What is the primary antiviral treatment for HSV esophagitis?

Acyclovir is the primary antiviral treatment for herpes simplex virus (HSV) esophagitis. This condition arises primarily in immunocompromised individuals, such as those with HIV/AIDS or transplant recipients. Acyclovir works by inhibiting viral DNA synthesis, effectively reducing the number of viral particles and helping to control the infection.

While valacyclovir and famciclovir are also antiviral medications that are used to treat HSV infections, they are prodrugs of acyclovir and famciclovir respectively. Their use may be indicated in various HSV infections, but acyclovir remains the first-line treatment in cases of HSV esophagitis due to its established efficacy and safety profile specifically for this condition.

Zidovudine, on the other hand, is an antiretroviral drug used to manage HIV infection and is not indicated for the treatment of HSV. Thus, while it has a critical role in HIV management, it does not address the viral cause of HSV esophagitis, which is why it is not a suitable choice for this particular condition.