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A virologic pilot study of valacyclovir in infectious mononucleosis
Journal article   Peer reviewed

A virologic pilot study of valacyclovir in infectious mononucleosis

Henry H Balfour, Kristin M Hokanson, Robyn M Schacherer, Christine M Fietzer, David O Schmeling, Carol J Holman, Heather E Vezina and Richard C Brundage
Journal of clinical virology, Vol.39(1), pp.16-21
2007
DOI: 10.1016/j.jcv.2007.02.002
PMID: 17369082

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Abstract

Infectious mononucleosis decreases the productivity of many college students and Epstein–Barr virus (EBV) infection may result in long-term immune damage. Evaluate the antiviral effect of valacyclovir during EBV-related acute infectious mononucleosis and explore potential clinical benefits. University students who presented during the first 7 days of illness were randomized to receive valacyclovir 3 g/day for 14 days or not. The quantity of Epstein–Barr virus (EBV) DNA in oral and whole blood samples was determined by real-time (TaqMan) PCR. The primary outcome was the proportion of subjects with laboratory-confirmed primary EBV infection who had ≥2 log 10 decrease in EBV copies/mL in oral washes during the treatment period. Secondary outcomes included clinical effects. Twenty subjects were studied. The proportion of valacyclovir recipients versus control subjects who had ≥2 log 10 decrease in EBV copies was significantly greater for both oral wash fluid-derived cell pellet ( P = 0.03) and supernatant ( P = 0.001) samples. At the end of the treatment period, the number of reported symptoms ( P = 0.03) and the severity of illness ( P = 0.049) were reduced among valacyclovir recipients as compared with controls. Valacyclovir therapy caused a reduction of EBV excretion and possibly produced a clinical benefit in infectious mononucleosis. Because our study was small and not placebo-controlled, these results must be confirmed by a larger, placebo-controlled trial.
EBV viremia Valacyclovir Infectious mononucleosis Real-time EBV PCR Epstein–Barr virus

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