Successful Management of Herpes Simplex Keratitis With Oral Valganciclovir in Patients Unresponsive or Allergic to Conventional Antiviral Therapy
| Autor: | Pedram Hamrah, Benjamin R Strauss, Neslihan Dilruba Koseoglu |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Administration Oral medicine.disease_cause Antiviral Agents Article Keratitis 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Oral administration Humans Valganciclovir Medicine Aged Retrospective Studies Aged 80 and over business.industry Retrospective cohort study Famciclovir Middle Aged medicine.disease Dermatology Ophthalmology Treatment Outcome Herpes simplex virus Chemoprophylaxis Keratitis Herpetic 030221 ophthalmology & optometry Female business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Cornea |
| ISSN: | 0277-3740 |
| Popis: | Purpose To describe 4 cases of presumably immunocompetent patients with herpes simplex virus (HSV) keratitis unresponsive (n = 3) or allergic (n = 1) to conventional antiviral therapy that improved with oral valganciclovir treatment. Methods Retrospective case series of 4 patients with HSV keratitis treated with oral valganciclovir between March 2016 and June 2018. Results We reviewed the records of 4 patients with recurrent epithelial HSV keratitis. Three patients were on antiviral prophylaxis because of a history of HSV keratitis. All patients were on oral acyclovir, valacyclovir, and/or famciclovir treatment with/without topical antiviral therapy for 4 to 6 months for prophylaxis and/or recurrent dendriform epithelial keratitis. While 3 patients had recurrent episodes during their active prophylaxis with oral antiviral therapies, one patient had a recurrence after she discontinued her oral prophylactic antiviral therapy due to recurrent self-reported allergic reactions. The patients presented with recurrent dendriform epithelial keratitis despite conventional antiviral therapy. We initiated oral valganciclovir 900 mg twice a day for 10 days as a treatment dose, followed by 900 mg daily for prophylaxis. The corneal epithelium subsequently healed within the first 2 weeks in all patients. The mean follow-up time for patients on valganciclovir prophylaxis was 8 months (range: 6-12 months), and none of the patients presented with any further recurrences. Conclusions In case of treatment-related side effects or failure with conventional antiviral therapies, oral valganciclovir may present an alternative for the treatment and prophylaxis of HSV keratitis. |
| Databáze: | OpenAIRE |
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