B virus infection of humans results in high morbidity and mortality in as many as 80% of identified cases.The main objective of this study was to conduct a comparative analysis of conventional and experimental antiviral drug susceptibilities of B virus isolates from multiple macaque species and zoonotically infected humans. We used a plaque reduction assay to establish the effective inhibitory doses of acyclovir, ganciclovir, and vidarabine, as well as those of a group of experimental nucleoside analogs with known anti-herpes simplex virus activity. Four of the experimental drugs tested were 10-to 100-fold more potent inhibitors of B virus replication than conventional antiviral agents. Drug efficacies were similar for multiple B virus isolates tested, with variations within 2-fold of the median effective concentration (EC 50 ) for each drug, and each EC 50 was considerably lower than those for B virus thymidine kinase (TK) mutants. We observed no differences in the viral TK amino acid sequence between B virus isolates from rhesus monkeys and those from human zoonoses. Differences in the TK protein sequence between cynomolgus and pigtail macaque B virus isolates did not affect drug sensitivity except in the case of one compound. Taken together, these data suggest that future B virus zoonoses will respond consistently to conventional antiviral treatment. Further, the considerably higher potency of FEAU (2-fluoro-5-ethyl-Ara-U) than of conventional antiviral drugs argues for its compassionate use in advanced human B virus infections.In its natural host, macaque monkeys, B virus (Macacine herpesvirus 1; Simplexvirus, Herpesviridae) causes lesions on epithelial surfaces (2, 33) and establishes reactivatable latent infection in sensory neurons (30, 37), like herpes simplex virus (HSV) in humans. B virus often results in severe pathogenesis, including paralysis, encephalitis, and in many cases, rapid death, following infection of humans (reviewed in reference 22). Nearly all reported cases of B virus zoonosis have been associated with individuals handling macaques during the course of research or technology development (33). Five fatalities, along with at least 23 cases in which the patient survived, have occurred in the past 20 years, underscoring that zoonotic infections remain a problem in the laboratory animal environment (7-9).The CDC's B Virus Working Group currently recommends treatment of confirmed zoonotic infections with herpesvirusspecific antiviral drugs, including acyclovir (ACV) and ganciclovir (GCV) (10). Both agents in this class of compounds are phosphorylated to active form by virus-encoded thymidine kinase (TK). The resulting nucleoside triphosphate analog inhibits viral DNA replication by termination of chain elongation and by direct inhibition of herpesvirus DNA polymerase (24). While ACV is effective against B virus both in cell culture and in animal models (6), the dose required for 50% plaque reduction is more than 10-fold higher for B virus than for HSV type 1 (HSV-1) (38). GCV is twice as pot...