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Cidofovir is a powerful, broad-spectrum anti-viral, nucleoside analogue. It has activity against cytomegalovirus (CMV) and other members of the herpes-virus family. After uptake into cells, cidofovir selectively inhibits viral-DNA polymerases relative to host-cell polymerases. It has a long intracellular half-life, allowing for less frequent dosing.
Intravenous cidofovir is licensed in human medicine
for the treatment of CMV infection in AIDS patients. The intravenous product
has been compounded for use topically in unresponsive mucocutaneous herpes-simplex
infections in humans. There is also a clinical case report of ophthalmic
use in a woman with conjunctival squamous-cell carcinoma.
Ophthalmic cidofovir is used in veterinary medicine for the treatment of conjunctivitis and keratitis associated with FHV-1. FHV-1 is a common infectious disease in cats caused by a cytopathic DNA virus. Other drugs that have been used to treat the oculars signs associated FHV-1 are vidarabine, trifluridine and idoxuridine. Many of these drugs require frequent administration, and some of the more effective drugs have the undesirable side effects of irritation and ocular discomfort.
Cidofovir has a long intracellular half-life and has been found to be effective with twice-daily administration and a relatively short duration of treatment. In experimentally infected animals, cidofovir decreased the severity of clinical signs and viral shedding and was well tolerated.
The most complete information on the use of ophthalmic
cidofovir for the treatment of FHV-1 is in a study by Fontenelle J.P.
et al. AJVR, Vol. 69, No.2, Feb 2008: 289-293
• Side effects vary with the species and the concentration
of the ophthalmic solution. In the study performed by Fontenelle, no irritation
or adverse effects were seen with a 0.5 percent solution. Stronger concentration
solutions caused irritation in other species. Other possible side effects
include ocular hypotonia, superficial punctuate keratitis and obstruction
of the nasolacrimal duct.
• Bacterial causes such as Mycoplasma felis
and Chlamydophilia felis should be ruled out in cases of acute
conjunctivitis.
• The anti-viral activity of cidofovir may be decreased by topical
ophthalmic corticosteroids.
• Conjunctivitis and erythematous eyelids were seen in a human study using 1 percent solution.
Dr.
Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania.
She has a master's degree in animal science from the University of Delaware
and graduated from the University of Pennsylvania School of Veterinary Medicine
in 1982.
She began to develop her interest in client education and medical writing 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
You can purchase books by Dr. Forney at www.exclusivelyequine.com
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