Journal Article

Value of Long-Term Administration of Acyclovir and Similar Agents for Protecting Against AIDS-Related Lymphoma: Case-Control and Historical Cohort Studies

Ignatius W. Fong, Jonathan Ho, Carvin Toy, Benjamin Lo and Michael W. Fong

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 30, issue 5, pages 757-761
Published in print May 2000 | ISSN: 1058-4838
Published online May 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/313761
Value of Long-Term Administration of Acyclovir and Similar Agents for Protecting Against AIDS-Related Lymphoma: Case-Control and Historical Cohort Studies

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Acyclovir or similar agents with activity against Epstein-Barr virus (EBV) theoretically may prevent non-Hodgkin's lymphoma (NHL) in AIDS. A case-control study of 29 patients with AIDS-related NHL and 58 matched control subjects assessed the frequency with which daily acyclovir (≥800 mg/d) or similar agents were used for ≥1 year. In a historical cohort of 304 patients with AIDS for ≥2 years, the prevalence of NHL was assessed among 3 groups of patients: those who received long-term treatment with high-dose acyclovir (or similar agents) or low-dose or intermittent acyclovir; those treated with ganciclovir/foscarnet for <1 year; and those who had not previously been treated with acyclovir, ganciclovir, or foscarnet. In the case-control study, 22 patients (72.4%) with NHL never received acyclovir or similar drugs versus 19 control subjects (32.8%; P = .002); 2 patients (6.9%) with NHL received acyclovir (≥800 mg/d) for ≥1 year versus 27 (46.6%) of control subjects (P = .0001). In the cohort study, 6 (6.8%) of 88 patients who received acyclovir (≥800 mg/d) for ≥1 year developed NHL versus 15 (15.5%) of 97 patients who received intermittent or lower-dose acyclovir and 30 (25.2%) of 119 patients who never received these agents (P = .002). Long-term administration (>1 year) of high-dose acyclovir or similar agents with anti-EBV activity may prevent NHL in patients with AIDS. A prospective, randomized study is warranted to confirm these results.

Journal Article.  2527 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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