[Chronic erosive, therapy-resistant perianal herpes (type II) with herpes proctitis in AIDS].
In an AIDS patient who had repeated successful treatment with acyclovir in his history, erosive herpes perianalis with herpes proctitis appeared, which persisted over several weeks. High-dose intravenous administration on of acyclovir (500-750 mg, 3 x daily, over 7 weeks) did not reveal any beneficial effects: However, almost complete clearing of the lesions occurred within 3 weeks of intravenous administration of Foscarnet (50 mg/kg body wt., 3 x daily). No relapse was seen in a follow-up period of 4 months. HSV type II was isolated by culture from the erosive lesions before treatment, but no virus was found 1 week after application of Foscarnet. The unusual chronic refractory course of a severe HSV type II infection in AIDS suggests the presence of an acyclovir-resistant HSV strain in this case. This is the first observation indicating acyclovir-resistance in the Federal Republic of Germany and a warning against the unlimited use of acyclovir in AIDS patients. Foscarnet may be beneficial in some of these cases.
Bratzke
B
B
Universitäts-Hautklinik und Poliklinik, Klinikum Steglitz, Freien Universität Berlin.
Orfanos
C E
CE
Stavermann
T
T
Ehlers
G
G
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D000212:Acyclovir / Q000008:administration & dosage*; D000328:Adult; D000998:Antiviral Agents; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D017245:Foscarnet; D006558:Herpes Genitalis / Q000188:drug therapy*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D009894:Opportunistic Infections / Q000188:drug therapy*; D010746:Phosphonoacetic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011349:Proctitis / Q000188:drug therapy*
D000998:Antiviral Agents; D017245:Foscarnet; D010746:Phosphonoacetic Acid; D000212:Acyclovir
Chronisch-erosiver, therapierefraktärer perianaler Herpes (Typ II) mit Herpes-Proktitis bei AIDS.