Antiviral agents for infectious mononucleosis (glandular fever)

<!DOCTYPE html> <html lang="en" > <head itemscope itemtype="http://schema.org/WebPage" prefix="og: http://ogp.me/ns#" > <meta charset="UTF-8"> <meta http-equiv="X-UA-Compatible" content="IE=edge">  <meta name="HandheldFriendly" content="True"> <meta name="MobileOptimized" content="320"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <link rel="preconnect" href="https://cdn.ncbi.nlm.nih.gov"> <link rel="preconnect" href="https://www.ncbi.nlm.nih.gov"> <link rel="preconnect" href="https://www.google-analytics.com"> <link rel="stylesheet" href="https://cdn.ncbi.nlm.nih.gov/pubmed/ed1a5a1f-b279-475e-88e3-75f261729818/CACHE/css/output.5ecf62baa0fa.css" type="text/css"> <link rel="stylesheet" href="https://cdn.ncbi.nlm.nih.gov/pubmed/ed1a5a1f-b279-475e-88e3-75f261729818/CACHE/css/output.452c70ce66f7.css" type="text/css"> <link rel="stylesheet" href="https://cdn.ncbi.nlm.nih.gov/pubmed/ed1a5a1f-b279-475e-88e3-75f261729818/CACHE/css/output.7bf600913d6e.css" type="text/css"> <link rel="stylesheet" href="https://cdn.ncbi.nlm.nih.gov/pubmed/ed1a5a1f-b279-475e-88e3-75f261729818/CACHE/css/output.0bfa59184c7a.css" type="text/css"> <link rel="stylesheet" href="https://cdn.ncbi.nlm.nih.gov/pubmed/ed1a5a1f-b279-475e-88e3-75f261729818/CACHE/css/output.b576742ffc3e.css" type="text/css"> <title>Antiviral agents for infectious mononucleosis (glandular fever) - PubMed</title> <link rel="preload" as="font" href="https://cdn.ncbi.nlm.nih.gov/pubmed/ed1a5a1f-b279-475e-88e3-75f261729818/uswds/dist/fonts/merriweather-bold-webfont.woff2" type="font/woff2" crossorigin />  <link rel="shortcut icon" type="image/ico" href="https://cdn.ncbi.nlm.nih.gov/coreutils/nwds/img/favicons/favicon.ico" /> <link rel="icon" type="image/png" href="https://cdn.ncbi.nlm.nih.gov/coreutils/nwds/img/favicons/favicon.png" />  <link rel="icon" type="image/png" sizes="192x192" href="https://cdn.ncbi.nlm.nih.gov/coreutils/nwds/img/favicons/favicon-192.png" />  <link rel="apple-touch-icon-precomposed" href="https://cdn.ncbi.nlm.nih.gov/coreutils/nwds/img/favicons/favicon-57.png">  <link rel="apple-touch-icon-precomposed" sizes="72x72" href="https://cdn.ncbi.nlm.nih.gov/coreutils/nwds/img/favicons/favicon-72.png">  <link rel="apple-touch-icon-precomposed" sizes="114x114" href="https://cdn.ncbi.nlm.nih.gov/coreutils/nwds/img/favicons/favicon-114.png">  <link rel="apple-touch-icon-precomposed" sizes="144x144" href="https://cdn.ncbi.nlm.nih.gov/coreutils/nwds/img/favicons/favicon-144.png">  <meta name="ncbi_sg_optimize_id" content="">  <meta name="theme-color" content="#20558a">  <meta name="referrer" content="origin-when-cross-origin"> <meta name="ncbi_pinger_gtm_track" content="true"/>  <meta name="ncbi_app" content="pubmed" /> <meta name="ncbi_db" content="pubmed" /> <meta name="ncbi_phid" content="2E48000141F01275000022E22E4A9953.1.m_6" /> <meta name="ncbi_pinger_stat_url" content="https://www.ncbi.nlm.nih.gov/stat" /> <meta name="log_category" content="literature" /> <meta name="ncbi_cost_center" content="pubmed" />  <meta name="ncbi_pdid" content="abstract" /> <meta name="log_op" content="retrieve" /> <meta name="uid" content="27933614" /> <meta name="ncbi_uid" content="27933614" /> <meta name="log_displayeduids" content="27933614" /> <meta name="log_source_db" content="pubmed,pmc" /> <meta name="log_icons_present" content="true" />  <meta name="description" content="The effectiveness of antiviral agents (acyclovir, valomaciclovir and valacyclovir) in acute IM is uncertain. The quality of the evidence is very low. The majority of included studies were at unclear or high risk of bias and so questions remain about the effectiveness of this intervention. Although t …"><meta name="keywords" content="pmid:27933614, PMC6463965, doi:10.1002/14651858.CD011487.pub2, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review, Muireann De Paor, Kirsty O'Brien, Susan M Smith, Acute Disease, Acyclovir / adverse effects, Acyclovir / analogs & derivatives*, Acyclovir / therapeutic use*, Adolescent, Adult, Antiviral Agents / adverse effects, Antiviral Agents / therapeutic use*, Child, Child, Preschool, Female, Guanine / adverse effects, Guanine / analogs & derivatives*, Guanine / therapeutic use, Humans, Infectious Mononucleosis / drug therapy*, Male, Randomized Controlled Trials as Topic, Valacyclovir, Valine / adverse effects, Valine / analogs & derivatives*, Valine / therapeutic use, Young Adult, PubMed Abstract, NIH, NLM, NCBI, National Institutes of Health, National Center for Biotechnology Information, National Library of Medicine, MEDLINE"><meta name="robots" content="index,nofollow,noarchive"><meta property="og:title" content="Antiviral agents for infectious mononucleosis (glandular fever) - PubMed"><meta property="og:url" content="https://pubmed.ncbi.nlm.nih.gov/27933614/"><meta property="og:description" content="The effectiveness of antiviral agents (acyclovir, valomaciclovir and valacyclovir) in acute IM is uncertain. The quality of the evidence is very low. The majority of included studies were at unclear or high risk of bias and so questions remain about the effectiveness of this intervention. Although t …"><meta property="og:image" content="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/pubmed-meta-image-v2.jpg"><meta property="og:image:secure_url" content="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/pubmed-meta-image-v2.jpg"><meta property="og:type" content="website"><meta property="og:site_name" content="PubMed"><meta name="twitter:domain" content="pubmed.ncbi.nlm.nih.gov"><meta name="twitter:card" content="summary_large_image"><meta name="twitter:title" content="Antiviral agents for infectious mononucleosis (glandular fever) - PubMed"><meta name="twitter:url" content="https://pubmed.ncbi.nlm.nih.gov/27933614/"><meta name="twitter:description" content="The effectiveness of antiviral agents (acyclovir, valomaciclovir and valacyclovir) in acute IM is uncertain. The quality of the evidence is very low. The majority of included studies were at unclear or high risk of bias and so questions remain about the effectiveness of this intervention. Although t …"><meta name="twitter:image" content="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/pubmed-meta-image-v2.jpg">  <link rel="search" type="application/opensearchdescription+xml" href="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/opensearch.xml" title="PubMed search">  <noscript> <link rel="stylesheet" type="text/css" href="https://cdn.ncbi.nlm.nih.gov/pubmed/ed1a5a1f-b279-475e-88e3-75f261729818/core/no-script.css"> </noscript> <meta name="citation_title" content="Antiviral agents for infectious mononucleosis (glandular fever)"> <meta name="citation_authors" content="De Paor M;O'Brien K;Fahey T;Smith SM;"> <meta name="citation_date" content="12/08/2016"> <meta name="citation_publisher" content="Cochrane Database Syst Rev"> <meta name="citation_journal_title" content="The Cochrane database of systematic reviews"> <meta name="citation_pmid" content="27933614"> <meta name="citation_abstract_html_url" content="https://pubmed.ncbi.nlm.nih.gov/27933614/"> <meta name="citation_volume" content="12"> <meta name="citation_issue" content="12"> <meta name="citation_doi" content="10.1002/14651858.CD011487.pub2"> <meta name="citation_issn" content="1469-493X"> <link rel="canonical" href="https://pubmed.ncbi.nlm.nih.gov/27933614/" /> </head> <body > <noscript> <div class="no-script-banner" id="no-script-banner"> <div class="warning-message"> <div class="warning-message-text"> This site needs JavaScript to work properly. 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new collection</label> </li> <li> <input type="radio" id="collections-action-panel-existing" class="collections-existing" name="collections" value="existing" checked="true" data-ga-category="save_share" data-ga-action="collections" data-ga-label="collections_radio_existing"> <label for="collections-action-panel-existing">Add to an existing collection</label> </li> </ul> </div> <div class="controls-wrapper"> <div class="action-panel-control-wrap new-collections-controls"> <label for="collections-action-panel-add-to-new" class="action-panel-label required-field-asterisk"> Name your collection: </label> <input type="text" name="add-to-new-collection" id="collections-action-panel-add-to-new" class="collections-action-add-to-new" pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/" maxlength="100" data-ga-category="save_share" data-ga-action="create_collection" data-ga-label="non_favorties_collection"> <div class="collections-new-name-too-long usa-input-error-message selection-validation-message"> Name must be less than 100 characters </div> </div> <div class="action-panel-control-wrap existing-collections-controls"> <label for="collections-action-panel-add-to-existing" class="action-panel-label"> Choose a collection: </label> <select id="collections-action-panel-add-to-existing" class="action-panel-selector collections-action-add-to-existing" data-ga-category="save_share" data-ga-action="select_collection" data-ga-label="($('#collections-action-add-to-existing').val() === 'Favorites') ? 'Favorites' : 'non_favorites_collection'"> </select> <div class="collections-retry-load-on-error usa-input-error-message selection-validation-message"> Unable to load your collection due to an error<br> <a href="#">Please try again</a> </div> </div> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Adding..." data-pinger-ignore data-ga-category="save_share" data-ga-action="collections" data-ga-label="add"> Add </button> <button class="action-panel-cancel" aria-label="Close 'Add to Collections' panel" ref="linksrc=close_collections_panel" aria-controls="collections-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="collections" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="bibliography-action-panel" class="bibliography-action-panel action-panel in-progress-dots-panel" aria-hidden="true" data-bibliography-open-panel-enabled="false" data-bibliography-open-panel-url-hash="#open-bibliography-panel"> <div class="inner-wrap"> <h3 class="action-panel-heading"> Add to My Bibliography </h3> <form id="bibliography-action-panel-form" class="bibliography-action-panel-form action-panel-content action-form action-panel-smaller-selectors" data-add-to-bibliography-max-amount="100" data-add-to-bibliography-batch-size="10" data-bibliography-delegates-url="/list-bibliography-delegates/" data-add-to-bibliography-url="/add-to-bibliography/" data-get-article-ids-by-search-url="/get-article-ids-by-search/" data-mybib-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/mybibliography/"> <input type="hidden" name="csrfmiddlewaretoken" value="gpfbvJE5GE1W0ujT9pX4X6014Byvo4Q69mml6jtQXqyFyGXNszedQ2QOWPkCEpUX"> <div class="action-panel-control-wrap bibliographies-controls"> <div class="choice-group"> <ul class="bibliographies-action-add radio-group-items"> <li> <input name="bibliography" id="my-bibliography" class="my-bibliography" type="radio" checked/> <label for="my-bibliography">My Bibliography</label> </li> </ul> </div> </div> <div class="bibliographies-retry-load-on-error usa-input-error-message selection-validation-message"> Unable to load your delegates due to an error<br> <a href="#">Please try again</a> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Adding..." data-pinger-ignore> Add </button> <button class="action-panel-cancel" aria-label="Close 'Add to bibliography' panel" ref="linksrc=close_bibliography_panel" aria-controls="bibliography-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="mybib" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="saved-search-action-panel" class="saved-search-action-panel action-panel " aria-hidden="true" data-saved-search-open-panel-enabled="false" data-saved-search-open-panel-url-hash="#open-saved-search-panel"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Your saved search </h2> <form id="saved-search-action-panel-form" class="saved-search-action-panel-form action-panel-content action-form" data-create-saved-search-url="/create-saved-search/" data-try-search-terms-url="/try-search-term/" data-saved-search-root-url="https://www.ncbi.nlm.nih.gov/myncbi/searches/"> <input type="hidden" name="csrfmiddlewaretoken" value="gpfbvJE5GE1W0ujT9pX4X6014Byvo4Q69mml6jtQXqyFyGXNszedQ2QOWPkCEpUX"> <div class="action-panel-control-wrap"> <label for="saved-search-name" class="action-panel-label saved-search-name-label required-field-asterisk"> Name of saved search: </label> <input maxlength="200" type="text" name="saved-search-name" id="saved-search-name" class="saved-search-name" value="" required pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/"> </div> <div class="action-panel-control-wrap"> <label for="saved-search-term" class="action-panel-label required-field-asterisk"> Search terms: </label> <textarea name="saved-search-term" id="saved-search-term" class="saved-search-term" required></textarea> </div> <div class="test-search-term-wrap"> <a href="#" class="try-search-term">Test search terms</a> </div> <div class="choice-group action-panel-extra-margin-top"> <span class="action-panel-label" id="fieldset-label"> Would you like email updates of new search results? </span> <fieldset id="saved-search-alert" aria-describedby="fieldset-label"> <legend class="usa-sr-only">Saved Search Alert Radio Buttons</legend> <ul class="radio-group-items"> <li> <input type="radio" id="saved-search-alert-yes" class="saved-search-alert-yes" name="saved-search-alert" value="yes" checked> <label for="saved-search-alert-yes" class="action-panel-label">Yes</label> </li> <li> <input aria-label="No radio input" type="radio" id="saved-search-alert-no" class="saved-search-alert-no" name="saved-search-alert" value="no"> <label for="saved-search-alert-no" class="action-panel-label">No</label> </li> </ul> </fieldset> </div> <div class="alert-schedule-wrap"> <div class="action-panel-control-wrap"> <label class="action-panel-label"> Email: </label> <span aria-label="Email address" id="saved-search-email" class="action-panel-label"><span class="action-panel-label-bold"></span> (<a class="myncbi-account-settings" href="https://www.ncbi.nlm.nih.gov/account/settings/">change</a>)</span> </div> <div class="action-panel-control-wrap action-panel-extra-margin-top"> <label for="saved-search-frequency" class="action-panel-label"> Frequency: </label> <select id="saved-search-frequency" class="no-border-panel-selector saved-search-frequency"> <option value="monthly">Monthly</option> <option value="weekly">Weekly</option> <option value="daily">Daily</option> </select> </div> <div class="action-panel-control-wrap saved-search-monthly-additional"> <label for="saved-search-monthly-on-day" class="action-panel-label"> Which day? </label> <select id="saved-search-monthly-on-day" class="no-border-panel-selector"> <option value="Sunday">The first Sunday</option> <option value="Monday">The first Monday</option> <option value="Tuesday">The first Tuesday</option> <option value="Wednesday">The first Wednesday</option> <option value="Thursday">The first Thursday</option> <option value="Friday">The first Friday</option> <option value="Saturday">The first Saturday</option> <option value="day">The first day</option> <option value="weekday">The first weekday</option> </select> </div> <div class="action-panel-control-wrap saved-search-weekly-additional"> <label for="saved-search-weekly-on-day" class="action-panel-label"> Which day? </label> <select id="saved-search-weekly-on-day" class="no-border-panel-selector saved-search-weekly-on-day"> <option value="Sunday">Sunday</option> <option value="Monday">Monday</option> <option value="Tuesday">Tuesday</option> <option value="Wednesday">Wednesday</option> <option value="Thursday">Thursday</option> <option value="Friday">Friday</option> <option value="Saturday">Saturday</option> </select> </div> <div class="action-panel-control-wrap"> <label for="saved-search-report" class="action-panel-label"> Report format: </label> <select id="saved-search-report" class="no-border-panel-selector saved-search-report"> <option value="DocSum">Summary</option> <option value="DocSumText">Summary (text)</option> <option value="Abstract">Abstract</option> <option value="AbstractText">Abstract (text)</option> <option value="MEDLINE">PubMed</option> </select> </div> <div class="action-panel-control-wrap"> <label for="saved-search-amount" class="action-panel-label"> Send at most: </label> <select id="saved-search-amount" class="no-border-panel-selector saved-search-amount"> <option value="1">1 item</option> <option value="5" selected>5 items</option> <option value="10">10 items</option> <option value="20">20 items</option> <option value="50">50 items</option> <option value="100">100 items</option> <option value="200">200 items</option> </select> </div> <div> <input type="checkbox" id="saved-search-send-if-no-result" class="saved-search-send-if-no-result" name="saved-search-send-if-no-result"> <label for="saved-search-send-if-no-result" class="action-panel-label smaller-checkbox"> Send even when there aren't any new results </label> </div> <div class="action-panel-control-wrap option-text-in-email-wrap"> <label for="saved-search-email-text" class="action-panel-label"> Optional text in email: </label> <textarea name="saved-search-email-text" id="saved-search-email-text" class="saved-search-email-text"></textarea> </div> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Saving..." data-ga-category="save_share" data-ga-action="alert" data-ga-label="save"> Save </button> <button class="action-panel-cancel" aria-label="Close 'Your saved search' panel" ref="linksrc=close_saved_search_panel" aria-controls="saved-search-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="alert" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="citation-manager-action-panel" class="citation-manager-action-panel action-panel" aria-hidden="true"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Create a file for external citation management software </h2> <form id="citation-manager-action-panel-form" class="action-panel-content action-form" action="/results-export-ids/" data-by-search-action="/results-export-search-data/" data-by-ids-action="/results-export-ids/" method="post" data-by-search-method="post" data-by-ids-method="post"> <input type="hidden" name="csrfmiddlewaretoken" value="gpfbvJE5GE1W0ujT9pX4X6014Byvo4Q69mml6jtQXqyFyGXNszedQ2QOWPkCEpUX"> <input name="results-format" type="hidden" value="pubmed"/> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Sending..." data-ga-category="save_share" data-ga-action="citation_manager" data-ga-label="save"> Create file </button> <button class="action-panel-cancel" aria-label="Close 'Send citations to citation manager' panel" ref="linksrc=close_citation_manager_panel" aria-controls="citation-manager-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="citation_manager" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="rss-action-panel" class="rss-action-panel action-panel " aria-hidden="true"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Your RSS Feed </h2> <form id="rss-action-panel-form" class="rss-action-panel-form action-panel-content action-form" data-create-rss-feed-url="/create-rss-feed-url/" data-search-form-term-value=""> <input type="hidden" name="csrfmiddlewaretoken" value="gpfbvJE5GE1W0ujT9pX4X6014Byvo4Q69mml6jtQXqyFyGXNszedQ2QOWPkCEpUX"> <div class="action-panel-control-wrap"> <label for="rss-name" class="action-panel-label required-field-asterisk"> Name of RSS Feed: </label> <input maxlength="200" placeholder="Name" type="text" name="rss-name" id="rss-name" class="rss-name" value='' required pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/"> </div> <div class="rss-limit-wrap"> <div class="action-panel-control-wrap action-panel-extra-margin-top"> <label for="rss-limit" class="action-panel-label"> Number of items displayed: </label> <select id="rss-limit" class="no-border-panel-selector rss-limit"> <option value="5">5</option> <option value="10">10</option> <option value="15" selected="selected">15</option> <option value="20">20</option> <option value="50">50</option> <option value="100">100</option> </select> </div> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Creating..." data-ga-category="save_share" data-ga-action="alert" data-ga-label="save"> Create RSS </button> <button class="action-panel-cancel" aria-label="Close 'Your RSS' panel" ref="linksrc=close_rss_panel" aria-controls="rss-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="alert" data-ga-label="cancel"> Cancel </button> </div> <div class="action-panel-control-wrap rss-link-copy-wrap"> <label for="rss-link" class="usa-sr-only">RSS Link</label> <input placeholder="Your RSS Feed Link" type="text" name="rss-link" id="rss-link" class="rss-link" title="RSS Link"> <button type="button" disabled class="rss-link-copy-button disabled" data-ga-category="save_share" data-ga-action="rss" data-ga-label="copy"> Copy </button> </div> </form> </div> </div> </div> </div> <div class="article-page" id="article-page" data-article-pmid="27933614"> <aside class="page-sidebar"> <div class="inner-wrap"> <div class="full-text-links"> <div class="full-view"> <h3 class="title"> Full text links </h3> <div class="full-text-links-list"> <a class="link-item dialog-focus" 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collection: </label><input type="text" name="add-to-new-collection" id="collections-action-dialog-add-to-new" class="collections-action-add-to-new" pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/" maxlength="100" data-ga-category="collections_button" data-ga-action="create_collection" data-ga-label="non_favorties_collection"><div class="collections-new-name-too-long usa-input-error-message selection-validation-message"> Name must be less than 100 characters </div></div><div class="action-panel-control-wrap existing-collections-controls"><label for="collections-action-dialog-add-to-existing" class="action-panel-label"> Choose a collection: </label><select id="collections-action-dialog-add-to-existing" class="action-panel-selector collections-action-add-to-existing" data-ga-category="collections_button" data-ga-action="select_collection" data-ga-label="($('.collections-action-add-to-existing').val() === 'Favorites') ? 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Antiviral agents for infectious mononucleosis (glandular fever) </h1> <div class="inline-authors"> <div class="authors"> <div class="authors-list"> <span class="authors-list-item "><a class="full-name" href="/?term=De+Paor+M&cauthor_id=27933614" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Muireann De Paor">Muireann De Paor</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="HRB Centre for Primary Care Research, Department of General Practice, RCSI Medical School, 123 St. Stephens Green, Dublin 2, Ireland." href="#full-view-affiliation-1" ref="linksrc=author_aff"> 1 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=O%27Brien+K&cauthor_id=27933614" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Kirsty O'Brien">Kirsty O'Brien</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="HRB Centre for Primary Care Research, Department of General Practice, RCSI Medical School, 123 St. Stephens Green, Dublin 2, Ireland." href="#full-view-affiliation-1" ref="linksrc=author_aff"> 1 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Fahey+T&cauthor_id=27933614" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Tom Fahey">Tom Fahey</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="HRB Centre for Primary Care Research, Department of General Practice, RCSI Medical School, 123 St. Stephens Green, Dublin 2, Ireland." href="#full-view-affiliation-1" ref="linksrc=author_aff"> 1 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Smith+SM&cauthor_id=27933614" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Susan M Smith">Susan M Smith</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="HRB Centre for Primary Care Research, Department of General Practice, RCSI Medical School, 123 St. Stephens Green, Dublin 2, Ireland." href="#full-view-affiliation-1" ref="linksrc=author_aff"> 1 </a></sup></span> </div> </div> </div> <div class="short-article-details"> Affiliations <button class="more-details" id="toggle-authors" data-alt-text="Collapse" aria-controls="expanded-authors" aria-expanded="false" data-pinger-ignore data-fetch-url="/27933614/long-authors/" data-id-prefix=""> <span class="title"> Expand </span> </button> </div> <div class="extended-article-details" id="expanded-authors" aria-hidden="true"> <div class="expanded-authors" id="full-view-expanded-authors"> <div class="affiliations"> 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class="authors-list-item "><a class="full-name" href="/?term=O%27Brien+K&cauthor_id=27933614" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Kirsty O'Brien">Kirsty O'Brien</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="HRB Centre for Primary Care Research, Department of General Practice, RCSI Medical School, 123 St. Stephens Green, Dublin 2, Ireland." href="#short-view-affiliation-1" ref="linksrc=author_aff"> 1 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Fahey+T&cauthor_id=27933614" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Tom Fahey">Tom Fahey</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="HRB Centre for Primary Care Research, Department of General Practice, RCSI Medical School, 123 St. Stephens Green, Dublin 2, Ireland." href="#short-view-affiliation-1" ref="linksrc=author_aff"> 1 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Smith+SM&cauthor_id=27933614" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Susan M Smith">Susan M Smith</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="HRB Centre for Primary Care Research, Department of General Practice, RCSI Medical School, 123 St. Stephens Green, Dublin 2, Ireland." href="#short-view-affiliation-1" ref="linksrc=author_aff"> 1 </a></sup></span> </div> </div> <div class="affiliations"> <h3 class="title"> Affiliation </h3> <ul class="item-list"> <li data-affiliation-id="short-view-affiliation-1" id="short-view-affiliation-1" ><sup class="key">1</sup> HRB Centre for Primary Care Research, Department of General Practice, RCSI Medical School, 123 St. Stephens Green, Dublin 2, Ireland.</li> </ul> </div> </div> <ul class="identifiers" id="short-view-identifiers"> <li> <span class="identifier pubmed"> <span class="id-label"> PMID: </span> <strong class="current-id" title="PubMed ID">27933614</strong> </span> </li> <li> <span class="identifier pmc"> <span class="id-label"> PMCID: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=PMC6463965&id_type=PMC" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6463965/" data-ga-category="full_text" data-ga-action="PMCID" > PMC6463965 </a> </span> </li> <li> <span class="identifier doi"> <span class="id-label"> DOI: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=10.1002/14651858.CD011487.pub2&id_type=DOI" href="https://doi.org/10.1002/14651858.cd011487.pub2" data-ga-category="full_text" data-ga-action="DOI" > 10.1002/14651858.CD011487.pub2 </a> </span> </li> </ul> <div class="in-clipboard-label " hidden> Item in Clipboard </div> </div> </div> </header> <div class="actions-buttons inline"><div class="inner-wrap"><button class="full-text-links-button full-text-links-dialog-trigger" title="Open dialog with full text links" ref="linksrc=full_text_links"> Full text links </button><button class="citation-button citation-dialog-trigger" aria-label="Open dialog with citation text in different styles" data-ga-category="save_share" data-ga-action="cite" data-ga-label="open" data-all-citations-url="/27933614/citations/" data-citation-style="nlm" data-pubmed-format-link="/27933614/export/"><span class="button-label">Cite</span></button><button class="more-actions-button more-actions-dialog-trigger" title="Open dialog with more actions to take" ref="linksrc=more_actions_btn"></button><div class="display-options" data-format-key="format" data-default-format-value="abstract" data-current-format-value="abstract" role="region"><button class="trigger usa-button" title="Change format" data-ga-category="display_options" data-ga-action="display_options_dialog"><span class="button-label">Display options</span></button><div class="dropdown" hidden><div class="title"> Display options </div><div class="content"><div class="format-container"><span class="option-label"> Format </span><select name="format" data-initial-value="abstract" aria-label="Display format" id="inline-actions-display-format"><option value="abstract">Abstract</option><option value="pubmed">PubMed</option><option value="pmid">PMID</option></select></div></div></div></div></div></div> <div class="abstract" id="abstract"> <h2 class="title"> Abstract </h2> <div class="abstract-content selected" id="eng-abstract"> <p> <strong class="sub-title"> Background: </strong> Infectious mononucleosis (IM) is a clinical syndrome, usually caused by the Epstein Barr virus (EPV), characterised by lymphadenopathy, fever and sore throat. Most cases of symptomatic IM occur in older teenagers or young adults. Usually IM is a benign self-limiting illness and requires only symptomatic treatment. However, occasionally the disease course can be complicated or prolonged and lead to decreased productivity in terms of school or work. Antiviral medications have been used to treat IM, but the use of antivirals for IM is controversial. They may be effective by preventing viral replication which helps to keep the virus inactive. However, there are no guidelines for antivirals in IM. </p> <p> <strong class="sub-title"> Objectives: </strong> To assess the effects of antiviral therapy for infectious mononucleosis (IM). </p> <p> <strong class="sub-title"> Search methods: </strong> We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 3, March 2016), which contains the Cochrane Acute Respiratory Infections (ARI) Group's Specialised Register, MEDLINE (1946 to 15 April 2016), Embase (1974 to 15 April 2016), CINAHL (1981 to 15 April 2016), LILACS (1982 to 15 April 2016) and Web of Science (1955 to 15 April 2016). We searched the World Health Organization (WHO) International Clinical Trials Registry Platform and ClinicalTrials.gov for completed and ongoing trials. </p> <p> <strong class="sub-title"> Selection criteria: </strong> We included randomised controlled trials (RCTs) comparing antivirals versus placebo or no treatment in IM. We included trials of immunocompetent participants of any age or sex with clinical and laboratory-confirmed diagnosis of IM, who had symptoms for up to 14 days. Our primary outcomes were time to clinical recovery and adverse events and side effects of medication. Secondary outcomes included duration of abnormal clinical examination, complications, viral shedding, health-related quality of life, days missing from school or work and economic outcomes. </p> <p> <strong class="sub-title"> Data collection and analysis: </strong> Two review authors independently assessed studies for inclusion, assessed the included studies' risk of bias and extracted data using a customised data extraction sheet. We used the GRADE criteria to rate the quality of the evidence. We pooled heterogeneous data where possible, and presented the results narratively where we could not statistically combine data. </p> <p> <strong class="sub-title"> Main results: </strong> We included seven RCTs with a total of 333 participants in our review. Three trials studied hospitalised patients, two trials were conducted in an outpatient setting, while the trial setting was unclear in two studies. Participants' ages ranged from two years to young adults. The type of antiviral, administration route, and treatment duration varied between the trials. The antivirals in the included studies were acyclovir, valomaciclovir and valacyclovir. Follow-up varied from 20 days to six months. The diagnosis of IM was based on clinical symptoms and laboratory parameters.The risk of bias for all included studies was either unclear or high risk of bias. The quality of evidence was graded as very low for all outcomes and so the results should be interpreted with caution. There were statistically significant improvements in the treatment group for two of the 12 outcomes. These improvements may be of limited clinical significance.There was a mean reduction in 'time to clinical recovery as assessed by physician' of five days in the treatment group but with wide confidence intervals (CIs) (95% CI -8.04 to -1.08; two studies, 87 participants). Prospective studies indicate that clinical signs and symptoms may take one month or more to resolve and that fatigue may be persistent in approximately 10% of patients at six-month follow-up, so this may not be a clinically meaningful result.Trial results for the outcome 'adverse events and side effects of medication' were reported narratively in only five studies. In some reports authors were unsure whether an adverse event was related to medication or complication of disease. These results could not be pooled due to the potential for double counting results but overall, the majority of trials reporting this outcome did not find any significant difference between treatment and control groups.There was a mean reduction in 'duration of lymphadenopathy' of nine days (95% CI -11.75 to -6.14, two studies, 61 participants) in favour of the treatment group.In terms of viral shedding, the overall effect from six studies was that viral shedding was suppressed while on antiviral treatment, but this effect was not sustained when treatment stopped.For all other outcomes there was no statistically significant difference between antiviral treatment and control groups. </p> <p> <strong class="sub-title"> Authors' conclusions: </strong> The effectiveness of antiviral agents (acyclovir, valomaciclovir and valacyclovir) in acute IM is uncertain. The quality of the evidence is very low. The majority of included studies were at unclear or high risk of bias and so questions remain about the effectiveness of this intervention. Although two of the 12 outcomes have results that favour treatment over control, the quality of the evidence of these results is very low and may not be clinically meaningful. Alongside the lack of evidence of effectiveness, decision makers need to consider the potential adverse events and possible associated costs, and antiviral resistance. Further research in this area is warranted. </p> </div> </div> <p class="disclaimer" id="disclaimer"> <a href="/disclaimer/" target="_blank" ga_category="literature_resources" ga_action="disclaimer_link" ga_label="under_abstract">PubMed Disclaimer</a> </p> <div class="conflict-of-interest" id="conflict-of-interest"> <h2 class="title"> Conflict of interest statement </h2> <div class="statement"> <p xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:p1="http://pubmed.gov/pub-one">Muireann De Paor: none known Kirsty O'Brien: none known Tom Fahey: none known Susan M Smith: none known.</p> </div> </div> <div class="figures" id="figures"> <h2 class="title"> Figures </h2> <div class="figures-list" id="slides-container" itemscope itemtype="http://schema.org/ImageGallery"> <figure class="figure-item " itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="0" data-label-slug="1"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/1952f2f42c93/nCD011487-AFig-FIG01.jpg" itemprop="contentUrl" aria-describedby="figure-caption-0" role="button" data-image-width="404" data-image-height="738" data-image-alt="1" data-pmc-id="PMC6463965" data-figure-id="CD011487-fig-0001"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-0" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/69742856ba7f/nCD011487-AFig-FIG01.gif" alt="1" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="404"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="738"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> 1 </p> </strong> <div class="figure-caption-contents"><p> Study flow diagram. </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> 1 </p> </strong> <div class="figure-caption-contents"><p> Study flow diagram. </p></div> </div> <figcaption id="figure-caption-0" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> 1 </strong> <div class="figure-caption-contents">Study flow diagram.</div> </figcaption> </figure> <figure class="figure-item " itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="1" data-label-slug="2"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/bbdf67205802/nCD011487-AFig-FIG02.jpg" itemprop="contentUrl" aria-describedby="figure-caption-1" role="button" data-image-width="339" data-image-height="551" data-image-alt="2" data-pmc-id="PMC6463965" data-figure-id="CD011487-fig-0002"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-1" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/51d7ac2897b9/nCD011487-AFig-FIG02.gif" alt="2" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="339"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="551"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> 2 </p> </strong> <div class="figure-caption-contents"><p> 'Risk of bias' summary: review authors'… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> 2 </p> </strong> <div class="figure-caption-contents"><p> 'Risk of bias' summary: review authors' judgements about each risk of bias item for… </p></div> </div> <figcaption id="figure-caption-1" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> 2 </strong> <div class="figure-caption-contents">'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.</div> </figcaption> </figure> <figure class="figure-item " itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="2" data-label-slug="3"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/a2f8692f04e5/nCD011487-AFig-FIG03.jpg" itemprop="contentUrl" aria-describedby="figure-caption-2" role="button" data-image-width="606" data-image-height="256" data-image-alt="3" data-pmc-id="PMC6463965" data-figure-id="CD011487-fig-0003"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-2" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/64ae92a31191/nCD011487-AFig-FIG03.gif" alt="3" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="606"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="256"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> 3 </p> </strong> <div class="figure-caption-contents"><p> 'Risk of bias' graph: review authors'… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> 3 </p> </strong> <div class="figure-caption-contents"><p> 'Risk of bias' graph: review authors' judgements about each risk of bias item presented… </p></div> </div> <figcaption id="figure-caption-2" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> 3 </strong> <div class="figure-caption-contents">'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.</div> </figcaption> </figure> <figure class="figure-item " itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="3" data-label-slug="11"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/1d67739dd364/nCD011487-CMP-001-01.jpg" itemprop="contentUrl" aria-describedby="figure-caption-3" role="button" data-image-width="566" data-image-height="157" data-image-alt="1.1" data-pmc-id="PMC6463965" data-figure-id="CD011487-fig-0004"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-3" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/ef6fb3067737/nCD011487-CMP-001-01.gif" alt="1.1" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="566"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="157"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> 1.1. Analysis </p> </strong> <div class="figure-caption-contents"><p> Comparison 1 Antivirals versus placebo/no… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> 1.1. Analysis </p> </strong> <div class="figure-caption-contents"><p> Comparison 1 Antivirals versus placebo/no treatment, Outcome 1 Time to clinical recovery doctor… </p></div> </div> <figcaption id="figure-caption-3" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> 1.1. Analysis </strong> <div class="figure-caption-contents">Comparison 1 Antivirals versus placebo/no treatment, Outcome 1 Time to clinical recovery doctor judgement.</div> </figcaption> </figure> <figure class="figure-item " itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="4" data-label-slug="12"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/96911407d621/nCD011487-CMP-001-02.jpg" itemprop="contentUrl" aria-describedby="figure-caption-4" role="button" data-image-width="566" data-image-height="157" data-image-alt="1.2" data-pmc-id="PMC6463965" data-figure-id="CD011487-fig-0005"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-4" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/21a31cda9c93/nCD011487-CMP-001-02.gif" alt="1.2" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="566"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="157"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> 1.2. Analysis </p> </strong> <div class="figure-caption-contents"><p> Comparison 1 Antivirals versus placebo/no… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> 1.2. Analysis </p> </strong> <div class="figure-caption-contents"><p> Comparison 1 Antivirals versus placebo/no treatment, Outcome 2 Time to clinical recovery patient… </p></div> </div> <figcaption id="figure-caption-4" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> 1.2. Analysis </strong> <div class="figure-caption-contents">Comparison 1 Antivirals versus placebo/no treatment, Outcome 2 Time to clinical recovery patient judgement.</div> </figcaption> </figure> <figure class="figure-item " itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="5" data-label-slug="14"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/4ffb7984669c/nCD011487-CMP-001-04.jpg" itemprop="contentUrl" aria-describedby="figure-caption-5" role="button" data-image-width="566" data-image-height="157" data-image-alt="1.4" data-pmc-id="PMC6463965" data-figure-id="CD011487-fig-0007"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-5" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/653fcd62f204/nCD011487-CMP-001-04.gif" alt="1.4" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="566"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="157"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> 1.4. Analysis </p> </strong> <div class="figure-caption-contents"><p> Comparison 1 Antivirals versus placebo/no… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> 1.4. Analysis </p> </strong> <div class="figure-caption-contents"><p> Comparison 1 Antivirals versus placebo/no treatment, Outcome 4 Duration of fever > 37.5 degree… </p></div> </div> <figcaption id="figure-caption-5" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> 1.4. Analysis </strong> <div class="figure-caption-contents">Comparison 1 Antivirals versus placebo/no treatment, Outcome 4 Duration of fever > 37.5 degree C.</div> </figcaption> </figure> <figure class="figure-item tail" itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="6" data-label-slug="15"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/ae47b03e7261/nCD011487-CMP-001-05.jpg" itemprop="contentUrl" aria-describedby="figure-caption-6" role="button" data-image-width="566" data-image-height="169" data-image-alt="1.5" data-pmc-id="PMC6463965" data-figure-id="CD011487-fig-0008"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-6" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/a91137f4df22/nCD011487-CMP-001-05.gif" alt="1.5" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="566"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="169"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> 1.5. Analysis </p> </strong> <div class="figure-caption-contents"><p> Comparison 1 Antivirals versus placebo/no… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> 1.5. Analysis </p> </strong> <div class="figure-caption-contents"><p> Comparison 1 Antivirals versus placebo/no treatment, Outcome 5 Duration of pharyngitis. </p></div> </div> <figcaption id="figure-caption-6" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> 1.5. Analysis </strong> <div class="figure-caption-contents">Comparison 1 Antivirals versus placebo/no treatment, Outcome 5 Duration of pharyngitis.</div> </figcaption> </figure> <figure class="figure-item tail" itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="7" data-label-slug="16"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/cfc1515d7453/nCD011487-CMP-001-06.jpg" itemprop="contentUrl" aria-describedby="figure-caption-7" role="button" data-image-width="566" data-image-height="157" data-image-alt="1.6" data-pmc-id="PMC6463965" data-figure-id="CD011487-fig-0009"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-7" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/882463742250/nCD011487-CMP-001-06.gif" alt="1.6" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="566"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="157"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> 1.6. Analysis </p> </strong> <div class="figure-caption-contents"><p> Comparison 1 Antivirals versus placebo/no… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> 1.6. Analysis </p> </strong> <div class="figure-caption-contents"><p> Comparison 1 Antivirals versus placebo/no treatment, Outcome 6 Duration of lymphadenopathy. </p></div> </div> <figcaption id="figure-caption-7" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> 1.6. Analysis </strong> <div class="figure-caption-contents">Comparison 1 Antivirals versus placebo/no treatment, Outcome 6 Duration of lymphadenopathy.</div> </figcaption> </figure> <figure class="figure-item tail" itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="8" data-label-slug="17"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/e82dc0e17b5f/nCD011487-CMP-001-07.jpg" itemprop="contentUrl" aria-describedby="figure-caption-8" role="button" data-image-width="566" data-image-height="157" data-image-alt="1.7" data-pmc-id="PMC6463965" data-figure-id="CD011487-fig-0010"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-8" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/01b28db9a46d/nCD011487-CMP-001-07.gif" alt="1.7" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="566"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="157"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> 1.7. Analysis </p> </strong> <div class="figure-caption-contents"><p> Comparison 1 Antivirals versus placebo/no… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> 1.7. Analysis </p> </strong> <div class="figure-caption-contents"><p> Comparison 1 Antivirals versus placebo/no treatment, Outcome 7 Duration of splenomegaly. </p></div> </div> <figcaption id="figure-caption-8" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> 1.7. Analysis </strong> <div class="figure-caption-contents">Comparison 1 Antivirals versus placebo/no treatment, Outcome 7 Duration of splenomegaly.</div> </figcaption> </figure> <figure class="figure-item tail" itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="9" data-label-slug="18"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/de4cf8927d1c/nCD011487-CMP-001-08.jpg" itemprop="contentUrl" aria-describedby="figure-caption-9" role="button" data-image-width="566" data-image-height="157" data-image-alt="1.8" data-pmc-id="PMC6463965" data-figure-id="CD011487-fig-0011"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-9" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/9d65e26cdb00/nCD011487-CMP-001-08.gif" alt="1.8" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="566"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="157"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> 1.8. Analysis </p> </strong> <div class="figure-caption-contents"><p> Comparison 1 Antivirals versus placebo/no… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> 1.8. Analysis </p> </strong> <div class="figure-caption-contents"><p> Comparison 1 Antivirals versus placebo/no treatment, Outcome 8 Duration of hepatomegaly. </p></div> </div> <figcaption id="figure-caption-9" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> 1.8. Analysis </strong> <div class="figure-caption-contents">Comparison 1 Antivirals versus placebo/no treatment, Outcome 8 Duration of hepatomegaly.</div> </figcaption> </figure> <figure class="figure-item tail" itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="10" data-label-slug="111"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/2e9b2ae8650f/nCD011487-CMP-001-11.jpg" itemprop="contentUrl" aria-describedby="figure-caption-10" role="button" data-image-width="566" data-image-height="157" data-image-alt="1.11" data-pmc-id="PMC6463965" data-figure-id="CD011487-fig-0014"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-10" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f72/6463965/d572120f042a/nCD011487-CMP-001-11.gif" alt="1.11" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="566"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="157"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> 1.11. Analysis </p> </strong> <div class="figure-caption-contents"><p> Comparison 1 Antivirals versus placebo/no… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> 1.11. Analysis </p> </strong> <div class="figure-caption-contents"><p> Comparison 1 Antivirals versus placebo/no treatment, Outcome 11 Days missing from school /… </p></div> </div> <figcaption id="figure-caption-10" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> 1.11. Analysis </strong> <div class="figure-caption-contents">Comparison 1 Antivirals versus placebo/no treatment, Outcome 11 Days missing from school / work.</div> </figcaption> </figure> </div> <div class="see-all actions-bar"> <button class="show-more" aria-controls="slides-container" data-ga-category="figure" data-ga-action="show_all"> All figures (11) </button> </div>  <div class="pswp figures-dialog" id="figures-dialog" tabindex="-1" role="dialog" aria-hidden="true" data-image-gallery-uid="article-figures" aria-label="Figures Dialog">  <div class="pswp__bg"></div>  <div class="pswp__scroll-wrap">  <div class="pswp__container"> <div class="pswp__item"></div> <div class="pswp__item"></div> <div class="pswp__item"></div> </div>  <div class="pswp__ui pswp__ui--hidden"> <div class="pswp__top-bar">  <div class="pswp__counter"></div> <button class="pswp__button pswp__button--close" title="Close (Esc)"></button> <button class="pswp__button pswp__button--share" title="Share"></button> <button 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Medical Care 1996;34(3):220‐33. - <a class="reference-link" href="/8628042/" ref="linksrc=references_link&ordinalpos=1" data-ga-category="reference" data-ga-action="8628042" > PubMed </a> </li> </ol> </li> </ol> </div> <div class="refs-list"> <h5 class="refs-list-title">White 2001</h5> <ol id="top-references-list-62" class="references-list"> <li> <ol class="references-and-notes-list"> <li class="skip-numbering" value="1"> White PD, Thomas JM, Kangro HO, Bruce‐Jones WD, Amess J, Crawford DH, et al. Predictions and associations of fatigue syndromes and mood disorders that occur after infectious mononucleosis. 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[DOI: 10.1002/14651858.CD011487] - <a class="reference-link" href="https://doi.org/10.1002/14651858.cd011487" ref="linksrc=references_link&ordinalpos=1" data-ga-category="reference" data-ga-action="10.1002/14651858.CD011487" > DOI </a> - <a class="reference-link" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6463965/" ref="linksrc=references_link&ordinalpos=2" data-ga-category="reference" data-ga-action="PMC6463965" > PMC </a> - <a class="reference-link" href="/27933614/" ref="linksrc=references_link&ordinalpos=3" data-ga-category="reference" data-ga-action="27933614" > PubMed </a> </li> </ol> </li> </ol> </div> </div> </div> </div> <div id="publication-types" class="publication-types keywords-section"> <h2 class="title"> Publication types </h2> <ul class="keywords-list"><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Meta-Analysis" tabindex="0" 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class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Antiviral Agents/adverse effects"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Antiviral Agents/adverse effects"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link major" aria-label="Toggle dropdown menu for keyword Antiviral Agents / therapeutic use*" tabindex="0" aria-controls="keyword-actions-mesh-terms-major-7" aria-expanded="false" data-pinger-ignore> Antiviral Agents / therapeutic use* </button><div id="keyword-actions-mesh-terms-major-7" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Antiviral Agents / therapeutic use*"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Antiviral+Agents%2Ftherapeutic+use%22%5BMAJR%5D&sort=date&sort_order=desc" data-href="/?term=%22Antiviral+Agents%2Ftherapeutic+use%22%5BMAJR%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Antiviral Agents/therapeutic use"[MAJR]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Antiviral Agents / therapeutic use*"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Antiviral+Agents" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Antiviral Agents / therapeutic use*"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Antiviral Agents/therapeutic use"[MAJR]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Antiviral Agents/therapeutic use"[MAJR]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Child" tabindex="0" aria-controls="keyword-actions-mesh-terms-8" aria-expanded="false" data-pinger-ignore> Child </button><div id="keyword-actions-mesh-terms-8" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Child"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Child%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Child%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Child"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Child"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Child" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Child"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Child"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Child"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Child, Preschool" tabindex="0" aria-controls="keyword-actions-mesh-terms-9" aria-expanded="false" data-pinger-ignore> Child, Preschool </button><div id="keyword-actions-mesh-terms-9" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Child, Preschool"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Child%2C+Preschool%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Child%2C+Preschool%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Child, Preschool"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Child, Preschool"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Child%2C+Preschool" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Child, Preschool"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Child, Preschool"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Child, Preschool"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Female" tabindex="0" aria-controls="keyword-actions-mesh-terms-10" aria-expanded="false" data-pinger-ignore> Female </button><div id="keyword-actions-mesh-terms-10" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Female"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Female%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Female%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Female"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Female"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Female" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Female"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Female"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Female"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Guanine / adverse effects" tabindex="0" aria-controls="keyword-actions-mesh-terms-11" aria-expanded="false" data-pinger-ignore> Guanine / adverse effects </button><div id="keyword-actions-mesh-terms-11" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Guanine / adverse effects"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Guanine%2Fadverse+effects%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Guanine%2Fadverse+effects%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Guanine/adverse effects"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Guanine / adverse effects"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Guanine" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Guanine / adverse effects"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Guanine/adverse effects"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Guanine/adverse effects"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link major" aria-label="Toggle dropdown menu for keyword Guanine / analogs & derivatives*" tabindex="0" aria-controls="keyword-actions-mesh-terms-major-12" aria-expanded="false" data-pinger-ignore> Guanine / analogs & derivatives* </button><div id="keyword-actions-mesh-terms-major-12" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Guanine / analogs & derivatives*"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Guanine%2Fanalogs+and+derivatives%22%5BMAJR%5D&sort=date&sort_order=desc" data-href="/?term=%22Guanine%2Fanalogs+and+derivatives%22%5BMAJR%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Guanine/analogs and derivatives"[MAJR]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Guanine / analogs & derivatives*"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Guanine" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Guanine / analogs & derivatives*"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Guanine/analogs and derivatives"[MAJR]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Guanine/analogs and derivatives"[MAJR]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Guanine / therapeutic use" tabindex="0" aria-controls="keyword-actions-mesh-terms-13" aria-expanded="false" data-pinger-ignore> Guanine / therapeutic use </button><div id="keyword-actions-mesh-terms-13" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Guanine / therapeutic use"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Guanine%2Ftherapeutic+use%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Guanine%2Ftherapeutic+use%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Guanine/therapeutic use"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Guanine / therapeutic use"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Guanine" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Guanine / therapeutic use"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Guanine/therapeutic use"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Guanine/therapeutic use"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Humans" tabindex="0" aria-controls="keyword-actions-mesh-terms-14" aria-expanded="false" data-pinger-ignore> Humans </button><div id="keyword-actions-mesh-terms-14" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Humans"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Humans"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Humans"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Humans" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Humans"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Humans"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Humans"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link major" aria-label="Toggle dropdown menu for keyword Infectious Mononucleosis / drug therapy*" tabindex="0" aria-controls="keyword-actions-mesh-terms-major-15" aria-expanded="false" data-pinger-ignore> Infectious Mononucleosis / drug therapy* </button><div id="keyword-actions-mesh-terms-major-15" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Infectious Mononucleosis / drug therapy*"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Infectious+Mononucleosis%2Fdrug+therapy%22%5BMAJR%5D&sort=date&sort_order=desc" data-href="/?term=%22Infectious+Mononucleosis%2Fdrug+therapy%22%5BMAJR%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Infectious Mononucleosis/drug therapy"[MAJR]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Infectious Mononucleosis / drug therapy*"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Infectious+Mononucleosis" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Infectious Mononucleosis / drug therapy*"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Infectious Mononucleosis/drug therapy"[MAJR]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Infectious Mononucleosis/drug therapy"[MAJR]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Male" tabindex="0" aria-controls="keyword-actions-mesh-terms-16" aria-expanded="false" data-pinger-ignore> Male </button><div id="keyword-actions-mesh-terms-16" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Male"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Male%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Male%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Male"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Male"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Male" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Male"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Male"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Male"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Randomized Controlled Trials as Topic" tabindex="0" aria-controls="keyword-actions-mesh-terms-17" aria-expanded="false" data-pinger-ignore> Randomized Controlled Trials as Topic </button><div id="keyword-actions-mesh-terms-17" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Randomized Controlled Trials as Topic"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Randomized+Controlled+Trials+as+Topic%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Randomized+Controlled+Trials+as+Topic%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Randomized Controlled Trials as Topic"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Randomized Controlled Trials as Topic"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Randomized+Controlled+Trials+as+Topic" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Randomized Controlled Trials as Topic"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Randomized Controlled Trials as Topic"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Randomized Controlled Trials as Topic"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Valacyclovir" tabindex="0" aria-controls="keyword-actions-mesh-terms-18" aria-expanded="false" data-pinger-ignore> Valacyclovir </button><div id="keyword-actions-mesh-terms-18" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Valacyclovir"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Valacyclovir%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Valacyclovir%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Valacyclovir"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Valacyclovir"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Valacyclovir" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Valacyclovir"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Valacyclovir"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Valacyclovir"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Valine / adverse effects" tabindex="0" aria-controls="keyword-actions-mesh-terms-19" aria-expanded="false" data-pinger-ignore> Valine / adverse effects </button><div id="keyword-actions-mesh-terms-19" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Valine / adverse effects"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Valine%2Fadverse+effects%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Valine%2Fadverse+effects%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Valine/adverse effects"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Valine / adverse effects"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Valine" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Valine / adverse effects"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Valine/adverse effects"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Valine/adverse effects"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link major" aria-label="Toggle dropdown menu for keyword Valine / analogs & derivatives*" tabindex="0" aria-controls="keyword-actions-mesh-terms-major-20" aria-expanded="false" data-pinger-ignore> Valine / analogs & derivatives* </button><div id="keyword-actions-mesh-terms-major-20" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Valine / analogs & derivatives*"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Valine%2Fanalogs+and+derivatives%22%5BMAJR%5D&sort=date&sort_order=desc" data-href="/?term=%22Valine%2Fanalogs+and+derivatives%22%5BMAJR%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Valine/analogs and derivatives"[MAJR]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Valine / analogs & derivatives*"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Valine" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Valine / analogs & derivatives*"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Valine/analogs and derivatives"[MAJR]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Valine/analogs and derivatives"[MAJR]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Valine / therapeutic use" tabindex="0" aria-controls="keyword-actions-mesh-terms-21" aria-expanded="false" data-pinger-ignore> Valine / therapeutic use </button><div id="keyword-actions-mesh-terms-21" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Valine / therapeutic use"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Valine%2Ftherapeutic+use%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Valine%2Ftherapeutic+use%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Valine/therapeutic use"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Valine / therapeutic use"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Valine" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Valine / therapeutic use"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Valine/therapeutic use"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Valine/therapeutic use"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Young Adult" tabindex="0" aria-controls="keyword-actions-mesh-terms-22" aria-expanded="false" data-pinger-ignore> Young Adult </button><div id="keyword-actions-mesh-terms-22" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Young Adult"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Young+Adult%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Young+Adult%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Young Adult"[MeSH]" data-ga-category="search" 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Agents"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Antiviral Agents"[nm]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Antiviral Agents"[nm]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Guanine" tabindex="0" aria-controls="keyword-actions-substances-1" aria-expanded="false" data-pinger-ignore> Guanine </button><div id="keyword-actions-substances-1" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Guanine"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Guanine%22%5Bnm%5D&sort=date&sort_order=desc" data-href="/?term=%22Guanine%22%5Bnm%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&keyword="Guanine"[nm]" data-ga-category="search" data-ga-action="substance" data-ga-label="Guanine"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=%22Guanine%22" data-ga-category="search_mesh" data-ga-action="substance_link" data-ga-label="Guanine"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Guanine"[nm]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Guanine"[nm]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword valomaciclovir" tabindex="0" 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data-href="/?term=%22Valine%22%5Bnm%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&keyword="Valine"[nm]" data-ga-category="search" data-ga-action="substance" data-ga-label="Valine"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=%22Valine%22" data-ga-category="search_mesh" data-ga-action="substance_link" data-ga-label="Valine"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Valine"[nm]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Valine"[nm]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Valacyclovir" tabindex="0" aria-controls="keyword-actions-substances-4" 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dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Valacyclovir"[nm]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Valacyclovir"[nm]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Acyclovir" tabindex="0" aria-controls="keyword-actions-substances-5" aria-expanded="false" data-pinger-ignore> Acyclovir </button><div id="keyword-actions-substances-5" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Acyclovir"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Acyclovir%22%5Bnm%5D&sort=date&sort_order=desc" data-href="/?term=%22Acyclovir%22%5Bnm%5D&sort=date&sort_order=desc" 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