arginine butyrate + ganciclovir + valganciclovir

**Arginine butyrate + ganciclovir + valganciclovir** is a combination regimen under clinical investigation for the treatment of **Epstein-Barr virus (EBV)-positive lymphoid malignancies**. This combination leverages *arginine butyrate*, a histone deacetylase inhibitor and short-chain fatty acid, to induce viral thymidine kinase (TK) expression in latently infected EBV-positive cells, which sensitizes these otherwise resistant cells to the prodrug antiviral agents *ganciclovir* and *valganciclovir*. Both ganciclovir and its oral prodrug valganciclovir are nucleoside analogues that inhibit viral DNA polymerase, leading to cell death in virally infected cells. Preclinical and clinical studies demonstrate that this combination can induce significant apoptosis and clinical remission in refractory EBV-positive lymphomas through this targeted potency. Valganciclovir, being a prodrug of ganciclovir, provides oral bioavailability, whereas ganciclovir is typically administered intravenously.