Herpes simplex virus resistant to acyclovir

Article Abstract:

Herpes simplex, an infectious disease caused by herpes simplex virus type I, is characterized by the development of skin lesions at sites where the mucous membrane joins the skin, such as the gums, throat, or eye. In addition to using antibiotics, this infection is commonly treated with the antiviral agent acyclovir. The sensitivity of herpes simplex virus isolates (which were obtained from infected persons) to acyclovir was evaluated. Herpes simplex virus resistance to acyclovir was found in 7 of 148 patients with a weakened immune system, but from none of 59 patients with a normal immune system. Herpes simplex disease was identified in all seven patients with the resistant virus and was more severe in children. The resistant virus was obtained from patients who were previously treated with acyclovir and had negligible or altered activity of the enzyme thymidine kinase. The results show that resistance of herpes simplex virus to acyclovir often develops in patients with weakened immune systems, and may be associated with severe disease. The presence of resistance to antiviral agents should be tested; early detection permits changes in antiviral therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Complications and side effects, Drug resistance, Immunodeficiency

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Options for prevention of cytomegalovirus disease

Article Abstract:

Cytomegalovirus is the most common cause of infection seen after bone marrow or organ transplantation. A study of the safety and efficacy of a new live vaccine is reported by Plotkin et al. in the April 1, 1991 issue of Annals of Internal Medicine. The new cytomegalovirus vaccine (not yet approved for use) appears to be safe and effective in diminishing the severity of cytomegalovirus disease. Immunoglobulins are proteins that have anti-cytomegalovirus activity, and their use has been shown to decrease the incidence of disease. Acyclovir, an anti-viral agent, also offers a certain degree of protection from cytomegalovirus disease. The cost of the latter two is quite expensive (approximately $1,100 annually for the acyclovir, and $6,200 for the immunoglobulin). A single administration of vaccine should prove to be much more cost-effective than either of the other methods. (Consumer Summary produced by Reliance Medical Information, Inc.)

Economic aspects, Prevention, Cytomegalovirus infections, editorial

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Progressive esophagitis from acyclovir-resistant herpes simplex

Article Abstract:

Acyclovir is an antiviral agent routinely used to treat and prevent herpes simplex viral infections in patients preparing for bone marrow transplantation. However, some strains of herpes simplex virus may become resistent to acyclovir treatment. Resistent strains of herpes simplex virus have demonstrated a reduction in thymidine kinase activity, a reaction required for acyclovir to exert its negative effect on the virus. A bone marrow transplant was performed on a 25-year-old woman with leukemia. Two weeks later, herpes simplex lesions were observed in her mouth and esophagus. The patient's esophagitis progressed even after acyclovir treatment because of antiviral drug resistance. Although she improved after intravenous foscarnet administration, the safety and efficacy of this treatment for acyclovir-resistent herpes simplex virus is not yet established. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Bone marrow, Bone marrow transplantation, Antiviral agents, Foscarnet

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