technical question/concern about how acyclovir works

There is no evidence whatsoever that acyclovir disrupts normal cellular (human) DNA. Acyclovir does not have any DNA, any nucleotide sequences. The notion that it's inserting DNA into either human or herpes virus genomes is unsupported.

In the simplest terms, acyclovir interferes with the virus's ability to synthesize new DNA. Inasmuch as that's about all a herpes virus is, a packet of unique DNA that hijacks the human cell and causes it to make more virus DNA and virions (virus particles), stopping the production of viral DNA essentially disables it. (I didn't say "kills it," as viruses are not alive. They are complex packets of enzymes and DNA or RNA that can chemically overtake the control of a human cell.)

The chemistry is this:
(http://www.druglib.com/druginfo/acyclovir/description_pharmacology/)

In vitro, acyclovir triphosphate stops replication of herpes viral DNA. This is accomplished in three ways: 1) competitive inhibition of viral DNA polymerase, 2) incorporation into and termination of the growing viral DNA chain, and 3) inactivation of the viral DNA polymerase. The greater antiviral activity of acyclovir against HSV compared to VZV is due to its more efficient phosphorylation by the viral TK.

Your DNA is safe. That of viruses is not.

--John of Ohio

 

You should also know there are several long term studies of acyclovir's safety and efficacy.

http://www.ncbi.nlm.nih.gov/pubmed/12353186
Valacyclovir for herpes simplex virus infection: long-term safety and sustained efficacy after 20 years' experience with acyclovir.

Tyring SK1, Baker D, Snowden W.



Author information



Abstract

An extensive clinical trial program combined with 5 years' postmarketing experience with valacyclovir provides evidence of favorable safety and efficacy in herpes simplex virus (HSV) management. Valacyclovir enhances acyclovir bioavailability compared with orally administered acyclovir. Long-term use of acyclovir for up to 10 years for HSV suppression is effective and well tolerated. Acyclovir is also approved for use in children, is available in some countries over the counter in cream formulation for herpes labialis, and has been monitored in over 1000 pregnancies. Safety monitoring data from clinical trials of valacyclovir, involving over 3000 immunocompetent and immunocompromised persons receiving long-term therapy for HSV suppression, were analyzed. Safety profiles of valacyclovir (</=1000 mg/day), acyclovir (800 mg/day), and placebo were similar. Extensive sensitivity monitoring of HSV isolates confirmed a very low rate of acyclovir resistance among immunocompetent subjects (<0.5%). The incidence of resistance among immunocompromised patients remains low at about 5%.

Long-term suppression of recurrent genital herpes with acyclovir. A 5-year benchmark. Acyclovir Study Group.
http://www.ncbi.nlm.nih.gov/pubmed/8481018
Goldberg LH1, Kaufman R, Kurtz TO, Conant MA, Eron LJ, Batenhorst RL, Boone GS.



Author information



Abstract

BACKGROUND AND DESIGN:

This multicenter trial (19 sites) was initiated in 1984 in more than 1100 immunocompetent individuals with a history of frequently recurring genital herpes (mean, > or = 12 episodes per year). The first year of this suppressive therapy trial was placebo controlled, with acyclovir being provided for episodic treatment in both groups. Thereafter, patients were treated with open-label acyclovir suppressive therapy on a long-term basis (400 mg twice daily) to continue to assess its long-term safety and efficacy. Complete data are available on 389 of the 430 patients who began the fifth year of the study.

RESULTS:

Patients were seen quarterly for review of diaries and clinical laboratory evaluations. The percentage of patients recurrence free for any 3-month quarter of the fifth year ranged from 86% to 90%. The mean annual number of recurrences per patient declined from 1.7 during the first year to 0.8 during the fifth year of suppressive therapy. The frequency of false prodromes has also decreased over time. More than 20% of the patients receiving suppressive therapy for 5 years have been recurrence free the entire time. The duration of herpetic outbreaks during suppressive therapy has not changed.

CONCLUSION:

This study extends the safety and efficacy profile of oral acyclovir in the suppression of genital herpes to 5 years. The majority of the patients were recurrence free on an annual basis during suppressive therapy. Therapy was well tolerated. Acyclovir usage was not associated with serious side effects or cumulative toxicity.

 

I have been told by several doctors that these antivirals are generally well tolerated and when needed can by taken for years safely by most people. If you have liver or kidney damage you want to discuss it with your doctor but for most people they are safer than most of the drugs most often prescribed to Menieres patients.

 

I think after days/weeks/months of constant ear pressure, ringing, fatigue, etc.....not to mention sudden severe vertigo attacks lasting hours - it is (to me) easier to "come to peace" with potential side effects. Especially if it is something that can address the other issues. Just my thoughts though and everyone is different.

For the record, I have been doing pretty well since I started Valtrex.

 

awesome nicmger! Fingers crossed it continues.