Introduction

In recent years, herpes virus infection has become a global concern due to its significant threat to public health. Herpesvirus is an infectious agent belonging to the herpesviridae family, which can cause latent and lytic infections in humans and various animals [1]. According to its genome organization and sequence, herpes viruses are subdivided into three subfamilies, namely α Herpesvirus, β Herpesvirus and Herpesvirus C [2]. There are currently eight known types of herpes viruses that can infect humans, known as human herpesvirus HHV, including herpes simplex virus (HSV-1 and HSV-2), varicella zoster virus (VZV), EB virus, human herpesvirus 6 (variants A and B), human herpesvirus 7, Kaposi sarcoma associated herpesvirus, and human cytomegalovirus (CMV) [3, 4]. The main feature of this virus family is its opposition to replication within the host cell and is not completely eliminated, leading to latent infection [2]. During the incubation period, the expression of viral protein is restricted, which limits the detection of the host immune system [5, 6]. According to the World Health Organization, there are currently 3.7 billion people under the age of 50 infected with herpes simplex virus type 1 and 491 million people aged 15 to 49 infected with herpes simplex virus type 2 worldwide.
Acyclovir (ACV) is an antiviral drug of guanine nucleoside analogues and is highly selective α Herpesvirus inhibitors [7] [8], due to their high selectivity and low cytotoxicity, are considered the beginning of a new era of antiviral therapy [9, 10]. Discovered in the early 1970s, it entered clinical research in 1977 and was first approved as an antiviral drug in 1982[7, 11, 12]. Subsequently, many potential anti herpesvirus compounds were synthesized, and currently, many have been approved and marketed [13-15]. They include GCV and derivatives (prodrugs) of these drugs, VACV and FCV [11, 16, 17]. These are nucleoside analogues, which are highly selective inhibitors of virus encoded DNA polymerase (DNA pol). Its antiviral effect is due to the inhibition of viral DNA synthesis in the mechanism of competitive incorporation of deoxyguanosine triphosphate (dGTP) into the DNA chain [18], thereby reducing symptoms, virus excretion and outbreak frequency, which can be used as inhibitory treatment, prophylactic treatment and risk adaptive prevention. These studies provide more novel structures for the development of ACV like antiviral drugs, which can more effectively address the shortcomings of ACV and improve antiviral ability, bringing a more open perspective for disease treatment [10] [19].
So far, there has been no targeting of people β Specific, efficient, and safe antiviral drugs for herpes virus and human herpesvirus C [17]. Currently, registered anti herpesvirus drugs can only control infections caused by HSV, VZV, and CMV [17] [20]. ACV is a first-line treatment drug for HSV-1, HSV-2, and VZV. ACV and VACV can be used as inhibitory treatments to prevent oral and genital recurrence of diseases caused by HSV-1 and HSV-2 [15, 16]. GCV inhibits replication of herpes A virus, CMV, EB virus, HHV6, 7, and 8, as well as hepatitis B virus (HBV). In clinical practice, it is the preferred drug for treating cytomegalovirus infections [21-23]. With the widespread use of the ”lovir” family of drugs, drug related ADEs have also received attention. Unfortunately, little is known about the differences in the real world of the ”lovir” family of drugs, and there are still many doubts about their medication choices, apart from focusing on therapeutic effects.
FAERS is a spontaneous reporting system for post market drug adverse events in the United States. It has a large amount of data, diverse data information, and is open to the public for free, including adverse events and medication errors submitted to the FDA [24]. The information reported in this database is aimed at supporting the FDA’s post market safety monitoring program for drugs and therapeutic biological products. Therefore, it can be used to identify new drug related adverse events that were not previously observed in clinical trials. Currently, both domestically and internationally, adverse event signal mining methods based on FAERS big data are widely used, which can fully utilize a large amount of real-world ADEs data, monitor drug safety information after marketing, and timely discover new and serious ADEs.
To rationalize the selection of anti-herpes virus drugs in the real world, this article is based on the FAERS database and conducts signal mining on the ADEs of DNA polymerase inhibitor class anti herpetic drugs. Based on the discovery and summary of DNA polymerase inhibitor class anti herpetic drugs ADEs, it aims to analyze their causes in the real world, propose reasonable medication recommendations, refine their usage rules, and develop necessary alternative strategies, To provide protection against herpes virus infection and provide guidance and reference for the rational and individualized use of clinical drugs.