title: Recurrence and resistance patterns of herpes simplex virus following cessation of > or = 6 years of chronic suppression with acyclovir. Acyclovir Study Group.
abstract: Questions have arisen regarding the clinical outcome and the possible selection of resistant virus when patients with genital herpes discontinue prolonged chronic acyclovir; 239 immunocompetent patients with a history of frequently recurring genital herpes who stopped successful suppressive therapy after 6 years were studied. Of the patients, 85.8% had at least one recurrence and 75% had at least two recurrences in the subsequent year (median time to first and second recurrence, 68 and 180 days, respectively). Herpes simplex virus isolates recovered from these patients had a median acyclovir sensitivity of 0.79 micrograms/mL and 4 (3.5%) were resistant (> or = 3 micrograms/mL). These values are comparable to those of pretherapy isolates and to reported values of isolates from acyclovir-naive patients. Also, paired pre- and posttherapy isolates from 13 patients showed no trend toward development of resistance. Thus, even after 6 years of acyclovir suppression, most patients continue to have recurrences, but the selection of resistant virus has not been observed.
authors.affiliation: Department of Medicine, Indiana University School of Medicine, Indianapolis 46202-5124.
authors.forename: K H
authors.initials: KH
authors.lastname: Fife
authors.forename: C S
authors.initials: CS
authors.lastname: Crumpacker
authors.forename: G J
authors.initials: GJ
authors.lastname: Mertz
authors.forename: E L
authors.initials: EL
authors.lastname: Hill
authors.forename: G S
authors.initials: GS
authors.lastname: Boone
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use*; D015331:Cohort Studies; D004352:Drug Resistance, Microbial; D005260:Female; D005500:Follow-Up Studies; D006561:Herpes Simplex / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D008297:Male; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D000212:Acyclovir