Successful clearance of cutaneous acyclovir-resistant, foscarnet-refractory herpes virus lesions with topical cidofovir in an allogeneic hematopoietic stem cell transplant patient.
Cidofovir is a deoxycytidine monophosphate analog with broad spectrum activity against various deoxyribonucleic acid viruses. Cidofovir is marketed as an injectable for intravenous use; however, there is a topical cidofovir formulation utilized for viral dermatologic infections. Here, we present a case of a successful clearance of a perianal acyclovir resistant and foscarnet refractory herpes simplex virus (HSV1) ulcer in a 34 year-old woman who had undergone allogeneic hematopoietic stem cell transplantation. After 1 week of therapy with cidofovir gel, the patient's ulcer was clinically improved, and the lesion was negative for herpes simplex virus transcripts by real-time polymerase chain reaction testing. The wound remained herpes simplex virus negative by real-time polymerase chain reaction on repeat testing 1 week later. Based on this and other reports in HIV/AIDS patients, we believe that cidofovir gel has utility in the management of cutaneous, acyclovir-resistant HSV infections.
Department of Pharmacy, University of North Carolina Hospitals and Clinics, Chapel Hill, NC 27514, USA. bmuluneh@unch.unc.edu
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Muluneh
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Dean
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Armistead
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Khan
D000212:Acyclovir / Q000008:administration & dosage / Q000494:pharmacology; D000287:Administration, Topical; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000077404:Cidofovir; D003596:Cytosine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D024882:Drug Resistance, Viral; D005260:Female; D017245:Foscarnet / Q000494:pharmacology; D005782:Gels; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006561:Herpes Simplex / Q000188:drug therapy* / Q000821:virology; D018259:Herpesvirus 1, Human / Q000302:isolation & purification; D006801:Humans; D063065:Organophosphonates / Q000008:administration & dosage / Q000627:therapeutic use*; D060888:Real-Time Polymerase Chain Reaction; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome
D000998:Antiviral Agents; D005782:Gels; D063065:Organophosphonates; D017245:Foscarnet; D003596:Cytosine; D000077404:Cidofovir; D000212:Acyclovir