title: Long-term follow-up of HIV-infected patients once diagnosed with acyclovir-resistant herpes simplex virus infection.
abstract: Acyclovir-resistant herpes simplex virus (HSV) infection is common in immunocompromised patients, but the course of such infection is little known. We describe the long-term follow-up of HIV-infected patients diagnosed once with acyclovir-resistant HSV infections. We retrospectively studied all HIV-infected patients between 2000 and 2010 diagnosed with virologically confirmed acyclovir-resistant HSV infection. Patients' socio-demographic and immunovirological characteristics were described. Response to foscarnet or cidofovir and recurrences were reported. Among 5295 HIV-infected patients, 13 (0.2%) were once diagnosed with an acyclovir-resistant HSV infection. Twelve patients were men, nine patients were of African origin. All patients reported previous acyclovir exposure and median CD4 count was 183 cells/mm(3) Ten patients presented exclusively with cutaneous lesions. Initially, 11 patients were treated with foscarnet and two with cidofovir. The median follow-up was 67 months (6-145). All patients recurred, 10 presenting at least one acyclovir-resistant HSV recurrence. The median number of acyclovir-resistant HSV recurrences per patient was 2 (0 - 5). Regarding the first and second recurrences, 7/13 (54%) and 5/11 (45%) HSV clinical isolates exhibited resistance to acyclovir, respectively. Acyclovir-resistant HSV infection prevalence was low in our cohort. The rate of acyclovir-resistant HSV episodes averaged 50% during the two first recurrences.
authors.affiliation: Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France INSERM UMR-S943 and University Pierre and Marie Curie, Paris, France sophie.seang@yahoo.fr.
authors.forename: Sophie
authors.initials: S
authors.lastname: Seang
authors.affiliation: UPMC Univ Paris, Paris, France Virology Department, Pitié-Salpêtrière University Hospital, Paris, France.
authors.forename: David
authors.initials: D
authors.lastname: Boutolleau
authors.affiliation: UPMC Univ Paris, Paris, France Virology Department, Pitié-Salpêtrière University Hospital, Paris, France.
authors.forename: Sonia
authors.initials: S
authors.lastname: Burrel
authors.affiliation: Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Regnier
authors.affiliation: Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France.
authors.forename: Loic
authors.initials: L
authors.lastname: Epelboin
authors.affiliation: Virology Department, Pitié-Salpêtrière University Hospital, Paris, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Voujon
authors.affiliation: Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France INSERM UMR-S943 and University Pierre and Marie Curie, Paris, France.
authors.forename: Marc-Antoine
authors.initials: MA
authors.lastname: Valantin
authors.affiliation: Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France INSERM UMR-S943 and University Pierre and Marie Curie, Paris, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Katlama
authors.affiliation: UPMC Univ Paris, Paris, France Virology Department, Pitié-Salpêtrière University Hospital, Paris, France.
authors.forename: Henri
authors.initials: H
authors.lastname: Agut
authors.affiliation: Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France INSERM UMR-S943 and University Pierre and Marie Curie, Paris, France UPMC Univ Paris, Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Caumes
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000188:drug therapy; D000212:Acyclovir / Q000008:administration & dosage* / Q000009:adverse effects; 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; D005500:Follow-Up Studies; D017245:Foscarnet / Q000008:administration & dosage / Q000627:therapeutic use*; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006561:Herpes Simplex / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D017193:Skin Diseases, Viral / Q000150:complications / Q000188:drug therapy; D012883:Skin Ulcer / Q000188:drug therapy; D012959:Socioeconomic Factors; D013937:Thymidine Kinase / Q000037:antagonists & inhibitors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D017245:Foscarnet; D003596:Cytosine; D013937:Thymidine Kinase; D000077404:Cidofovir; D000212:Acyclovir
keywords: AIDS; HIV; HSV; Herpes simplex virus; acyclovir-resistant; foscarnet; imiquimod; sexually transmitted infection; thymidine kinase mutation