Acyclovir: The Best Antiviral Drug?

INTERN/MENTOR PERIOD 6
JENNIFER HAN

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Many diseases and viruses affect humans in their daily lives. We have a host prey
relationship where viruses grow in our body by taking over our immune system and energy.
Viruses spread through air or by human contact. One of the commonly infectious virus types are
Sexually Transmitted Diseases (STDs). A recent statistics from the Centers for Disease Control
and Prevention show that there are 19.7 million new STDs every year in US alone. Herpes
simplex type 2 is the second most widely-spread sexually transmitted infection, an estimated
number of 24 million in 2008. As it is shown through data, many STD patients suffer from
herpes, and researchers are trying to find better cures and methods in treating the disease. There
are various types of drugs to use for treating herpes, such as pencyclovir and famciclovir. They
are all widely used and known to work in slowing down the growth of the virus. However, a
specific disease was found and put out on a market. Acyclovir is a specific antiherpetic drug
which acts by competing with viral thymidine kinase and also inhibits DNA polymerase and is
primarily used for the treatment of herpes simplex virus infections (Mindle 1171). Many
scientists and pharmaceutical researchers are trying to use ACV more frequently than other
drugs. Many researches have been done with the drug, and the results show that ACV is possibly
the best drug for treating herpes virus. It is evident that Acyclovir is the best antiviral drug
considering the effectiveness, less side-effects, and the cost-efficiency of the drug.
Herpes simplex virus (HSV) has variety of forms. From those, HSV type 2 is a major and
increasing cause of morbidity in many countries. The infection might hospitalize patients, and
the virus never truly goes away. Also, the virus can lead to much more serious diseases such as
carcinoma and other cancer-causing viruses. Even though there are many drugs out on the
market for HSV patients, the researchers wanted to know which drug was the best for treating
the virus. Finding the result would benefit scientists in focusing the experiments with best-

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working drugs, and most researchers will use the same drug for the similar results in order to
compare. Among many other drugs, the researchers wanted to experiment Acyclovir and its
effect. The researchers have done some experiments trying to determine if Acyclovir is right for
HSV patients. When they conducted experiment, the researchers informed patients of the
experiment. Patients with a severe attack of HSV-2 were treated with acyclovir in a randomized,
double-blind, placebo-controlled trial. The drug tests were repeated on the 4th and 7th days of
the hospital stay. Patients conditions were recorded daily for 7 days, and then twice a week until
they were healed (Mindel 698). Half of the patients received placebo and the other the actual
drug, and the result showed faster rate of healing time for the Acyclovir. The healing time,
duration of vesicles, new lesion formation, viral shedding, and all symptoms were significantly
shorter in patients treated with acyclovir than in the controls. Intravenous acyclovir seems to be a
safe and effective therapy for patients having their first attack of genital herpes (Mindel 697).
Others might argue how this experiment shows Acyclovir is better than other drugs. Mindel's
previous research was on how Acyclovir is more effective than inosine pranobex, another
antiviral drug. With the same method and same procedure, Mindel successfully proved the
effectiveness of the drug. The procedure helps to support the validity of the research because
Mindel and contributors highlighted all the exceptions and details that directs the readers to an
answer with little or no assumptions. There was another research conducted to see which drug is
effective in releasing virus and keeping the prevalence of the infection by using possible antiviral
drugs and the management of the condition. The researchers focus on two types of drugs,
Acyclovir and Tenofovir. The researchers focused on inducing drugs onto different cells,
recorded their reactivity and endurance to the drug, and observed cell's latency and reactivation
period. They concluded that both acyclovir and tenofovir work to slow down the virus growth,

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however acyclovir is a little more effective in eliminating the virus with not much recurrences
and tolerance caused in the cells. The main focus of this article is actually to test the tolerance
and whether or not the patients might need new drugs in the future. Through this experiment,
people can be aware of the possible immunity the cells might gain from the frequent use of
certain drugs. The researchers also succeeded in showing others how effective acyclovir is in
creating reduced tolerance level and less recurrences, which would help to lower the drug usage
and the tolerance level as well.
Most antiviral drugs have side-effects that follows. Some of the symptoms they express
can be more lethal than the actual virus itself. However, Acyclovir shows less number of sideeffects than other drugs. Acyclovir does have some side-effects, but they are mostly minor or not
as significant as how much the drug helps the body. To test, Mindel and fellow researchers set up
another experiments comparing Acyclovir and inosine pranobex. 77 patients with a first attack of
genital herpes were entered into a double-blind trial to compare the efficacy of acyclovir with
that of inosine pranobex. 24 patients received acyclovir, 25 inosine pranobex, and 28 both drugs
(Mindel 1171). First-attack genital herpes is a severe illness lasting two to three weeks,
characterized by genital pain and dysuria and often accompanied by systemic symptoms
including malaise, fever, and headaches. Inosine pranobex is an immunomodulator whose action
depends upon stimulation of the bodys own immune mechanism (Mindel 1171). One group
received active acyclovir and "dummy" inosine pranobex, one received active inosine pranobex
and dummy acyclovir, and the third group received both active acyclovir and active inosine
pranobex. The data showed that patients treated with acyclovir or both drugs healed more
quickly and had a shorter duration of viral shedding than those treated with inosine pranobex
(Mindel 1172). The usual symptoms were also shorter with acyclovir than with inosine

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pranobex. The time of subsequent recurrences were similar but acyclovir took longer for the
virus to recur. This experiment proved that Acyclovir is the treatment of choice for patients with
a first attack of genital herpes. The rate of which the virus decreased was significantly faster with
Acyclovir than with inosine pranobex, which shows how much Acyclovir is effective in treating
first-attack genital herpes. Even though this does not mean we can completely eliminate the
virus, it can help slow down the recurrence of the virus and heal the wounds faster. The doctors
obtained the data through a long-term experiment with different types of patients. The median
time to healing in the acyclovir group and the group receiving acyclovir and inosine pranobex
was shorter than in the inosine-pranobex group (Mindel 1172). Women showed that the duration
of dysuria and all symptoms was shorter in those treated with acyclovir than in those treated with
inosine pranobex. This experiment by Mindel and his researchers shows that Acyclovir is the
best antiviral drug used for patients. It shows significantly slower rate of virus recurrences, it
eliminated more than half of the HSV virus living in a body, and there are not too severe
symptoms or the side-effects have short duration time compared to other drugs.
Acyclovir is a commonly-used drug, used widely across the HSV patients and
researchers. Since most researchers want to be efficient in doing the experiments and deciding
equipment to use during the experiment, the cost is important. Also, for the virus patients, the
cost of the drug impacts whether or not they use it. If the cost is too high, the patients might
having hard times trying to afford, and it would not considered to be available to everyone for
use. Even if Acyclovir was tested and researched to be shown as the most effective antiviral drug
for HSV, if the cost is not affordable by most patients, it is no use. One researcher and his fellow
workers tried to find a beneficial way for patients to save money. They estimated the risk of HSV
recurrence in acyclovir-treated and -untreated patients, and the estimates of costs were derived

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from average hospital and outpatient clinic charges at our institution (Scott 57). Calculations
were run separately for four different groups of patients with different cases and severity of
HSV. After the experiment, it turns out that acyclovir treatment on patients with a history of
genital herpes resulted in an estimated savings of $183.00 per patient or $36,600,000 per year.
Women with their first episode of herpes diagnosed during pregnancy or with frequent
recurrences benefitted even more, achieving a savings of $455.00 and $391.00 per patient,
respectively (Scott 57). On a national level, this translates to $36,600,000 per year just in
reduced costs.
Herpes simplex virus is a member of the alphaherpesvirus subgroup of the Herpesviridae,
which is a family of a large, double-stranded DNA viruses widely distributed among animals and
man (Hodge 3). Many people do not realize that this virus is very common throughout people,
and most people have the genes and the actual virus for HSV. Most of the potential virus for
HSV stay in their latency period. During the periods of latency, no infectious virus is detected in
the host, and it causes problem for the patients and doctors trying to cure the virus (Hodge 3).
Once the virus starts its work, it will occur around skin, lips, and genital area, and if the virus
reoccurs frequently in the same area it appeared last, one can assume it is HSV. Since this virus
is so common in the United States and in general, that most doctors and researchers have done
their study and found ways to cure or slow down the process. Even though the name and the
symptoms might scare some people, it is curable and there are tested drugs out on the market to
help eliminating virus. HSV is not completely avoidable; once infected, a person cannot
completely cure. However, with Acyclovir or any other drugs that work the best for individual,
people should not worry. Researchers are still looking for better cures and ways to treat the
patients, and they will find better cures in the future, hoping to cure most of the HSV patients.

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Reference Sources for Synthesis Paper
Hodge, R. Anthony Vere, and Hugh J. Field. "Antiviral Agents for Herpes Simplex Virus."
Advances in Pharmacology 67 (2013): 1-38. Print.
Mindel, Adrian. et al. "Intravenous Acyclovir for the Treatment of Primary Genital Herpes."
Lancet (1982): 697-700. Print.
Mindel, A. et al. "Treatment of First-Attack Genital HerpesAcyclovir versus Inosine
Pranobex." Lancet (1987): 1171-73. Print.
Moss, John A., et al. "Simultaneous Delivery of Tenofovir and Acyclovir via an Intravaginal
Ring." Antimicrobial Agents and Chemotherapy 59.11 (2015): 875-82. Print.
Scott, L., and Alexander J. "Cost-effectiveness of acyclovir suppression to prevent recurrent
genital herpes in term pregnancy." American Journal of Perinatology (1998): 57-62.
Print.