Re: Acyclovir as a Prophylaxis

[Guest guest]

Stacie

We have not seen resistance develop from the use of acyclovir (or

other related antivirals) as prophylaxis. In actuality it is quite

rare to see someone develop shingles while receiving prophylaxis, but

I suspect they will respond to full dose treatment.

I use valacyclovir (Valtrex) in my patients just because it requires

only once-a-day dosing, but they all work equally well.

Rick Furman, MD

>

> Dr. Furman,

>

> Since there has been much discussion on shingles and

> antivirals, I thought I would pose a question that I

> have.

>

> I am severely compromised and have had 4 cases of

> shingles. My physician and I have decided that I

> should use Acyclovir as a prophylactic drug. I am

> taking 200mg, 3 times daily.

>

> Will this cause drug resistance as can occur with

> antibiotics? I know that I need this drug when

> shingles erupt, yet I am attempting to prevent

> outbreaks (and help to protect my new grandson from

> being exposed by me, and causing chicken pox in him).

>

> I know that I am walking a fine line here. We have

> also debated using prophylactic antibiotics and

> antifungals, but it is difficult to weigh their

> benefits as prophylactics versus the risks of drug

> resistance.

>

> I would appreciate your insights. Thank you for your

> commitment to the CLL community.

>

> Stacie

>

> PS - I have very low IGG, IGA, and IGM levels (require

> monthly IVIG). CD4 count hover at 200 or slightly

> below. And I am periodically neutropenic.

>

> In His grip,

>

> Stacie

> Current Age 45;

> CLL diagnosed at age 33 in 1997 after becoming ill in 1996 at age 32

>

> DISEASE HISTORY:

> Multiple Anaphylactic Drug Reactions-Desensitization now required

for all drugs

> Leukapheresis 1999-2001 to lower WBC levels of over 300,000

> Fludarabine + Rituxan (5 days + 1 day) May 2002;

> Fludarabine (5 days) Sept. 2003

> Fludarabine + Rituxan (4 days + 1 day) April 2004;

> RBC transfusions

> 98% marrow involvement since 1999

> Rituxan-4 Weekly Infusions - October 1- October 23, 2004

> Singulair-Vitamin D-Green Tea Extract-And Other Supplements Since

October 2004 in addition to acupuncture and Chinese Massage

> 2007 Monthly IVIG begins due to being severely immunocompromised

> (Low neutrophils, Low IgG, IgA, and IgM as well as depleted T-Cells)

> 2008 Used Artemisinin and Butyrate which lowered WBC

> Contemplating Next Treatment ...

>

> " For by Me your days will be multiplied and years added unto your

life. " - Proverbs 9:11

>

> My faith and love of God: My source of hope, life, and healing.

>

[Guest guest]

Thank you for your insights, Dr. Furman. I am relieved

to know that the risk for developing drug resistance

with ongoing Acyclovir therapy is not a real concern.

With gratitude,

Stacie

In His grip,

Stacie

Current Age 45;

CLL diagnosed at age 33 in 1997 after becoming ill in 1996 at age 32

DISEASE HISTORY:

Multiple Anaphylactic Drug Reactions-Desensitization now required for all drugs

Leukapheresis 1999-2001 to lower WBC levels of over 300,000

Fludarabine + Rituxan (5 days + 1 day) May 2002;

Fludarabine (5 days) Sept. 2003

Fludarabine + Rituxan (4 days + 1 day) April 2004;

RBC transfusions

98% marrow involvement since 1999

Rituxan-4 Weekly Infusions - October 1- October 23, 2004

Singulair-Vitamin D-Green Tea Extract-And Other Supplements Since October 2004

in addition to acupuncture and Chinese Massage

2007 Monthly IVIG begins due to being severely immunocompromised

(Low neutrophils, Low IgG, IgA, and IgM as well as depleted T-Cells)

2008 Used Artemisinin and Butyrate which lowered WBC

Contemplating Next Treatment ...

" For by Me your days will be multiplied and years added unto your life. " -

Proverbs 9:11

My faith and love of God: My source of hope, life, and healing.