Treatment of varicella in the immunocompetent adult.

Varicella in the immunocompetent adult is an infrequent but potentially serious infection. Previous studies in immunocompetent hosts and normal adults have demonstrated the value of intravenous acyclovir in the treatment of varicella-zoster virus infections. Oral acyclovir has also shown efficacy in both normal adults with zoster (shingles) and immunocompetent children with varicella. A recently completed double-blind placebo-controlled study of oral acyclovir in immunocompetent adults with uncomplicated varicella also demonstrated efficacy. Therapy within the first day reduced the time to 100% crusting of skin lesions from 7.4 to 5.6 days, and reduced the duration of fever by one-half day. Symptoms were also diminished. These benefits were observed only when therapy was initiated within 24 hours of the appearance of the rash. Adults with complicated varicella (usually symptomatic varicella pneumonia) should receive intravenous acyclovir. Several new agents for varicella-zoster therapy are being evaluated; brovavir is a new agent currently being compared to placebo in the treatment of adult varicella.