2-Amino-7-[(1,3-dihydroxy-2-propoxy)methyl]purine (compound S2242) represents the first antivirally active nucleoside analog with the side chain attached to the N-7 position of the purine ring. Compound S2242 strongly inhibits the in vitro replication of both herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) (50% effective concentration [EC50], 0.1 to 0.2 ,ug/ml), varicella-zoster virus (EC50, 0.01 to 0.02 ,ug/ml) and thymidine kinase (TK)-deficient strains of HSV (EC50, 0.4 ,Lg/ml) and varicella-zoster virus (EC50, 0.2 to 0.5 ,ug/ml). Potent activity was also observed against murine cytomegalovirus (EC50, 1 gig/ml), human cytomegalovirus (HCMV) (EC50, 0.04 to 0.1 ,ug/ml), and human herpesvirus 6 (EC50, 0.0005 ,ug/ml). Compound S2242 (i) was not cytotoxic to confluent Vero, HeLa, or human fibroblast cells at concentrations of > 100 ,ug/ml, (ii) proved somewhat more cytostatic to Vero, HEL, HeLa, and C127I cells than ganciclovir, and (iii) was markedly more cytostatic than ganciclovir to the growth of the human lymphocytic cell lines HSB-2 and CEM°. In contrast to ganciclovir, (i) compound S2242 proved not to be cytocidal to murine mammary carcinoma (FM3A) cells transfected with the HSV-1 or HSV-2 TK gene, (ii) exogenously added thymidine had only a limited effect on its anti-HSV-1 activity, and (iii) the compound was not phosphorylated by HSV-1-encoded TK derived from HSV-1 TK-transfected FM3A cells, indicating that the compound is not activated by a virally encoded TK.Compound S2242 inhibited (i) the expression of late HCMV antigens at an EC50 of 0.07 ,ug/ml (0.6 ,ug/ml for ganciclovir) and (ii) HCMV DNA synthesis at an EC50 of 0.1 ,ug/ml (0.32 ,ug/ml for ganciclovir), i.e., values that are close to the EC50s for inhibition of HCMV-induced cytopathogenicity. Neither ganciclovir nor S2242 had any effect on the expression of immediate-early HCMV antigens, which occurs before viral DNA synthesis. In time-of-addition experiments, S2242 behaved like ganciclovir and acyclovir; i.e., the addition of the drugs could be delayed until the onset of viral DNA synthesis.Agents approved in one or more countries to treat herpesvirus infection include idoxuridine, trifluridine, vidarabine, and acyclovir for the topical treatment of herpetic eye infection; vidarabine and acyclovir for the systemic treatment of herpes encephalitis, acyclovir for the topical and systemic (oral or intravenous) treatment of genital herpes; acyclovir for the systemic (intravenous, oral) treatment of herpes simplex virus (HSV) or varicella-zoster virus (VZV) infections in immunosuppressed patients; and ganciclovir and foscarnet for the systemic (intravenous) treatment of human cytomegalovirus (HCMV) retinitis in patients with AIDS. Foscarnet is effective in the treatment of infections with acyclovir-resistant thymidine kinase-deficient (TK-) HSV or VZV mutants and ganciclovir-resistant HCMV infections (5,16,18,25). However, double resistant viruses (i.e., ganciclovir-and foscarnet-resistant HCMV and acyclovir-and foscarnet-resistant HSV) have b...