Effect of valacyclovir on EHV-5 viral kinetics in horses with equine multinodular pulmonary fibrosis

J Vet Intern Med. 2018 Sep;32(5):1763-1767. doi: 10.1111/jvim.15230. Epub 2018 Sep 17.

Abstract

Background: Equine herpesvirus-5 is commonly isolated from the lungs of horses with EMPF, suggesting an etiological link. Valacyclovir is used empirically to treat EMPF; however, no data is available concerning its impact on EHV-5 viral kinetics.

Objectives: To determine the effect of oral administration of valacyclovir on EHV-5 viral load measured by qPCR in blood, nasal secretions (NS) and BALF in horses with EMPF.

Animals: Six horses diagnosed with EMPF.

Methods: A prospective clinical trial was performed. Horses received 10 days of PO administered valacyclovir (loading dose 30 mg/kg, maintenance dose 20 mg/kg). Blood, NS, and BALF were collected for EHV-5 viral kinetics analyses during treatment. Blood and NS were collected every other day. BALF was collected on day 0 and day 10.

Results: There was no statistical difference in median EHV-5 viral load between day 0 and day 10 for all samples tested. In blood median EHV-5 viral load was 7676 (range 575-39 781) on day 0 and 6822 (range 1136-18 635) glycoprotein B (gB) gene copies per million cells on day 10. For NS median EHV-5 viral load was 2.944 × 106 (range 184 691-3.394 × 109 ) on day 0 and 8.803 × 106 (range 251 186-9.868 × 108 ) gB gene copies per million cells on day 10. For BALF median EHV-5 viral load was 59,842 (range 61-315 655) on day 0 and 185 083 (range 3562-542 417) gB gene copies per million cells on day 10.

Conclusions and clinical importance: Valacyclovir might not be an effective short-term antiviral treatment but efficacy in treatment of EMPF is unknown.

Keywords: anti-viral drugs; herpesvirus; interstitial pneumonia; qPCR.

Publication types

  • Clinical Trial, Veterinary

MeSH terms

  • Animals
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / therapeutic use
  • Bronchoalveolar Lavage Fluid
  • DNA, Viral
  • Dose-Response Relationship, Drug
  • Female
  • Gammaherpesvirinae*
  • Herpesviridae Infections / drug therapy
  • Herpesviridae Infections / veterinary*
  • Herpesviridae Infections / virology
  • Horse Diseases / drug therapy*
  • Horses
  • Male
  • Pulmonary Fibrosis / pathology
  • Pulmonary Fibrosis / veterinary*
  • Pulmonary Fibrosis / virology
  • Valacyclovir / administration & dosage
  • Valacyclovir / therapeutic use*
  • Virus Replication / drug effects

Substances

  • Antiviral Agents
  • DNA, Viral
  • Valacyclovir

Supplementary concepts

  • Equid gammaherpesvirus 5