Treatment of Mucocutaneous Herpes Simplex Virus Infections Unresponsive to Acyclovir With Topical Foscarnet Cream in AIDS Patients: A Phase I/II Study

J Acquir Immune Defic Syndr. 1999 Aug 1;21(4):301-6. doi: 10.1097/00126334-199908010-00007.


The efficacy and toxicity of foscarnet cream for the treatment of mucocutaneous herpes simplex virus lesions or lesions that were clinically unresponsive to systemic acyclovir treatment (median, 30.5 days) in AIDS patients were studied in a phase I/II, open-label, nonrandomized multicenter trial. In the study, 20 patients with advanced stages of AIDS were treated with foscarnet 1% cream five times a day for a mean duration of 34.5 days. Response of index lesions (n = 20) was judged to be completely healed (8 lesions), excellent (4 lesions), or good (1 lesion) in 65% of lesions. The median time to first negative herpes simplex virus culture of index lesion was 8 days. Among 15 patients with pain at baseline, 11 had complete resolution of pain and 2 had at least a 50% reduction. Clinical adverse events included skin ulceration (4 patients), application site reactions (3 patients), fever (3 patients), and headache (3 patients). Five (25%) patients developed new lesions due to herpes simplex virus at sites other than those being treated topically while enrolled in the study. Topical foscarnet 1% cream appears to be a safe and effective treatment for acyclovir-unresponsive mucocutaneous herpes simplex virus infection in AIDS patients.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase I
  • Clinical Trial, Phase II
  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy*
  • Acyclovir / therapeutic use
  • Administration, Topical
  • Adult
  • Antiviral Agents / administration & dosage*
  • Antiviral Agents / adverse effects
  • Drug Eruptions / etiology
  • Drug Resistance, Microbial
  • Female
  • Foscarnet / administration & dosage*
  • Foscarnet / adverse effects
  • Herpes Simplex / complications*
  • Herpes Simplex / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Safety
  • Skin Ulcer / chemically induced


  • Antiviral Agents
  • Foscarnet
  • Acyclovir