Foscarnet therapy in five patients with AIDS and acyclovir-resistant varicella-zoster virus infection.
OBJECTIVE
To determine whether foscarnet has potential efficacy in the treatment of acyclovir-resistant mucocutaneous varicella-zoster infection in patients with the acquired immunodeficiency syndrome (AIDS).


METHODS
Open-label study.


METHODS
Three university medical centers.


METHODS
Five patients with AIDS who were infected with thymidine-kinase-deficient or -altered strains of varicella-zoster virus.


METHODS
Foscarnet, 40 mg/kg body weight every 8 hours in 1-hour infusions for 10 or more days.


RESULTS
Four patients had healing in response to foscarnet therapy, and each of four tested patients became culture negative for virus during foscarnet therapy. Results of fluorescent antigen testing remained positive during therapy in two patients; one of these patients had concomitant clinical failure but the other patient healed fully. One patient had complete healing despite the emergence of resistance to foscarnet in serial specimens obtained during foscarnet therapy.


CONCLUSIONS
Foscarnet is a potentially effective and tolerable antiviral agent for patients with acyclovir-resistant, varicella-zoster virus infection; however, the optimal dosage and duration of therapy require further study, as does the relation between clinical findings and in-vitro susceptibility results.
Safrin
S
S
University of California, San Francisco.
Berger
T G
TG
Gilson
I
I
Wolfe
P R
PR
Wofsy
C B
CB
Mills
J
J
Biron
K K
KK
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D004352:Drug Resistance, Microbial; D017245:Foscarnet; D006562:Herpes Zoster / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D014645:Herpesvirus 3, Human / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D010746:Phosphonoacetic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012874:Skin Diseases, Infectious / Q000188:drug therapy / Q000209:etiology
D000998:Antiviral Agents; D017245:Foscarnet; D010746:Phosphonoacetic Acid; D000212:Acyclovir