Acyclovir-Resistant Herpes Simplex Virus Infection

rgb(140,81,165)
Last updated February 20, 2015
Case Authors: 
David H. Spach, MD's picture
Real name: 
David H. Spach, MD
Professor of Medicine
Division of Infectious Diseases
Clinical Director, Mountain West AIDS Education and Training Center
University of Washington School of Medicine
Disclosures: 
None
Learning Objectives: 
  1. Describe the basic mechanism of action of acyclovir (Zovirax).
  2. Discuss best treatment options for HIV-infected patients with acyclovir-resistant herpes simplex virus infections.

Display Group

References
  1. Balfour HH Jr. Antiviral drugs. N Engl J Med. 1999;340:1255-68.
  2. Deval J. Antimicrobial strategies: inhibition of viral polymerases by 3'-hydroxyl nucleosides. Drugs. 2009;69:151-66.
  3. Piret J, Boivin G. Resistance of herpes simplex viruses to nucleoside analogues: mechanisms, prevalence, and management. Antimicrob Agents Chemother. 2010 ;55:459-72.
  4. Gilbert C, Bestman-Smith J, Boivin G. Resistance of herpesviruses to antiviral drugs: clinical impacts and molecular mechanisms. Drug Resist Updat. 2002;5:88-114.
  5. Levin MJ, Bacon TH, Leary JJ. Resistance of herpes simplex virus infections to nucleoside analogues in HIV-infected patients. Clin Infect Dis. 2004;39 Suppl 5:S248-57.
  6. Burrel S, Deback C, Agut H, Boutolleau D. Genotypic characterization of UL23 thymidine kinase and UL30 DNA polymerase of clinical isolates of herpes simplex virus: natural polymorphism and mutations associated with resistance to antivirals. Antimicrob Agents Chemother. 2010;54:4833-42.
  7. Pottage JC Jr, Kessler HA. Herpes simplex virus resistance to acyclovir: clinical relevance. Infect Agents Dis. 1995;4:115-24.
  8. Crumpacker CS, Schnipper LE, Marlowe SI, Kowalsky PN, Hershey BJ, Levin MJ. Resistance to antiviral drugs of herpes simplex virus isolated from a patient treated with acyclovir. N Engl J Med. 1982;306:343-6.
  9. Reyes M, Shaik NS, Graber JM, et al. Acyclovir-resistant genital herpes among persons attending sexually transmitted disease and human immunodeficiency virus clinics. Arch Intern Med. 2003;163:76-80.
  10. Erlich KS, Mills J, Chatis P, et al. Acyclovir-resistant herpes simplex virus infections in patients with the acquired immunodeficiency syndrome. N Engl J Med. 1989;320:293-6.
  11. Gateley A, Gander RM, Johnson PC, Kit S, Otsuka H, Kohl S. Herpes simplex virus type 2 meningoencephalitis resistant to acyclovir in a patient with AIDS. J Infect Dis. 1990;161:711-5.
  12. Field HJ. Herpes simplex virus antiviral drug resistance--current trends and future prospects. J Clin Virol. 2001;21:261-9.
  13. Marks GL, Nolan PE, Erlich KS, Ellis MN. Mucocutaneous dissemination of acyclovir-resistant herpes simplex virus in a patient with AIDS. Rev Infect Dis. 1989;11:474-6.
  14. Safrin S, Assaykeen T, Follansbee S, Mills J. Foscarnet therapy for acyclovir-resistant mucocutaneous herpes simplex virus infection in 26 AIDS patients: preliminary data. J Infect Dis. 1990;161:1078-84.
  15. Safrin S, Crumpacker C, Chatis P, et al. A controlled trial comparing foscarnet with vidarabine for acyclovir-resistant mucocutaneous herpes simplex in the acquired immunodeficiency syndrome. The AIDS Clinical Trials Group. N Engl J Med. 1991;325:551-5.
  16. Erlich KS, Jacobson MA, Koehler JE, et al. Foscarnet therapy for severe acyclovir-resistant herpes simplex virus type-2 infections in patients with the acquired immunodeficiency syndrome (AIDS). An uncontrolled trial. Ann Intern Med. 1989;110:710-3.
  17. Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. Non-CMV herpes: herpes simplex virus. May 7, 2013.
  18. Snoeck R, Andrei G, De Clercq E, et al. A new topical treatment for resistant herpes simplex infections. N Engl J Med. 1993;329:968-9.
  19. Lalezari J, Schacker T, Feinberg J, et al. A randomized, double-blind, placebo-controlled trial of cidofovir gel for the treatment of acyclovir-unresponsive mucocutaneous herpes simplex virus infection in patients with AIDS. J Infect Dis. 1997;176:892-8.
  20. Lalezari JP, Drew WL, Glutzer E, et al. Treatment with intravenous (S)-1-[3-hydroxy-2-(phosphonylmethoxy)propyl]-cytosine of acyclovir-resistant mucocutaneous infection with herpes simplex virus in a patient with AIDS. J Infect Dis. 1994;170:570-2.
  21. Kessler HA, Hurwitz S, Farthing C, et al. Pilot study of topical trifluridine for the treatment of acyclovir-resistant mucocutaneous herpes simplex disease in patients with AIDS (ACTG 172). AIDS Clinical Trials Group. J Acquir Immune Defic Syndr Hum Retrovirol. 1996;12:147-52.
  22. Gilbert J, Drehs MM, Weinberg JM. Topical imiquimod for acyclovir-unresponsive herpes simplex virus 2 infection. Arch Dermatol. 2001;137:1015-7.
  23. Martinez V, Molina JM, Scieux C, Ribaud P, Morfin F. Topical imiquimod for recurrent acyclovir-resistant HSV infection. Am J Med. 2006;119:e9-11.