].<ref name="AHFS2015">{{Cite web | title = Acyclovir |url =http://www.drugs.com/monograph/acyclovir.html| publisher = The American Society of Health-System Pharmacists|access-date=Jan 1, 2015}}</ref> Use of aciclovir has largely been replaced with use of the newer version, [[valaciclovir]]. ==Mechanism of action== Aciclovir inhibits replication of the herpesvirus by targeting the viral DNA polymerase, a viral enzyme which makes copies of the viral genome. | The viral DNA polymerase mistakenly incorporates aciclovir into the viral genome instead of guanosine, which effectively terminates the copying of the genome.<ref>{{Cite journal | last = Elion | first = G.B. | date = 1982-07-20 | title = Mechanism of action and selectivity of acyclovir |url =https://www.ncbi.nlm.nih.gov/pubmed/6285736 | journal = The American Journal of Medicine | volume = 73 | issue = 1A | pages = 7β13|issn=0002-9343|pmid=6285736}}</ref> == Clinical Use == Aciclovir is prescribed for active infections of [[herpes simplex virus]] (cold sores, genital sores) as well as for active infections of [[varicella zoster virus]] (chickenpox, shingles). It is also used to prevent reactivation of these viruses while the viruses are in the latent, inactive state. Even when the virus appears to be in the latent, inactive state, aciclovir can reduce the proinflammatory cytokines produced by infected cells.<ref name="Halford1997">{{Cite journal | last = Halford | first = W.P. | last2 = Gebhardt | first2 = B.M. | last3 = Carr | first3 = D.J. | date = 1997-11-10 | title = Acyclovir blocks cytokine gene expression in trigeminal ganglia latently infected with herpes simplex virus type 1 | url = https://www.ncbi.nlm.nih.gov/pubmed/9375008 | journal = Virology | volume = 238 | issue = 1 | pages = 53β63|doi=10.1006/viro.1997.8806|issn=0042-6822|pmid=9375008}}</ref> ==Aciclovir as a treatment for ME/CFS== In 1988, [[Stephen Straus|Straus]] et al. conducted a double-blind, placebo-controlled study of the efficacy of aciclovir in patients with [[chronic fatigue syndrome|CFS]]. One group was given a course of IV aciclovir followed by oral aciclovir. The other group received a placebo. Patients with and without antibodies to [[Epstein-Barr virus]] early antigens were included in the study. The researchers concluded that aciclovir, as used in this study, did not ameliorate the symptoms of [[chronic fatigue syndrome]]: "Of the 24 patients who completed the trial, similar numbers improved with acyclovir therapy and with placebo (11 and 10, respectively). Neither acyclovir treatment nor clinical improvement correlated with alterations in laboratory findings, including titers of antibody to Epstein-Barr virus."<ref name="Straus1988">{{Cite journal | last = Straus | first = Stephen E. | author-link = Stephen Straus | last2 = Dale | first2 = Janet K. | author-link2 = | last3 = Tobi | first3 = Martin | author-link3 = | last4 = Lawley | first4 = Thomas | author-link4 = | last5 = Preble | first5 = Olivia | author-link5 = | last6 = Blaese | first6 = R. Michael | last7 = Hallahan | first7 = Claire | last8 = Henle | first8 = Werner | date = 1988-12-29 | title = Acyclovir Treatment of the Chronic Fatigue Syndrome | url =https://doi.org/10.1056/NEJM198812293192602 | journal = New England Journal of Medicine | volume = 319 | issue = 26 | pages = 1692β1698|doi=10.1056/NEJM198812293192602|issn=0028-4793|pmid=2849717|quote=|via=}}</ref> ==Clinicians== ==Risks and safety== ==Costs and availability== ==See also == ==Learn more== *[https://en.wikipedia.org/wiki/Aciclovir Wikipedia - Aciclovir] ==References== {{Reflist}} [[Category:Potential treatments]] [[Category:Antivirals]]
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