Antiviral chemotherapy has come of age, and, after an initial slow pro-
gress, the development of new antiviral agents has proceeded at a more
rapid pace and the perspectives for their clinical use have increased
considerably. Now, 25 years after the first antiviral assay
(idoxuridine) was introduced in the clinic, it is fitting to commemorate
the beginning of the antivirals' era. In its introductory chapter B.E.
Juel-Jensen touches on what may be con- sidered as five of the most
fundamental requirements of an antiviral drug: efficacy, relative
non-toxicity, easy solubility, ready availability and rea- sonable cost.
Surely, the antiviral drugs that have so far been used in the clinic
could still be improved upon as one or more of these five essential
demands are concerned. How is all began is narrated by W.H. Prusoff. The
first antiviral drugs to be used in humans were methisazone and
idoxuridine, the former, which is now of archival interest, in the
prevention of smallpox, the latter, which was approved for clinical use
in the United States in 1962, for the topical treatment of herpetic
keratitis. In terms of potency, also because of solubility reasons,
idoxuridine has been superseded by trifluridine in the topical treatment
of herpes simplex epithelial keratitis. H.E. Kaufman did not find
trifluridine or acyclovir ef- fective in the treatment of deep stromal
keratitis or iritis and he reckons that other antiviral drugs (i.e.
bromovinyldeoxyuridine) would not be effec- tive either.
