Management of acyclovir-resistant herpes simplex and varicella-zoster virus infections.
Persons with AIDS who have CD4+ counts < or = 100 and transplant patients, especially bone marrow allograft recipients, may experience clinically significant infections with acyclovir-resistant herpes simplex virus (HSV) or varicella-zoster virus (VZV). Patients who have received prior repeated acyclovir treatment appear to be at the highest risk of harboring acyclovir-resistant strains. Algorithms for the management of these infections were developed at a recent roundtable symposium. The consensus of the panelists was that treatment with foscarnet should be initiated within 7-10 days in patients suspected to have acyclovir-resistant HSV or VZV infections. Foscarnet therapy should be continued for at least 10 days or until lesions are completely healed.
Balfour
H H
HH
Department of Laboratory Medicine & Pathology, University of Minnesota Health Sciences Center, Minneapolis.
Benson
C
C
Braun
J
J
Cassens
B
B
Erice
A
A
Friedman-Kien
A
A
Klein
T
T
Polsky
B
B
Safrin
S
S
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000212:Acyclovir / Q000494:pharmacology* / Q000627:therapeutic use; D000328:Adult; D000465:Algorithms; D004352:Drug Resistance, Microbial; D005260:Female; D017245:Foscarnet / Q000627:therapeutic use*; D006561:Herpes Simplex / Q000188:drug therapy / Q000382:microbiology; D006562:Herpes Zoster / Q000188:drug therapy / Q000382:microbiology; D006566:Herpesviridae Infections / Q000188:drug therapy* / Q000382:microbiology; D014645:Herpesvirus 3, Human / Q000187:drug effects*; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D012008:Recurrence; D018139:Simplexvirus / Q000187:drug effects*; D014271:Trifluridine / Q000627:therapeutic use; D014740:Vidarabine / Q000627:therapeutic use
D017245:Foscarnet; D014740:Vidarabine; D014271:Trifluridine; D000212:Acyclovir