scholarly journals Herpes Simplex Virus Resistance to Acyclovir and Penciclovir after Two Decades of Antiviral Therapy

2003 ◽  
Vol 16 (1) ◽  
pp. 114-128 ◽  
Author(s):  
Teresa H. Bacon ◽  
Myron J. Levin ◽  
Jeffry J. Leary ◽  
Robert T. Sarisky ◽  
David Sutton
Keyword(s):  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Antiviral Therapy ◽  
Virus Resistance ◽  
Host Factors ◽  
Nucleoside Analogues ◽  
Resistant Virus ◽  
The Past ◽  
Simplex Virus ◽  
Virus Isolates

SUMMARY Acyclovir, penciclovir, and their prodrugs have been widely used during the past two decades for the treatment of herpesvirus infections. In spite of the distribution of over 2.3 × 106 kg of these nucleoside analogues, the prevalence of acyclovir resistance in herpes simplex virus isolates from immunocompetent hosts has remained stable at approximately 0.3%. In immuncompromised patients, in whom the risk for developing resistance is much greater, the prevalence of resistant virus has also remained stable but at a higher level, typically 4 to 7%. These observations are examined in the light of characteristics of the virus, the drugs, and host factors.

Surveillance of herpes simplex virus resistance to antivirals: A 4-year survey

2013 ◽  
Vol 100 (2) ◽  
pp. 365-372 ◽  
Author(s):  
Sonia Burrel ◽  
Catherine Aime ◽  
Laurence Hermet ◽  
Zaïna Ait-Arkoub ◽  
Henri Agut ◽  
...  
Keyword(s):  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Virus Resistance ◽  
Simplex Virus

scholarly journals Identification of ribonucleotide reductase mutation causing temperature‐sensitivity of herpes simplex virus isolates from whitlow by deep sequencing

2015 ◽  
Vol 3 (6) ◽  
pp. 461-467
Author(s):  
Tohru Daikoku ◽  
Yukari Oyama ◽  
Misako Yajima ◽  
Tsuyoshi Sekizuka ◽  
Makoto Kuroda ◽  
...  
Keyword(s):  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Deep Sequencing ◽  
Temperature Sensitivity ◽  
Ribonucleotide Reductase ◽  
Simplex Virus ◽  
Virus Isolates

Herpes Simplex Virus Encephalitis (HSE) after Allogeneic Hematopoietic Stem Cell Transplatation (alloHSCT): Impact of Early Diagnosis and Treatment on Outcome.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 5002-5002
Author(s):  
Irene M. Cavattoni ◽  
Enrico Morello ◽  
Marco Casini ◽  
Norma Decaminada ◽  
Leonardo Pagani ◽  
...  
Keyword(s):  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Early Diagnosis ◽  
Antiviral Therapy ◽  
Brain Mri ◽  
Morbidity And Mortality ◽  
Diagnosis And Treatment ◽  
Hematopoietic Stem ◽  
Simplex Virus ◽  
Hsv 1

Abstract Introduction: HSE is a rare but very severe central nervous system (CNS) infection caused by Herpes simplex virus type 1 (HSV-1) in almost all cases, and characterized by a high morbidity and mortality rate (97 and 70% without therapy, respectively). Immunosuppression, is a known risk factor and both early diagnosis and treatment are critical points for a good outcome in this setting. Hereby we reported two cases of HSE after alloHSCT. Patients: A 35-year-old female with relapsed multiple myeloma, underwent alloHSCT from a matched unrelated donor (MUD). On day +120, she developed an acute onset of fever, drowsiness, and generalized seizures. After 48 hours, a rapid deterioration of neurological symtoms was observed and the brain MRI showed acute encephalitis with high signal intensity in the temporal lobe and insula cortex (fig. 1). The HSV-PCR from cerebrospinal fluid (CSF) was positive for HSV-1, and a treatment with acyclovir 30 mg/Kg/d was initiated, 72 hours after the hospital admission. A 66 year-old male with high risk AML underwent MUD alloHSCT. Thirteen months after transplant, an acute sialoadenitis and HSV-1 gengivostomatitis occurred, followed by fever and focal seizures. Since typical lesions of HSE were demonstrated by brain MRI, antiviral therapy with aciclovir was promptly administrated, within 24 hours from the symptoms onset. HSV-PCR on CSF was performed two days later, and proved negative, probably due to ongoing antiviral therapy and delay to CSF analysis. After 21 days of antiviral treatment, both patients recovered from the acute phase, but in the first case we observed serious neurological sequelae that required prolonged unsuccessful cognitive rehabilitation. The second patient didn’t experienced significant residual neurological impairment, and didn’t require any other supportive measure. Both pts have had chronic GVHD and received prolonged courses of immunosuppressive therapy; they experienced recurrent CMV infections thereafter, and were under high dose foscarnet therapy at the diagnosis of HSE, but without HSV prophylaxis. Conclusion: the time from diagnosis-to-antiviral therapy, and the level of consciousness at the onset of symptoms are two major risk factors impairing morbidity and mortality of HSE. In heavily immunosuppressed alloHSCT pts with initial focal neurological signs, an early and aggressive diagnostic approach should be performed as emergency, even if they are under anti-CMV therapy; prompt acyclovir administration is therefore warranted in these settings, in order to prevent severe disability or mortality. Figure Figure

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