Sherer R, Muller K, Blair S, Kathpalia S, Muldoon R, Hill E; International Conference on AIDS.
Int Conf AIDS. 1989 Jun 4-9; 5: 229 (abstract no. M.B.P.47).
Section of Retrovirology, Division of Infectious Disease, Cook County Hospital, Chicago, IL, USA
OBJECTIVE: Investigation of foscarnet as an alternate treatment of acyclovir-resistant herpes simplex virus II infection in AIDS. METHODS: A 28 y.o. black woman with HIV positivity for 2 months and 239 T4 cells presented with AIDS and severe vulvo-vaginal, perineal, and perirectal HSV II infection in November, 1988. The lesions extended from the mons veneris to the peri-anal area. There was no response to intravenous acyclovir 10 mg/kg TID and nafcillin for 14 days. The addition of zidovudine produced no additional benefit. A trial of ARA-A alone was discontinued after 5 days due to severe leukopenia and thrombocytopenia. AZT and acyclovir at 20 mg/kg/ml were resumed, with serum levels of 48 ugm/1 (peak) and 22 ugm/1 (trough), and no response was observed. HSV sensitivities to 3 drugs - acyclovir, ARA-A, & foscarnet - performed by automated colorimetric analysis are shown in table I: TABULAR DATA, SEE ABSTRACT VOLUME. Foscarnet was begun at 30mg/kg q 8h; the serum creatinine was 2.0.mg/ml. RESULTS: Symptoms improved immediately, and there was complete healing after 3 weeks. No renal or calcium metabolism abnormalities were observed. The patient is currently stable on AZT. CONCLUSIONS: Foscarnet is an effective alternate therapy for thymidine-kinase (TK) deficient or TK-altered acyclovir-resistant herpes simplex virus II in persons with AIDS. Early diagnosis by culture and sensitivity is essential. Further clinical trials of foscarnet are warranted.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Acyclovir
- Female
- Foscarnet
- Herpes Simplex
- Herpesvirus 2, Human
- Humans
- Simplexvirus
- Thymidine Kinase
- Vidarabine
- therapy
Other ID:
UI: 102176900
From Meeting Abstracts