A Controlled Trial Comparing Foscarnet with Vidarabine for Acyclovir-Resistant Mucocutaneous Herpes Simplex in the Acquired Immunodeficiency Syndrome

Abstract

For the treatment of acyclovir-resistant herpes simplex infection in patients with AIDS, foscarnet has superior efficacy and less frequent serious toxicity than vidarabine. Once the treatment is stopped, however; there is a high frequency of relapse.

Differential Susceptibility of Several Drug-Resistant Strains of Herpes Simplex Virus Type 2 to Various Antiviral Compounds

“…ACV resistance in immunocompromised patients most often occurs after prolonged courses of intermittent or continuous ACV administration for the treatment of recurrent episodes of HSV in the setting of a high degree of immunosuppression. Alternative antiviral agents for the treatment of Acvr HSV infections are foscarnet (phosphonoformic acid; PFA) and vidarabine (araA), PFA being the drug of choice for the treatment of such infections due to its better efficacy and lower toxicity when compared to araA (Vinckier et al, 1987;Safrin et al, 1991). However, PFAr HSV strains have also been recovered from immunocompromised patients .…”

Highly Reliable Heterologous System for Evaluating Resistance of Clinical Herpes Simplex Virus Isolates to Nucleoside Analogues

“…Expression of the TK gene from ACV-susceptible clinical isolates resulted in Leishmania susceptibility to GCV, whereas expression of a TK gene with frameshift mutations or nucleotide substitutions from ACV-resistant isolates gave rise to parasites with high levels of GCV resistance. The expression of the HSV TK gene in Leishmania provides an easy, reliable, and sensitive assay for evaluating HSV susceptibility to nucleoside analogues and for assessing the role of specific viral TK mutations.Acyclovir (ACV)-resistant herpes simplex viruses (HSV) infections are relatively frequent and can be associated with significant morbidity among immunocompromised patients (14,15,17,37,38). Resistance to ACV can be the result of point mutations within the viral thymidine kinase (TK) gene, encoding the enzyme responsible for the initial phosphorylation of ACV into ACV-monophosphate or, more rarely, mutations within the viral DNA polymerase (pol) gene (4, 10).…”

“…Acyclovir (ACV)-resistant herpes simplex viruses (HSV) infections are relatively frequent and can be associated with significant morbidity among immunocompromised patients (14,15,17,37,38). Resistance to ACV can be the result of point mutations within the viral thymidine kinase (TK) gene, encoding the enzyme responsible for the initial phosphorylation of ACV into ACV-monophosphate or, more rarely, mutations within the viral DNA polymerase (pol) gene (4, 10).…”

Clinical Guidelines for the Treatment and Prevention of Opportunistic Infections in HIV-infected Koreans

“…Acyclovir 내성이 의심되는 경우 병변에서 바이러스를 분 리, 배양하여 감수성 검사를 시행한다(AII) [243]. Acyclovir내성 헤르 페스바이러스의 으뜸치료제는 정주 foscarnet이다(AI) [244]. 외부병 변의 경우 국소적 trifluridine, cidofovir, imiquimod 등의 장기치료 (21-28일 이상)가 도움이 될 수 있다(CIII).…”