Resistance of herpes simplex virus infections to nucleoside analogues in HIV-infected patients

Clin Infect Dis. 2004 Nov 1:39 Suppl 5:S248-57. doi: 10.1086/422364.


Antiviral treatment of herpes simplex virus (HSV) infections with nucleoside analogues has been well established for >2 decades, but isolation of drug-resistant HSV from immunocompetent patients has remained infrequent (0.1%-0.7% of isolates) during this period. Even when drug-resistant HSV is isolated from an immunocompetent patient, this virus, with rare exceptions, is cleared normally without adverse clinical outcome. Although drug-resistant HSV is more commonly isolated from immunocompromised patients (4%-7% of isolates) and is more likely to be clinically significant, the prevalence of drug-resistant HSV even among these patients, has been stable over the past 2 decades. Despite this stable prevalence, disease due to drug-resistant HSV remains an important problem for many immunocompromised patients, including those with HIV infection. This article reviews the prevalence, pathogenesis, and implications of drug-resistant HSV infections in HIV-infected patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acyclovir / pharmacology
  • Acyclovir / therapeutic use
  • Animals
  • Antiviral Agents / pharmacology*
  • Antiviral Agents / therapeutic use
  • Drug Resistance, Viral / genetics
  • Drug Resistance, Viral / immunology
  • HIV Infections / complications*
  • HIV Infections / immunology
  • Herpes Simplex / complications
  • Herpes Simplex / drug therapy*
  • Herpes Simplex / immunology
  • Humans
  • Immunity, Cellular
  • Immunocompetence
  • Immunocompromised Host
  • Nucleosides / pharmacology*
  • Nucleosides / therapeutic use
  • Recurrence
  • Simplexvirus / drug effects*
  • Simplexvirus / genetics
  • Simplexvirus / pathogenicity


  • Antiviral Agents
  • Nucleosides
  • Acyclovir