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One of these statements about nucleoside analogues is false – which is it?
- They accumulate only in infected cells, limiting tissue distribution and toxicity
- Valaciclovir is aprodrug of aciclovir
- Famcicloviris a prodrug of penciclovir
- Penciclovir triphosphate has a lower affinity for viral DNA polymerase and is less effective than aciclovir
Which one of these statements about herpes simplex infection and its treatment is false?
- HSV-1 may cause genital infection
- In children, aciclovir suspension at 15mg per kg five times daily for seven days, started within the first three days of symptom onset, shortens the duration of all clinical manifestations by about 50 per cent
- Over-the-counter aciclovir and penciclovir creams do not reduce the duration of episodes or produce faster lesion healing
- Oral aciclovir 400mg twice daily or valaciclovir 500mg once daily are useful for preventing recurrent cold sores
Which one of these statements about herpes virus infections is false?
- The seroprevalenceof HSV-2 in high-risk groups such as HIV-positive people and commercial sex workers is >65 per cent
- The dose of valaciclovirfor prophylaxis of herpes gladiatorum is 500 or 1000mg once or twice daily during the sporting season
- Topical aciclovir is indicated for the treatment of eczema herpeticum
- Patients with HSV eye infection should be referred to a specialist for treatment with topical and or systemic antivirals
Which one of these statements about varicella-zoster virus infection is false?
- Recurrent shingles or shingles occurring in younger people should raise suspicion of poor T-cell immunity
- Antiviral treatmentfor an adult with chickenpox should begin within seven days of symptom onset
- Oral treatment with 800mg aciclovir five times per day generally suffices for uncomplicated chickenpox in adults
- Zoster hyperimmune globulin is indicated for susceptible at-risk groups within 10 days of a significant varicella exposure
One of these statements about varicella-zoster virus infection is false – which is it?
- The rash of zoster is typically unilateral and lasts two to fourdays
- Rash severity is a risk factor for higher risk of prolonged pain
- The most appropriate way to minimise pain is to prevent further damage by the use of antiviral agents that stop varicella-zoster virus replication
- Valaciclovir has been shown to be superior to aciclovir in reducing the proportion of patients with pain after six months
One of these statements is false – which is it?
- Nortriptyline is as effective as amitriptyline at reducing postherpetic neuralgia but is better tolerated
- Anticonvulsants such as gabapentin and pregabalin are not as effective as the tricyclics in the treatment of postherpetic neuralgia
- Anxiety and depression are associated with a worse outcome in herpes zoster infection
- Herpes zoster vaccination can significantly reduce the incidence, morbidity and postherpetic neuralgia associated with zoster infection in adults aged over 60

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