title: [Chronic erosive, therapy-resistant perianal herpes (type II) with herpes proctitis in AIDS].
abstract: 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.
authors.affiliation: Universitäts-Hautklinik und Poliklinik, Klinikum Steglitz, Freien Universität Berlin.
authors.forename: B
authors.initials: B
authors.lastname: Bratzke
authors.forename: C E
authors.initials: CE
authors.lastname: Orfanos
authors.forename: T
authors.initials: T
authors.lastname: Stavermann
authors.forename: G
authors.initials: G
authors.lastname: Ehlers
mesh_terms: 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*
chemical_list: D000998:Antiviral Agents; D017245:Foscarnet; D010746:Phosphonoacetic Acid; D000212:Acyclovir
vernacular_title: Chronisch-erosiver, therapierefraktärer perianaler Herpes (Typ II) mit Herpes-Proktitis bei AIDS.