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Virus resistance in clinical practice.

C Dekker, M N Ellis, C McLaren

    The Journal of Antimicrobial Chemotherapy
    |September 1, 1983
    PubMed
    Summary
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    Most herpes simplex virus (HSV) isolates show high sensitivity to acyclovir, with resistance rarely developing even after therapy. Standardized testing is needed to correlate in-vitro sensitivity with clinical outcomes.

    Area of Science:

    • Virology
    • Antiviral Drug Research
    • Clinical Microbiology

    Background:

    • Herpes simplex virus (HSV) infections are common and acyclovir is a primary antiviral treatment.
    • Understanding acyclovir resistance is crucial for effective HSV management, especially in immunocompromised individuals.

    Purpose of the Study:

    • To evaluate the in-vitro sensitivity of a large number of herpes simplex virus (HSV) isolates to acyclovir.
    • To investigate the impact of acyclovir therapy on HSV sensitivity and the development of resistance.
    • To highlight the need for standardized methods for correlating in-vitro sensitivity with clinical response.

    Main Methods:

    • Testing acyclovir sensitivity of over 800 HSV isolates from more than 300 patients.
    • Utilizing the dye-uptake method for sensitivity assessment.

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  • Analyzing viral sensitivity in relation to patient therapy and clinical outcomes.

    • Main Results:

    • Approximately 90% of HSV isolates were inhibited by less than 1 mg/l of acyclovir, indicating broad sensitivity.
    • Acyclovir therapy generally did not significantly alter HSV sensitivity, except in a few severely immunocompromised patients.
    • Resistant HSV isolates in immunocompromised patients led to asymptomatic or indolent infections.
    • Viral sensitivity remained consistent across recurrences, irrespective of prior therapy.

    Conclusions:

    • The majority of HSV isolates exhibit high susceptibility to acyclovir.
    • Development of acyclovir resistance is uncommon but can occur in severely immunocompromised patients.
    • Standardized and convenient methods for virus sensitivity testing are essential for further research and clinical application.