Dual infection with polyomavirus BK and acyclovir-resistant herpes simplex virus successfully treated with cidofovir in a bone marrow transplant recipient

Transpl Infect Dis. 2007 Jun;9(2):126-31. doi: 10.1111/j.1399-3062.2006.00186.x.

Abstract

A hematopoietic stem cell transplant recipient developed a mucosal herpes simplex virus-1 (HSV-1) infection while under acyclovir (ACV) treatment (HSV was later shown to be resistant to ACV). Concomitantly, the patient presented a hemorrhagic cystitis (HC) due to polyomavirus BK, for which intravenous cidofovir (CDV) was prescribed. The patient benefited from the broad-spectrum anti-DNA virus activity of CDV, and not only the HC resolved without signs of nephrotoxicity but also the HSV-1 lesions disappeared. This is the first report describing the effect of CDV on 2 simultaneous and unrelated DNA viral infections in an immunosuppressed transplant recipient. In addition, we describe here that this HSV-1 isolate possesses a unique phenotype and genotype.

Publication types

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

MeSH terms

  • Acyclovir / therapeutic use*
  • Adolescent
  • Antiviral Agents / therapeutic use*
  • BK Virus*
  • Bone Marrow Transplantation / adverse effects*
  • Cidofovir
  • Cytosine / analogs & derivatives*
  • Cytosine / therapeutic use
  • Drug Resistance, Viral
  • Female
  • Herpes Simplex / complications
  • Herpes Simplex / drug therapy*
  • Herpesvirus 1, Human / isolation & purification*
  • Humans
  • Organophosphonates / therapeutic use*
  • Polyomavirus Infections / complications
  • Polyomavirus Infections / drug therapy*
  • Tumor Virus Infections / complications
  • Tumor Virus Infections / drug therapy*

Substances

  • Antiviral Agents
  • Organophosphonates
  • Cytosine
  • Cidofovir
  • Acyclovir