Breton G, Caumes E, Fillet AM, Lecomte C, Katlama C, Bricaire F; International Conference on AIDS.

Int Conf AIDS. 1998; 12: 574 (abstract no. 32269).

Service De Maladies Inffectueuses, Hospital Pitie-Salpetriere, Paris, France.

OBJECTIVE: To report the epidemiological and clinical features of acyclovir-resistant herpes zoster and to evaluate the efficacy of foscarnet. DESIGN AND METHODS: Retrospective study of all consecutive cases of acyclovir-resistant herpes zoster. Herpes zoster was confirmed by isolation of VZV in culture. Acyclovir resistance was defined as a failure to heal despite intravenous (30 mg/kg/day) or oral (4 g.day) acyclovir treatment. Patients were treated with foscarnet (200 mg/kg/day). RESULTS: Eighteen patients were included; 14 had AIDS. The mean CD4+ cell count was 20 x 106/L. The mean number of previous zoster episodes was 1.53 in the 15 patients with a history of zoster. Fifteen of the 16 patients evaluable for previous acyclovir treatment had received the drug. Skin lesions were crusted or verrucous papules in 17 cases (94%) and occurred a mean of 8.7 weeks (2-24 weeks) previously. Thirteen patients were treated with intravenous foscarnet (200 mg/kg/day) for a mean of 17.8 days (range, 12 to 30 days). Complete healing was observed in 10 (77%) of the 13 treated patients. The treatment was well tolerated, except by one patient. Zoster relapsed after foscarnet cessation in 5 (50%) of the 10 responding patients. The median time to relapse was 110 days (range, 30 to 360 days). Of the 16 patients available for long-term follow-up, 4 (25%) died of VZV-associated visceral complications after a mean of 9.8 months, and 10 died of other infections after a mean of 5.4 months. The onset of acyclovir-resistant herpes zoster is associated with severe immunodepression, reccurences of zoster and previous acyclovir treatment. Such infection has poor long term pragnosis but respond well to foscarnet at a daily dose of 200 mg/kg.

Publication Types:

• Meeting Abstracts

Keywords:

• AIDS Vaccines
• Acquired Immunodeficiency Syndrome
• Acyclovir
• Foscarnet
• HIV Infections
• HIV Seropositivity
• Herpes Zoster
• Herpesvirus 3, Human
• Humans
• Retrospective Studies
• therapy

Other ID:

• 98398560

UI: 102229784

From Meeting Abstracts