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[Acyclovir-resistant herpes simplex virus infections in immunocompromised patients]
C L Jansen1, W G Maris-Tegeler, P M Wertheim-van Dillen
1Afd. Medische Microbiologie, Academisch Medisch Centrum, Amsterdam.
Nederlands Tijdschrift Voor Geneeskunde
|February 8, 1992
Summary
Herpes simplex virus (HSV) in immunocompromised patients can develop resistance to acyclovir (ACV). This study found ACV-resistant HSV isolates were sensitive to foscarnet, offering an alternative treatment option.
Area of Science:
- Virology
- Infectious Diseases
- Antiviral Therapy
Background:
- Herpes simplex virus (HSV) infections pose a significant challenge in immunocompromised patients, often requiring prolonged antiviral treatment.
- Acyclovir (ACV) is a primary antiviral agent used for HSV, but resistance can emerge, particularly in this patient population.
Observation:
- This retrospective study analyzed HSV isolates from immunocompromised patients (AIDS, bone marrow transplant recipients) treated with antiviral agents.
- Plaque reduction assays were used to determine the in vitro sensitivity of HSV isolates to antiviral compounds, including acyclovir.
Findings:
- In vitro acyclovir (ACV) resistance was demonstrated in HSV isolates from patients with suspected clinical resistance.
- A clear correlation was observed between the clinical progression of HSV infection and in vitro resistance to ACV.
- HSV isolates resistant to ACV in vitro remained sensitive to foscarnet, both clinically and in vitro.
Implications:
- Clinicians should consider acyclovir (ACV) resistance in immunocompromised patients with HSV infections unresponsive to treatment or showing disease progression.
- In vitro resistance testing is crucial for guiding appropriate antiviral therapy.
- Foscarnet represents a viable alternative treatment for ACV-resistant HSV infections in immunocompromised individuals.