Virology 132:26-37, 1984). Typically, these resistance mutations map to the thymidine kinase (TK) gene and render the virus TK deficient. To examine this process more closely, a plating efficiency assay was used to determine whether the frequencies of naturally occurring mutations in populations of the laboratory strains HSV-1 SC16, HSV-2 SB5, and HSV-2 333 grown in MRC-5 cells were similar when scored for resistance to penciclovir (PCV) and ACV. Our results indicate that (i) HSV mutants resistant to PCV and those resistant to ACV accumulate at approximately equal frequencies during replication in cell culture, (ii) the spontaneous mutation frequency for the HSV-1 strain SC16 is similar to that previously reported for HSV-1 laboratory strains KOS and Cl101, and (iii) spontaneous mutations in the laboratory HSV-2 strains examined were 9-to 16-fold more frequent than those in the HSV-1 strain SC16. These observations were confirmed and extended for a group of eight clinical isolates in which the HSV-2 mutation frequency was approximately 30 times higher than that for HSV-1 isolates. In conclusion, our results indicate that the frequencies of naturally occurring, or spontaneous, HSV mutants resistant to PCV and those resistant to ACV are similar. However, HSV-2 strains may have a greater propensity to generate drug-resistant mutants than do HSV-1 strains.The antiviral drug standard for the treatment of herpes simplex virus (HSV) infections including herpes labialis and genital herpes for almost 2 decades has been acyclovir (ACV) [9-(2-hydroxyethoxymethyl)guanine]. However, with the more recent introduction of penciclovir (PCV) (BRL 39123) [9-(4-hydroxy-3-hydroxymethylbut-1-yl)guanine] and its oral prodrug, famciclovir, the usage of antivirals alternative to ACV for the management of herpesvirus infections has also increased. Identical activation pathways and similar modes of action suggest that the mechanisms of HSV resistance to PCV and ACV are likely to be analogous (2, 40). An assumption that the frequency with which resistance in HSV arises is identical for PCV and ACV can be based on the biochemical similarities of the two compounds and the cross-resistance of thymidine kinase (TK)-negative mutants; however, direct genetic evidence is not available.A low level of replication errors is typically associated with DNA synthesis (10, 33). Resistance to PCV or ACV can arise by a single base mutation in the DNA encoding the HSV TK protein which activates the antiviral agent (6, 23, 29). These spontaneous mutations occur during DNA replication and are independent of the presence of antiviral drug (16). These errors, or random mutations, provide genetic diversity to facilitate the adaptation and evolution of an organism (15). Data from a study of the molecular evolution of HSV type 1 (HSV-1) show that its evolution is slow; the mutation rate was estimated to be 3.5 ϫ 10 Ϫ8 substitutions per site per year (36). Mispaired deoxyribonucleoside triphosphates are often removed by the HSV polymerase (Pol) through its associat...

Penciclovir (PCV), an antiherpesvirus agent in the same class as acyclovir (ACV), is phosphorylated in herpes simplex virus (HSV)-infected cells by the viral thymidine kinase (TK).Resistance to ACV has been mapped to mutations within either the TK or the DNA polymerase gene. An identical activation pathway, the similarity in mode of action, and the invariant cross-resistance of TK-negative mutants argue that the mechanisms of resistance to PCV and ACV are likely to be analogous. A total of 48 HSV type 1 (HSV-1) and HSV-2 isolates were selected after passage in the presence of increasing concentrations of PCV or ACV in MRC-5 cells. Phenotypic analysis suggested these isolates were deficient in TK activity. Moreover, sequencing of the TK genes from ACV-selected mutants identified two homopolymeric G-C nucleotide stretches as putative hot spots, thereby confirming previous reports examining Acv r clinical isolates. Surprisingly, mutations identified in PCV-selected mutants were generally not in these regions but distributed throughout the TK gene and at similar frequencies of occurrence within A-T or G-C nucleotides, regardless of virus type. Furthermore, HSV-1 isolates selected in the presence of ACV commonly included frameshift mutations, while PCV-selected HSV-1 mutants contained mostly nonconservative amino acid changes. Data from this panel of laboratory isolates show that Pcv r mutants share cross-resistance and only limited sequence similarity with HSV mutants identified following ACV selection. Subtle differences between PCV and ACV in the interaction with viral TK or polymerase may account for the different spectra of genotypes observed for the two sets of mutants.The introduction of penciclovir [PCV;9-(4-hydroxy-3-hydroxymethylbut-1-yl)guanine] and its prodrug, famciclovir, (FCV), resulted in the use of antivirals alternative to acyclovir (ACV) for treatment of herpes simplex virus (HSV) infections. Biochemical studies have indicated that PCV, like ACV, is phosphorylated by the viral thymidine kinase (TK) to a monophosphate and subsequently converted by cellular enzymes to a triphosphate, which inhibits the HSV DNA polymerase (Pol) (44). Although PCV and ACV have identical activation pathways and similar modes of action (14, 44), and the frequencies with which resistance in HSV arises to PCV and ACV in cell culture are identical (36), the affinities and therefore the fine molecular interactions of PCV, ACV, and their triphosphates with TK and Pol differ (14). The last point raises the possibility that drug-resistant mutants selected by these antiviral agents may differ.Resistance to acyclovir typically arises by a single mutation in either the TK or Pol gene (11,23,29). The viral TK, unlike DNA polymerase, is not essential for virus replication in cell culture (13), although in vivo analyses implicate it in HSV virulence, pathogenicity, and reactivation from latency (9,15,20,41). Mutations in HSV TK are the most common causes of clinical resistance to ACV (7,34), and the majority of mutants completely lac...

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The commonly used antiviral drugs acyclovir (ACV) and penciclovir (PCV) possess similarly potent antiviral activities in vivo against herpes simplex virus (HSV). Assay methods for sensitivity to ACV are not necessarily transferable to PCV, even though the two drugs have similar in vivo potencies and mechanisms of action. We determined by plaque reduction assay the relative activities of ACV and PCV against five laboratory-adapted strains of HSV types 1 and 2 (including sensitive and resistant strains) in seven human cell lines and one nonhuman primate cell line. Seven characteristics were used to evaluate the cell lines. All cell lines were similar in their plating efficiencies and abilities to discriminate between sensitive and resistant HSV isolates. Vero and MRC-5 cells yielded the most discordant 50% inhibitory concentrations (IC 50 s) for the two HSV types, while Vero and WI-38 VA-13 cells yielded large differences in the IC 50 s of ACV and PCV. The limited life spans and poor plaque morphologies of the fibroblast lines were undesirable characteristics. Among the transformed cell lines producing well-defined plaques, A549 cells provided the best concordance between IC 50 s for the two HSV types and two antiherpes drugs. Comparison experiments with a yield reduction format indicated that the use of assays of this type might allow some of the cell-specific properties observed in plaque reduction assays to be avoided. Antiviral susceptibility testing of herpes simplex virus (HSV)clinical isolates is important because of the frequency of infection of immunocompromised hosts with resistant HSV strains and the increasing worldwide use of antiviral analog therapy. The National Committee for Clinical Laboratory Standards (NCCLS) has proposed a standard method (18) for in vitro determination of HSV susceptibility to two antivirals, acyclovir (ACV) and foscarnet (phosphonoformic acid [FOS]). For other prescribed antiviral drugs, such as penciclovir (PCV) and its prodrug famciclovir, the standard may need to be modified. The plaque reduction assay (PRA) provided in the NCCLS standard is the most commonly reported method for evaluations of the susceptibilities of clinical isolates to ACV and the technique to which new methods are compared (16,18,22,24,26,28,30). ACV resistance of HSV measured by PRA correlates with isolates from clinical infections unresponsive to ACV therapy; thus, the PRA is biologically relevant (25).Testing of the susceptibilities of HSV isolates to ACV has typically been performed in Vero (African green monkey kidney), MRC-5, or HEL (diploid human embryonic lung) cells. A priori, lines derived from human cells would be preferred for a standard assay, since current and future drugs are developed and optimized for activity in the human system. Vero cells do represent a continuous cell line that readily forms distinct plaques upon infection with HSV, but they are nonhuman in origin. Conversely, MRC-5 and HEL cells, which are human in origin and which have the appropriate metabolism (11, 32), represen...

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