Improvement of refractory acyclovir-resistant herpes simplex virus type 1 infection by continuous acyclovir administration

J Infect Chemother. 2019 Jan;25(1):65-67. doi: 10.1016/j.jiac.2018.07.004. Epub 2018 Jul 29.

Abstract

Resistant herpes simplex virus type 1 (HSV-1) infection is sometimes fatal for immunocompromised patients. Here, we report 10-year-old girl receiving hematopoietic stem cell transplantation developed refractory HSV-1 infection, which was persisted to intermittent acyclovir (ACV) or foscarnet (FOS) administrations but was improved by continuous ACV administration. The isolates from the lesion were identified with low susceptibilities to ACV and FOS by plaque reduction assay due to DNA pol gene mutation. Continuous ACV administration overcomes the efficacy of intermittent administration and could be the best option to treat severe HSV-1 infectious patients.

Keywords: Allogeneic hematopoietic transplantation; Continuous acyclovir administration; DNA polymerase; Herpes simplex virus 1; Virological resistance.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / administration & dosage*
  • Acyclovir / therapeutic use
  • Antiviral Agents / administration & dosage*
  • Antiviral Agents / therapeutic use
  • Child
  • Drug Resistance, Viral*
  • Female
  • Foscarnet / administration & dosage
  • Foscarnet / therapeutic use
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Herpes Simplex / complications
  • Herpes Simplex / diagnosis
  • Herpes Simplex / drug therapy*
  • Herpes Simplex / virology
  • Herpesvirus 1, Human / drug effects*
  • Herpesvirus 1, Human / genetics
  • Herpesvirus 1, Human / isolation & purification
  • Humans
  • Infusions, Intravenous
  • Leukemia, Monocytic, Acute / complications
  • Leukemia, Monocytic, Acute / drug therapy*
  • Leukemia, Monocytic, Acute / virology
  • Lip / pathology
  • Lip / virology
  • Mutation

Substances

  • Antiviral Agents
  • Foscarnet
  • Acyclovir