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A perspective on resistance to acyclovir in herpes simplex virus.
The Journal of Antimicrobial Chemotherapy
|September 1, 1983
Summary
Herpes simplex virus can develop acyclovir resistance through mutations affecting viral enzymes. While rare clinically, resistant strains may emerge, particularly in immunosuppressed individuals.
Area of Science:
- Virology
- Antimicrobial Resistance
Background:
- Acyclovir is a key antiviral medication for herpes simplex virus (HSV) infections.
- HSV resistance to acyclovir can arise from mutations in viral enzymes essential for drug activation.
Purpose of the Study:
- To investigate the mechanisms of acyclovir resistance in herpes simplex virus.
- To assess the frequency and clinical implications of resistant HSV strains.
Main Methods:
- Analysis of mutations in HSV-encoded thymidine kinase and DNA polymerase.
- In vitro replication assays of resistant HSV variants.
- Review of clinical cases of acyclovir resistance.
Main Results:
- Mutations in thymidine kinase can lead to complete loss of enzyme activity, conferring acyclovir resistance.
- Resistant HSV variants emerge readily in cell culture but less frequently in vivo.
- Thymidine kinase-deficient mutants are often attenuated but can cause resistance in immunosuppressed patients.
Conclusions:
- Acyclovir resistance in HSV is primarily mediated by mutations in viral enzymes.
- While not a current widespread clinical issue, the potential for emergent resistance exists.
- Monitoring and understanding resistance mechanisms are crucial for managing HSV infections.