Clinical characteristics of acyclovir-resistant herpetic keratitis and experimental studies of isolates

Yao, Yufeng; Inoue, Yoshitsugu; Kase, Tetsuo; Uchihori, Yasutaka; Mori, Yasuko; Ohashi, Yuichi

doi:10.1007/bf02343061

Cited by 17 publications

(19 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Less frequent are mutations in the viral DNA polymerase gene that may lead to cross-resistance to FOS [7,8]. In contrast to the extensive study of genital herpes and herpes labialis, large surveys of the incidence of ACV resistance in patients with HK are lacking [4 -8]; thus far, there have been only a few anecdotal case reports of ACV R corneal HSV-1 in patients with HK [4,[9][10][11][12]. In the present study, we determine the prevalence and molecular characteristics of ACV R corneal HSV-1 in a cohort of 173 patients with HK; in addition, cross-resistance to GCV and FOS is determined.…”

mentioning

confidence: 99%

Acyclovir‐Resistant Corneal HSV‐1 Isolates from Patients with Herpetic Keratitis

et al. 2008

View full text Add to dashboard Cite

The prevalence and molecular characteristics of isolates from 173 immunocompetent patients with herpetic keratitis (HK) who were infected with acyclovir (ACV)-resistant (ACV(R)) corneal herpes simplex virus (HSV)-1 was determined. Isolates from 11 (6.4%) of the patients were ACV(R), and 9 of these 11 patients were refractory to therapy with ACV; the ACV(R) isolates from 5 and 1 of these 9 patients were cross-resistant to gancyclovir and to both gancyclovir and foscarnet, respectively. Of the 11 ACV(R) isolates, 10 had, in the thymidine kinase gene, mutations that presumably conferred the ACV(R) phenotype. These data demonstrate a relatively high prevalence of corneal HSV-1 ACV(R) isolates in patients with HK, which emphasizes the need to monitor for ACV susceptibility in patients with HK who are refractory to therapy with ACV.

show abstract

mentioning

confidence: 99%

Acyclovir‐Resistant Corneal HSV‐1 Isolates from Patients with Herpetic Keratitis

et al. 2008

View full text Add to dashboard Cite

show abstract

“…Dagegen müssen 1%ige Trifluridin-haltige Augentropfen 7-bis 9-mal/Tag angewandt werden, zeigen aber auch schon nach wenigen Tagen eine Besserung [9,67]. Bei Aciclovir-Resistenz, die vor allem bei immungeschwächten Patienten auftritt, ist 1%iges Trifluridin sowohl bei der Keratitis herpetica als auch bei mukokutanen Läsionen als wichtigste Therapiealternative zu sehen [28,76]. Obwohl Invitro-und In-vivo-Studien zeigen konnten, dass topisch angewandtes Brivudin bei Keratitis herpetica eine exzellente und auch stärkere Wirkung als Aciclovir besitzt, ist die Zulassung bisher nur auf den Zoster beschränkt [39,47].…”

Section: Therapieunclassified

Eczema herpeticatum

Wetzel

Wollenberg

2004

Hautarzt

View full text Add to dashboard Cite

Patients affected by atopic dermatitis tend to develop viral infections. Probably the most feared complication of atopic dermatitis is eczema herpeticum, a disseminated infection with herpes simplex virus. A monomorphic eruption of dome-shaped blisters, pustules and erosions in the eczematous skin lesions along with severe systemic illness leads to the diagnosis. The clinical diagnosis may be confirmed by polymerase chain reaction, viral culture, electron microscopy with negative staining, Tzanck test, immunofluorescence tests or serology. While intravenous acyclovir is still regarded as standard treatment of eczema herpeticum, several recently-developed antiviral drugs provide therapeutic options.

show abstract

“…Some cases of herpes simplex virus (HSV) keratitis refractory to topical acyclovir (ACV) treatment were previously reported as epithelial keratitis [1, 2]. Conventional diagnosis of an ACV-resistant HSV keratitis using a viral culture following in vitro drug sensitivity testing [1] is generally difficult and complicated.…”

Section: Introductionmentioning

confidence: 99%

“…Conventional diagnosis of an ACV-resistant HSV keratitis using a viral culture following in vitro drug sensitivity testing [1] is generally difficult and complicated. Recently, we reported a simple and useful method for diagnosing drug-resistant herpetic infection using real-time polymerase chain reaction (PCR) by monitoring the changes in the viral DNA copy numbers before and after ACV treatment [3].…”

Section: Introductionmentioning

confidence: 99%

Necrotizing Keratitis Caused by Acyclovir-Resistant Herpes Simplex Virus

Toriyama

Suzuki

Kobayashi

et al. 2014

Case Rep Ophthalmol

Self Cite

View full text Add to dashboard Cite

Background: We report a case of necrotizing keratitis caused by acyclovir (ACV)-resistant herpes simplex virus (HSV) with a clinical appearance similar to a previous fungal keratitis infection. Methods: Observational case report. Results: Penetrating keratoplasty was performed in the left eye with a history of herpetic keratitis that resolved with periodic treatment with ACV ointment and a topical steroid. The left eye was painful and red with an abscess and corneal erosion in the peripheral donor cornea. Examination of the scraped corneal epithelium by light microscopy and culturing identified Candida albicans; polymerase chain reaction (PCR) was negative for human herpes viruses. After antifungal treatment, the ocular pain gradually decreased and the lesions slowly improved but recurred with a similar clinical appearance. A second light microscopy examination and cultures were negative for pathogens including C. albicans. PCR was positive for HSV-1 DNA; treatment with 3% topical ACV ointment was unsuccessful. A third examination showed only HSV-1 DNA. Despite antiviral ACV ointment, no clinical improvement occurred based on the HSV DNA copy numbers, which were the same before and after treatment, indicating a possible ACV-resistant strain. When topical trifluorothymidine was substituted for ACV, clinical improvement occurred and the HSV DNA copy numbers decreased. Conclusion: Necrotizing keratitis induced by ACV-resistant HSV occurred independently after fungal keratitis, with a similar clinical appearance in this case, making diagnosis and treatment difficult. Monitoring the HSV DNA load by real-time PCR could be useful for refractory cases even with atypical clinical appearances.

show abstract

Clinical characteristics of acyclovir-resistant herpetic keratitis and experimental studies of isolates

Cited by 17 publications

References 19 publications

Acyclovir‐Resistant Corneal HSV‐1 Isolates from Patients with Herpetic Keratitis

Acyclovir‐Resistant Corneal HSV‐1 Isolates from Patients with Herpetic Keratitis

Eczema herpeticatum

Necrotizing Keratitis Caused by Acyclovir-Resistant Herpes Simplex Virus

Contact Info

Product

Resources

About