title: Novel resistance-associated mutations of thymidine kinase and DNA polymerase genes of herpes simplex virus type 1 and type 2.
abstract: BACKGROUND
  Studies to verify correlations between phenotypes and genotypes of herpes simplex virus (HSV) are an important tool to establish a database of resistance-associated mutations.
  
  
  METHODS
  In this study, 32 acyclovir (ACV)-resistant clinical HSV-1 and 4 ACV-resistant clinical HSV-2 isolates were examined in parallel by both phenotypic and genotypic resistance testing. Additionally, five non-viable HSV-1 strains and two non-viable HSV-2 strains with clinical resistance were included in genotypic resistance analysis.
  
  
  RESULTS
  All ACV-resistant HSV isolates showed cross-resistance to brivudin and penciclovir, and were sensitive to foscarnet and cidofovir. Acyclovir resistance was assigned to frameshift and single non-synonymous mutations of the thymidine kinase (TK) gene in 32 out of 37 HSV-1 strains and in 4 out of 6 HSV-2 strains. In three HSV-1 isolates, there were resistance-associated amino acid substitutions of the DNA polymerase (pol). Six substitutions in the TK and two in the DNA pol gene could not be attributed without doubt to either ACV resistance or natural gene polymorphism. Altogether, 10 resistance-related mutations in the TK and 1 in the DNA pol gene have not been reported previously.
  
  
  CONCLUSIONS
  The novel non-synonymous mutations found in this study enrich the knowledge about the genetic alterations of TK and DNA pol genes in ACV-resistant clinical HSV strains. Together with data from the literature, the findings justify the generation of a HSV database that contains resistance mutations associated with ACV resistance phenotype.
authors.affiliation: Institute of Virology and Antiviral Therapy, German Reference Laboratory for HSV and VZV, Jena University Clinic, Jena, Germany. Andreas.Sauerbrei@med.uni-jena.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Sauerbrei
authors.forename: Kathrin
authors.initials: K
authors.lastname: Bohn
authors.forename: Albert
authors.initials: A
authors.lastname: Heim
authors.forename: Jörg
authors.initials: J
authors.lastname: Hofmann
authors.forename: Benedikt
authors.initials: B
authors.lastname: Weissbrich
authors.forename: Paul
authors.initials: P
authors.lastname: Schnitzler
authors.forename: Dieter
authors.initials: D
authors.lastname: Hoffmann
authors.forename: Roland
authors.initials: R
authors.lastname: Zell
authors.forename: Gerhard
authors.initials: G
authors.lastname: Jahn
authors.forename: Peter
authors.initials: P
authors.lastname: Wutzler
authors.forename: Klaus
authors.initials: K
authors.lastname: Hamprecht
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001973:Bromodeoxyuridine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D000077404:Cidofovir; D003596:Cytosine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D004259:DNA-Directed DNA Polymerase / Q000235:genetics*; D024882:Drug Resistance, Viral / Q000235:genetics*; D005260:Female; D017245:Foscarnet / Q000008:administration & dosage / Q000627:therapeutic use; D005838:Genotype; D006147:Guanine; D006561:Herpes Simplex / Q000188:drug therapy* / Q000821:virology; D018259:Herpesvirus 1, Human / Q000201:enzymology / Q000235:genetics* / Q000302:isolation & purification; D018258:Herpesvirus 2, Human / Q000201:enzymology / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009154:Mutation; D063065:Organophosphonates / Q000008:administration & dosage / Q000627:therapeutic use; D017422:Sequence Analysis, DNA; D013937:Thymidine Kinase / Q000235:genetics*; D014764:Viral Proteins / Q000235:genetics
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D014764:Viral Proteins; C020235:brivudine; C053539:penciclovir; D017245:Foscarnet; D006147:Guanine; D003596:Cytosine; D013937:Thymidine Kinase; D004259:DNA-Directed DNA Polymerase; D001973:Bromodeoxyuridine; D000077404:Cidofovir; D000212:Acyclovir