A Retrospective, Case-Control Study of Acyclovir Resistance in Herpes Simplex Virus

Abstract

Background. Occasional cases of acyclovir resistance have been documented in the treatment of herpes simplex virus (HSV) infection. Thirty-eight subjects with acyclovir-resistant infections were identified in an epidemiological surveillance program involving 1811 HSV-infected subjects in France.Methods. Twenty-three index cases from whom acyclovir-resistant HSV strains had been isolated were compared with 46 control subjects matched for immunological status. Sociodemographic characteristics, features of the acyclovir-resistant HSV episode, history of HSV infection, treatment, outcome, and immunological history were recorded.Results. Twenty-two index case patients presented with immunodepression. Sixty-five percent reported clinically manifest recurrences, compared with 33% of matched control subjects. Significantly more index case patients had used antiviral drugs, and they had used them more often than had control subjects. However, 26.1% of index case patients reported no antiviral exposure in the previous 2 years. Two-thirds of the strains recovered from the index case patients were isolated because of suspicion of clinical resistance to acyclovir.Conclusions. Clinical treatment resistance is associated with acyclovir-resistant HSV strains, but acyclovirresistant strains were also isolated from treatment-naive subjects.

The in vitro Anti-Herpes Simplex Virus Type-1 and Type-2 Activity of Long Dan Xie Gan Tan, a Prescription of Traditional Chinese Medicine

“…However, the widespread use of nucleoside-based drugs has led to the emergence of an HSV strain resistant to those related drugs, especially among immunocompromised patients. According to previous surveys, a consistent rate of resistance of 0.28-0.33% of HSV isolates has been recovered from normally immunocompetent people in the general population [3][4][5][6][7][8][9][10] , with higher rates being observed in people with depressed immune function (6-7.6%) [4,5] , in bone marrow graft recipients (7.0-15.4%) [6][7][8] and in people with human immunodefi-ciency virus (HIV) infection (4.2-7.1%) [7][8][9][10] . The high prevalence of ACV-resistant HSV among immunocompromised populations suggests that new medication is needed.…”

Antiviral activity of Aloe vera against herpes simplex virus type 2: An in vitro study

“…Considering the complications of this virus, some synthetic antiviral compounds such as acyclovir, penciclovir and vidarabine were developed for treatment of active herpetic infections, but they are not effective for the treatment of latent infections (Naesens and De Clercq, 2001). On the other hand the severe side effects and the development of some resistant mutants of this virus especially during long term medication with antiviral drugs were reported (Malvy et al, 2005;Pottage et al, 1995). Also, regarding the increasing prevalence of genital herpes, there is an urgent need to develop new anti-HSV-2 drugs.…”

Purification and characterization of a novel anti-HSV-2 protein with antiproliferative and peroxidase activities from <italic>Stellaria media</italic>

“…The major antiviral therapy for HSV infection involves the use of nucleoside analogues, such as acyclovir. However, the increasing clinical use of this type of antiviral agents has been linked with the emergence of drug-resistant herpes virus strains [3][4][5]. Therefore, the development of anti-HSV agents with different modes of action is required.…”