Epstein-Barr Virus Replication in Oral Hairy Leukoplakia: Response, Persistence, and Resistance to Treatment with Valacyclovir
Nineteen cases of human immunodeficiency virus (HIV)–associated oral hairy leukoplakia (HLP) and Epstein-Barr virus (EBV) replication were treated with high-dose oral valacyclovir to inhibit productive EBV replication. The clinical, histopathological, and molecular viral responses to treatment were...
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| Veröffentlicht in: | The Journal of infectious diseases 2003-09, Vol.188 (6), p.883-890 |
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| creator | Walling, Dennis M. Flaitz, Catherine M. Nichols, C. Mark |
| description | Nineteen cases of human immunodeficiency virus (HIV)–associated oral hairy leukoplakia (HLP) and Epstein-Barr virus (EBV) replication were treated with high-dose oral valacyclovir to inhibit productive EBV replication. The clinical, histopathological, and molecular viral responses to treatment were assessed in surgical biopsy specimens obtained before, during, and after treatment. In the majority of treated cases, HLP was resolved, and EBV replication was terminated. In many cases, the initial response to inhibition of replication was a persistent, nonproductive, EBV infection of the oral mucosa, characterized by limited expression of replicative EBV genes, especially BZLF1. In some cases, productive EBV replication recurred after discontinuation of treatment with valacyclovir. In a few treated cases, treatment failed, and productive EBV replication persisted, possibly because of the evolution of acyclovir-resistant EBV. In summary, safe treatment of HLP and of EBV replication, with valacyclovir, provides new insight into the mechanisms of EBV persistence in oral mucosa |
| doi_str_mv | 10.1086/378072 |
| format | Article |
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In a few treated cases, treatment failed, and productive EBV replication persisted, possibly because of the evolution of acyclovir-resistant EBV. 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Mark</creatorcontrib><title>Epstein-Barr Virus Replication in Oral Hairy Leukoplakia: Response, Persistence, and Resistance to Treatment with Valacyclovir</title><title>The Journal of infectious diseases</title><addtitle>The Journal of Infectious Diseases</addtitle><addtitle>The Journal of Infectious Diseases</addtitle><description>Nineteen cases of human immunodeficiency virus (HIV)–associated oral hairy leukoplakia (HLP) and Epstein-Barr virus (EBV) replication were treated with high-dose oral valacyclovir to inhibit productive EBV replication. The clinical, histopathological, and molecular viral responses to treatment were assessed in surgical biopsy specimens obtained before, during, and after treatment. In the majority of treated cases, HLP was resolved, and EBV replication was terminated. In many cases, the initial response to inhibition of replication was a persistent, nonproductive, EBV infection of the oral mucosa, characterized by limited expression of replicative EBV genes, especially BZLF1. In some cases, productive EBV replication recurred after discontinuation of treatment with valacyclovir. In a few treated cases, treatment failed, and productive EBV replication persisted, possibly because of the evolution of acyclovir-resistant EBV. 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Mark</creator><general>The University of Chicago Press</general><general>University of Chicago Press</general><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20030915</creationdate><title>Epstein-Barr Virus Replication in Oral Hairy Leukoplakia: Response, Persistence, and Resistance to Treatment with Valacyclovir</title><author>Walling, Dennis M. ; Flaitz, Catherine M. ; Nichols, C. Mark</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c481t-25eeb39d21d54582aa90d3ab5dba0ac2cc9d88dd97bb1b2ce8c0e45e289714673</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Acyclovir - administration & dosage</topic><topic>Acyclovir - analogs & derivatives</topic><topic>Acyclovir - therapeutic use</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Antiviral Agents - administration & dosage</topic><topic>Antiviral Agents - therapeutic use</topic><topic>Antivirals</topic><topic>Biological and medical sciences</topic><topic>Biopsies</topic><topic>Drug Resistance, Viral</topic><topic>Epstein Barr virus infections</topic><topic>Epstein-Barr virus</topic><topic>Genes</topic><topic>Genotypes</topic><topic>Hairy leukoplakia</topic><topic>Herpesvirus 4, Human - drug effects</topic><topic>Herpesvirus 4, Human - genetics</topic><topic>Herpesvirus 4, Human - physiology</topic><topic>HIV Infections - complications</topic><topic>Human herpesvirus 4</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Lesions</topic><topic>Leukoplakia, Hairy - drug therapy</topic><topic>Leukoplakia, Hairy - virology</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mouth</topic><topic>Mouth Mucosa - virology</topic><topic>Specimens</topic><topic>Treatment Outcome</topic><topic>Valine - administration & dosage</topic><topic>Valine - analogs & derivatives</topic><topic>Valine - therapeutic use</topic><topic>Viral diseases</topic><topic>Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye</topic><topic>Viral Proteins - genetics</topic><topic>Viral Proteins - metabolism</topic><topic>Virus Replication - drug effects</topic><topic>Viruses</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Walling, Dennis M.</creatorcontrib><creatorcontrib>Flaitz, Catherine M.</creatorcontrib><creatorcontrib>Nichols, C. Mark</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Walling, Dennis M.</au><au>Flaitz, Catherine M.</au><au>Nichols, C. Mark</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epstein-Barr Virus Replication in Oral Hairy Leukoplakia: Response, Persistence, and Resistance to Treatment with Valacyclovir</atitle><jtitle>The Journal of infectious diseases</jtitle><stitle>The Journal of Infectious Diseases</stitle><addtitle>The Journal of Infectious Diseases</addtitle><date>2003-09-15</date><risdate>2003</risdate><volume>188</volume><issue>6</issue><spage>883</spage><epage>890</epage><pages>883-890</pages><issn>0022-1899</issn><eissn>1537-6613</eissn><coden>JIDIAQ</coden><abstract>Nineteen cases of human immunodeficiency virus (HIV)–associated oral hairy leukoplakia (HLP) and Epstein-Barr virus (EBV) replication were treated with high-dose oral valacyclovir to inhibit productive EBV replication. The clinical, histopathological, and molecular viral responses to treatment were assessed in surgical biopsy specimens obtained before, during, and after treatment. In the majority of treated cases, HLP was resolved, and EBV replication was terminated. In many cases, the initial response to inhibition of replication was a persistent, nonproductive, EBV infection of the oral mucosa, characterized by limited expression of replicative EBV genes, especially BZLF1. In some cases, productive EBV replication recurred after discontinuation of treatment with valacyclovir. In a few treated cases, treatment failed, and productive EBV replication persisted, possibly because of the evolution of acyclovir-resistant EBV. In summary, safe treatment of HLP and of EBV replication, with valacyclovir, provides new insight into the mechanisms of EBV persistence in oral mucosa</abstract><cop>Chicago, IL</cop><pub>The University of Chicago Press</pub><pmid>12964120</pmid><doi>10.1086/378072</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The Journal of infectious diseases, 2003-09, Vol.188 (6), p.883-890 |
| issn | 0022-1899 1537-6613 |
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| source | MEDLINE; JSTOR Archive Collection A-Z Listing; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Acyclovir - administration & dosage Acyclovir - analogs & derivatives Acyclovir - therapeutic use Adolescent Adult Aged Antiviral Agents - administration & dosage Antiviral Agents - therapeutic use Antivirals Biological and medical sciences Biopsies Drug Resistance, Viral Epstein Barr virus infections Epstein-Barr virus Genes Genotypes Hairy leukoplakia Herpesvirus 4, Human - drug effects Herpesvirus 4, Human - genetics Herpesvirus 4, Human - physiology HIV Infections - complications Human herpesvirus 4 Human viral diseases Humans Infectious diseases Lesions Leukoplakia, Hairy - drug therapy Leukoplakia, Hairy - virology Medical sciences Middle Aged Mouth Mouth Mucosa - virology Specimens Treatment Outcome Valine - administration & dosage Valine - analogs & derivatives Valine - therapeutic use Viral diseases Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye Viral Proteins - genetics Viral Proteins - metabolism Virus Replication - drug effects Viruses |
| title | Epstein-Barr Virus Replication in Oral Hairy Leukoplakia: Response, Persistence, and Resistance to Treatment with Valacyclovir |
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