Disseminated herpes zoster in the immunocompromised host: a comparative trial of acyclovir and vidarabine. The NIAID Collaborative Antiviral Study Group

J Infect Dis. 1992 Mar;165(3):450-5. doi: 10.1093/infdis/165.3.450.


Seventy-three immunocompromised patients with disseminated herpes zoster were evaluated in a double-blind controlled trial of acyclovir (n = 37) versus vidarabine (n = 36) therapy. Acyclovir was administered at 30 mg/kg/day at 8-h intervals and vidarabine was given as a continuous 12-h infusion at 10 mg/kg/day for 7 days (longer if resolution of cutaneous or visceral disease was incomplete). No demographic differences existed between treatment groups. No deaths attributable to varicella-zoster virus infection occurred within 1 month of treatment. Neither rates of cutaneous healing, resolution of acute neuritis, and frequency of postherpetic neuralgia nor adverse clinical and laboratory events differed between treatment groups. Acyclovir recipients were discharged from the hospital more promptly than vidarabine recipients (P = .04, log rank test). These data indicate that disseminated herpes zoster is amenable to therapy with either acyclovir or vidarabine; resultant mortality is low.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acyclovir / administration & dosage
  • Acyclovir / adverse effects
  • Acyclovir / therapeutic use*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Cost-Benefit Analysis
  • Double-Blind Method
  • Female
  • Hepatitis, Viral, Human / drug therapy
  • Herpes Zoster / drug therapy*
  • Humans
  • Immunocompromised Host*
  • Infusions, Intravenous
  • Male
  • Meningoencephalitis / drug therapy
  • Middle Aged
  • Neuritis / drug therapy
  • Pneumonia, Viral / drug therapy
  • Skin Diseases, Infectious / drug therapy
  • Vidarabine / administration & dosage
  • Vidarabine / adverse effects
  • Vidarabine / therapeutic use*


  • Vidarabine
  • Acyclovir