Skip to main content
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1985 Apr;27(4):600–604. doi: 10.1128/aac.27.4.600

Inhibition of human cytomegalovirus by combined acyclovir and vidarabine.

S A Spector, E Kelley
PMCID: PMC180103  PMID: 2988432

Abstract

The inhibition of human cytomegalovirus (HCMV) isolates by acyclovir (ACV) and vidarabine (ara-A) was assessed by using an infectious-center plaque-reduction assay. When fixed concentrations of 4.5 micrograms of ACV and 250 ng of ara-A per ml were compared singly and in combination, the viral inhibition resulting from the ACV-ara-A combination was synergistic for three of four HCMV clinical isolates studied and additive for one HCMV isolate. An additional four HCMV strains obtained at postmortem examination from the lungs of bone marrow transplant patients were assessed for sensitivity to ACV-ara-A by using the dose required for 50% viral inhibition (ID50) as the endpoint. The mean ID50 of ACV for the four HCMV isolates was 12.3 micrograms/ml, whereas the mean ID50 of ara-A was 3.4 micrograms/ml. When 1 microgram of ara-A per ml (which yielded a mean plaque reduction of 23.6%) was combined with ACV, a mean of 5.2 micrograms of ACV per ml was required for 50% viral inhibition. The sum of the fractional inhibitory concentrations for each of the four HCMV isolates was less than 1, indicating synergy by the ACV-ara-A combination. Although DNA synthesis in growing human embryonic lung fibroblast (HEL) cells, as determined by [3H]thymidine incorporation, was diminished to 61% of that in untreated control cells when 22.5 micrograms of ACV and 1 microgram of ara-A per ml were used, there was no additive inhibition of DNA synthesis when the two-drug combination was used. HEL cell growth remained at 97% of control cell growth at 72 h when concentrations as high as 45 micrograms of ACV combined with 1 microgram of ara-A per ml were used.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arvin A. M., Kushner J. H., Feldman S., Baehner R. L., Hammond D., Merigan T. C. Human leukocyte interferon for the treatment of varicella in children with cancer. N Engl J Med. 1982 Apr 1;306(13):761–765. doi: 10.1056/NEJM198204013061301. [DOI] [PubMed] [Google Scholar]
  2. Berenbaum M. C. A method for testing for synergy with any number of agents. J Infect Dis. 1978 Feb;137(2):122–130. doi: 10.1093/infdis/137.2.122. [DOI] [PubMed] [Google Scholar]
  3. Betts R. F. Cytomegalovirus infection in transplant patients. Prog Med Virol. 1982;28:44–64. [PubMed] [Google Scholar]
  4. Bryson Y. J., Dillon M., Lovett M., Acuna G., Taylor S., Cherry J. D., Johnson B. L., Wiesmeier E., Growdon W., Creagh-Kirk T. Treatment of first episodes of genital herpes simplex virus infection with oral acyclovir. A randomized double-blind controlled trial in normal subjects. N Engl J Med. 1983 Apr 21;308(16):916–921. doi: 10.1056/NEJM198304213081602. [DOI] [PubMed] [Google Scholar]
  5. Bryson Y. J., Sweetman L., Connor J. D. Simple sensitive microbioassay for adenine arabinoside and hypoxanthine arabinoside in human plasma. Antimicrob Agents Chemother. 1978 Dec;14(6):909–915. doi: 10.1128/aac.14.6.909. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Crumpacker C. S., Schnipper L. E., Zaia J. A., Levin M. J. Growth inhibition by acycloguanosine of herpesviruses isolated from human infections. Antimicrob Agents Chemother. 1979 May;15(5):642–645. doi: 10.1128/aac.15.5.642. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hirsch M. S., Schooley R. T. Drug therapy. Treatment of herpesvirus infections. N Engl J Med. 1983 Oct 20;309(16):963–970. doi: 10.1056/NEJM198310203091607. [DOI] [PubMed] [Google Scholar]
  8. Levin M. J., Leary P. L. Inhibition of human herpesviruses by combination of acyclovir and human leukocyte interferon. Infect Immun. 1981 Jun;32(3):995–999. doi: 10.1128/iai.32.3.995-999.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. MacDonald H., Tobin JO'H Congenital cytomegalovirus infection: a collaborative study on epidemiological, clinical and laboratory findings. Dev Med Child Neurol. 1978 Aug;20(4):471–482. doi: 10.1111/j.1469-8749.1978.tb15248.x. [DOI] [PubMed] [Google Scholar]
  10. Meyers J. D., McGuffin R. W., Bryson Y. J., Cantell K., Thomas E. D. Treatment of cytomegalovirus pneumonia after marrow transplant with combined vidarabine and human leukocyte interferon. J Infect Dis. 1982 Jul;146(1):80–84. doi: 10.1093/infdis/146.1.80. [DOI] [PubMed] [Google Scholar]
  11. Moellering R. C., Jr Antimicrobial synergism--an elusive concept. J Infect Dis. 1979 Oct;140(4):639–641. doi: 10.1093/infdis/140.4.639. [DOI] [PubMed] [Google Scholar]
  12. Myers J. D., Spencer H. C., Jr, Watts J. C., Gregg M. B., Stewart J. A., Troupin R. H., Thomas E. D. Cytomegalovirus pneumonia after human marrow transplantation. Ann Intern Med. 1975 Feb;82(2):181–188. doi: 10.7326/0003-4819-82-2-181. [DOI] [PubMed] [Google Scholar]
  13. Norden C. W., Wentzel H., Keleti E. Comparison of techniques for measurement of in vitro antibiotic synergism. J Infect Dis. 1979 Oct;140(4):629–633. doi: 10.1093/infdis/140.4.629. [DOI] [PubMed] [Google Scholar]
  14. Park N. H., Callahan J. G., Pavan-Langston D. Effect of combined acyclovir and vidarabine on infection with herpes simplex virus in vitro and in vivo. J Infect Dis. 1984 May;149(5):757–762. doi: 10.1093/infdis/149.5.757. [DOI] [PubMed] [Google Scholar]
  15. Quinnan G. V., Jr, Kirmani N., Rook A. H., Manischewitz J. F., Jackson L., Moreschi G., Santos G. W., Saral R., Burns W. H. Cytotoxic t cells in cytomegalovirus infection: HLA-restricted T-lymphocyte and non-T-lymphocyte cytotoxic responses correlate with recovery from cytomegalovirus infection in bone-marrow-transplant recipients. N Engl J Med. 1982 Jul 1;307(1):7–13. doi: 10.1056/NEJM198207013070102. [DOI] [PubMed] [Google Scholar]
  16. Reynolds D. W., Stagno S., Stubbs K. G., Dahle A. J., Livingston M. M., Saxon S. S., Alford C. A. Inapparent congenital cytomegalovirus infection with elevated cord IgM levels. Casual relation with auditory and mental deficiency. N Engl J Med. 1974 Feb 7;290(6):291–296. doi: 10.1056/NEJM197402072900601. [DOI] [PubMed] [Google Scholar]
  17. Rogers M. F., Morens D. M., Stewart J. A., Kaminski R. M., Spira T. J., Feorino P. M., Larsen S. A., Francis D. P., Wilson M., Kaufman L. National case-control study of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men: Part 2. Laboratory results. Ann Intern Med. 1983 Aug;99(2):151–158. doi: 10.7326/0003-4819-99-2-151. [DOI] [PubMed] [Google Scholar]
  18. Rubin R. H., Russell P. S., Levin M., Cohen C. From the National Institutes of Health. Summary of a workshop on cytomegalovirus infections during organ transplantation. J Infect Dis. 1979 Jun;139(6):728–734. doi: 10.1093/infdis/139.6.728. [DOI] [PubMed] [Google Scholar]
  19. Smith C. A., Wigdahl B., Rapp F. Synergistic antiviral activity of acyclovir and interferon on human cytomegalovirus. Antimicrob Agents Chemother. 1983 Sep;24(3):325–332. doi: 10.1128/aac.24.3.325. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Spector S. A., Rua J. A., Spector D. H., McMillan R. Detection of human cytomegalovirus in clinical specimens by DNA-DNA hybridization. J Infect Dis. 1984 Jul;150(1):121–126. doi: 10.1093/infdis/150.1.121. [DOI] [PubMed] [Google Scholar]
  21. Spector S. A., Schmidt K., Ticknor W., Grossman M. Cytomegaloviruria in older infants in intensive care nurseries. J Pediatr. 1979 Sep;95(3):444–446. doi: 10.1016/s0022-3476(79)80532-6. [DOI] [PubMed] [Google Scholar]
  22. Spector S. A., Tyndall M., Kelley E. Effects of acyclovir combined with other antiviral agents on human cytomegalovirus. Am J Med. 1982 Jul 20;73(1A):36–39. doi: 10.1016/0002-9343(82)90060-2. [DOI] [PubMed] [Google Scholar]
  23. Spector S. A., Tyndall M., Kelley E. Inhibition of human cytomegalovirus by trifluorothymidine. Antimicrob Agents Chemother. 1983 Jan;23(1):113–118. doi: 10.1128/aac.23.1.113. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Valeriote F., Lin H. s. Synergistic interaction of anticancer agents: a cellular perspective. Cancer Chemother Rep. 1975 Sep-Oct;59(5):895–900. [PubMed] [Google Scholar]
  25. Wade J. C., McGuffin R. W., Springmeyer S. C., Newton B., Singer J. W., Meyers J. D. Treatment of cytomegaloviral pneumonia with high-dose acyclovir and human leukocyte interferon. J Infect Dis. 1983 Sep;148(3):557–562. doi: 10.1093/infdis/148.3.557. [DOI] [PubMed] [Google Scholar]
  26. Wade J. C., Newton B., McLaren C., Flournoy N., Keeney R. E., Meyers J. D. Intravenous acyclovir to treat mucocutaneous herpes simplex virus infection after marrow transplantation: a double-blind trial. Ann Intern Med. 1982 Mar;96(3):265–269. doi: 10.7326/0003-4819-96-3-265. [DOI] [PubMed] [Google Scholar]
  27. Whitley R. J., Soong S. J., Hirsch M. S., Karchmer A. W., Dolin R., Galasso G., Dunnick J. K., Alford C. A. Herpes simplex encephalitis: vidarabine therapy and diagnostic problems. N Engl J Med. 1981 Feb 5;304(6):313–318. doi: 10.1056/NEJM198102053040602. [DOI] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES