[Acyclovir-resistance zona in a immunocompromised HIV seronegative patient].
BACKGROUND
Resistance to antiviral therapy is getting actually more frequent. Immunocompromised host are more concerned with this problem.


METHODS
We present a case of disseminated zoster resisting to acyclovir (ACV) therapy, but healing with foscarnet in a man treated with chemotherapy for lymphoma and seronegative for HIV. CI50 of VZV strain was 48 microM for ACV, which was 2.8 times higher than value of the reference OKA strain tested simultaneously, which confirmed the resistance for ACV.


CONCLUSIONS
Immunocompromised patients often present varicella zoster virus (VZV) infection. They usually heal in response to ACV therapy, but some HIV infected patients have already presented with resistant strains of VZV. This case is the first described in a non-HIV infected patient. Foscarnet therapy resulted twice in complete healing because of its direct activity on viral DNA polymerase, so it is efficaceous therapy for patients with thymidine-kinase-deficient ACV-resistant VZV infection.
Lesueur
A
A
Service de médecine interne 2, Hôpital Cochin, Paris.
Fillet
A M
AM
Bouscary
D
D
Ginsburg
C
C
Palmer
P
P
Chaine
B
B
Salmon-Ceron
D
D
Dreyfus
F
F
Huraux
J M
JM
Sicard
D
D
D000212:Acyclovir; D000998:Antiviral Agents; D004352:Drug Resistance, Microbial; D017245:Foscarnet / Q000627:therapeutic use; D018023:HIV Seronegativity; D006562:Herpes Zoster / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology*; D006801:Humans; D016867:Immunocompromised Host; D016399:Lymphoma, T-Cell / Q000150:complications / Q000276:immunology / Q000628:therapy*; D008297:Male; D008875:Middle Aged
D000998:Antiviral Agents; D017245:Foscarnet; D000212:Acyclovir