Treatment of acyclovir-resistant herpes simplex virus with intralesional cidofovir

Enescu, Christina D; Petry, Sarah Utz; Nartker, Nathan; Moossavi, Meena

doi:10.1016/j.jdcr.2021.05.001

Cited by 7 publications

(5 citation statements)

References 9 publications

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“…While foscarnet and cidofovir are typically effective in treating acyclovir-resistant HSV infections, they are usually administered parenterally and have a risk of nephrotoxicity. 2,7,8 Topical antiviral agents such as trifluridine have been evaluated for antiviral drug resistance but have only partial activity. 2 Imiquimod is an immune response modifier that stimulates cytokine production, including interferon-alpha, enhancing cell-mediated immunity against viral infections.…”

Section: Discussionmentioning

confidence: 99%

Recalcitrant ulcerative genital herpes in an immunocompetent individual treated successfully with imiquimod

Sachan,

Potluri,

Gopinath

et al. 2023

Int J STD AIDS

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Background This case report describes the successful use of imiquimod to treat genital herpes in an immunocompetent individual with acyclovir-resistant HSV. Case report A 32 year old male patient, presented with asymptomatic non-healing ulcers over the genital region for 2 years. The ulcers initially responded to acyclovir but became persistent after a few months. He also received multiple courses of antibiotics. On examination, the patient had bilateral inguinal lymphadenopathy and multiple painless ulcers over the coronal sulcus. Routine investigations were normal. The patient was treated with oral and intravenous acyclovir but showed no response. He was then started on topical imiquimod cream applied on alternate days. After one week, the patient presented with pain, redness, burning sensation, and fresh ulcer over the glans which were suspected to be imiquimod-induced irritant reaction or ulcer. Imiquimod was withheld for one week and then restarted at a twice-weekly schedule. After 1 month and 7 days of treatment with imiquimod at a twice-weekly schedule, there was healing of the ulcers. Conclusion This case report illustrates the efficacy of imiquimod cream as a topical treatment for genital herpes simplex in an immunocompetent patient who had previously been unresponsive to treatment with acyclovir.

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Section: Discussionmentioning

confidence: 99%

Recalcitrant ulcerative genital herpes in an immunocompetent individual treated successfully with imiquimod

Sachan,

Potluri,

Gopinath

et al. 2023

Int J STD AIDS

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“…Despite the limitations of small-scale studies, the literature suggests that cidofovir may be effective in both immunocompetent and immunosuppressed patients [6]. While topical cidofovir has been used more widely, studies have demonstrated that systemic and subcutaneously formulations of cidofovir are safe in patients with HIV/AIDS, lymphomas, leukemias, and those with chronic infection, including disseminated tuberculosis (Table 1) [5,14,18,19,22,[25][26][27].…”

Section: Clinical Usesmentioning

confidence: 99%

“…The first patient trialed on IL cidofovir was initially treated with six months of combined IV and IL cidofovir (15 mg/mL), followed by three months of IL-only therapy with significant regression and without evidence of HSV recurrence [14]. Four subsequent patients with extensive genital HSV have been reported in the literature who were treated with two to six rounds of 12.5 to 15 mg/mL IL cidofovir, with near resolution being documented as soon as two weeks following the treatment and resolution as early as six weeks [22,[25][26][27]. One patient with a hypertrophic anal lesion was treated with a combination of IL cidofovir and imiquimod 5% cream, and saw no evidence of recurrence three months following treatment [26].…”

Section: Herpes Simplex Virusmentioning

confidence: 99%

Cutaneous Applications of the Antiviral Drug Cidofovir: A Review

Poppens,

Ruci,

Davis

2024

JCM

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Background: Cidofovir, an antiviral drug approved for cytomegalovirus retinitis, has emerged as an alternative treatment option for virally induced cutaneous and mucocutaneous conditions, as well as being trialed as a treatment for select neoplasms. In this review, we highlight the existing evidence, clinical uses, and rationale of using cidofovir for the treatment of cutaneous pathologies. Methods: A PubMed database literature search was conducted to identify relevant articles for inclusion in this review. Results: Cidofovir has several cutaneous applications in various formulations including intravenous, topical, and subcutaneous administrations. Primarily through case reports, case series, and retrospective reviews, cidofovir has demonstrated efficacy in treating a variety of virally induced conditions—verruca vulgaris, herpes simplex virus, molluscum contagiosum—as well as in adjuvant treatment for select neoplasms. The drug has shown efficacy in immunocompromised and immunocompetent adults and children alike. Conclusions: The body of literature supports the use of cidofovir as an effective and well-tolerated treatment for many viral cutaneous pathologies, and encourages further study for its use as an adjuvant therapy for neoplastic disease.

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“…It also demonstrates in-vitro activity against several DNA viruses like herpesvirus, poxvirus, polyomavirus, and papillomavirus (de Clercq, 2003). It is used off-label in respiratory papillomatosis (Ballestas et al, 2021), acyclovir-resistant herpes simplex virus (Enescu et al, 2021), skin lesions associated with herpesvirus (Ferrer et al, 2021), BK polyomavirus (Napolitano et al, 2021). We have thus built upon the existing bibliometric analyses pertaining to mpox virus disease (Cheng et al, 2022;Zeeshan et al, 2022).…”

Section: Bibliometric Analysismentioning

confidence: 99%

Pharmacological treatment and vaccines in monkeypox virus: a narrative review and bibliometric analysis

et al. 2023

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Mpox (earlier known as monkeypox) virus infection is a recognized public health emergency. There has been little research on the treatment options. This article reviews the specific drugs used to treat mpox virus infection and the vaccines used here. Instead of focusing on the mechanistic basis, this review narrates the practical, real-life experiences of individual patients of mpox virus disease being administered these medicines. We conducted a bibliometric analysis on the treatment of the mpox virus using data from several databases like PubMed, Scopus, and Embase. The research on this topic has grown tremendously recently but it is highly concentrated in a few countries. Cidofovir is the most studied drug. This is because it is indicated and also used off-label for several conditions. The drugs used for mpox virus infection include tecovirimat, cidofovir, brincidofovir, vaccinia immune globulin, and trifluridine. Tecovirimat is used most frequently. It is a promising option in progressive mpox disease in terms of both efficacy and safety. Brincidofovir has been associated with treatment discontinuation due to elevated hepatic enzymes. Cidofovir is also not the preferred drug, often used because of the unavailability of tecovirimat. Trifluridine is used topically as an add-on agent along with tecovirimat for ocular manifestations of mpox virus disease. No study reports individual patient data for vaccinia immune globulin. Though no vaccine is currently approved for mpox virus infection, ACAM 2000 and JYNNEOS are the vaccines being mainly considered. ACAM 2000 is capable of replicating and may cause severe adverse reactions. It is used when JYNNEOS is contraindicated. Several drugs and vaccines are under development and have been discussed alongside pragmatic aspects of mpox virus treatment and prevention. Further studies can provide more insight into the safety and efficacy of Tecovirimat in actively progressing mpox virus disease.

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Treatment of acyclovir-resistant herpes simplex virus with intralesional cidofovir

Cited by 7 publications

References 9 publications

Recalcitrant ulcerative genital herpes in an immunocompetent individual treated successfully with imiquimod

Recalcitrant ulcerative genital herpes in an immunocompetent individual treated successfully with imiquimod

Cutaneous Applications of the Antiviral Drug Cidofovir: A Review

Pharmacological treatment and vaccines in monkeypox virus: a narrative review and bibliometric analysis

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