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Successful therapy of progressive acyclovir-resistant orofacial herpes simplex with intravenous foscarnet in an AIDS patient.

Sall RK, Kauffman CL, Levy CS; International Conference on AIDS.

Int Conf AIDS. 1989 Jun 4-9; 5: 230 (abstract no. M.B.P.49).

Washington Hospital Center, and George Washington University Medical Center, Washington, D.C., USA

OBJECTIVE: To determine the clinical efficacy of intermittently administered intravenous foscarnet in the treatment of progressive acyclovir-resistant herpes simplex virus infection. METHOD: A 31-year-old homosexual white male with a history of AIDS post pneumocystis pneumonia developed a type 2 hermetic lesion on his left upper lip. The lesion resolved initially with oral acyclovir but recurred several months later and progressed to involve the majority of the patient's face despite multiple courses of oral and intravenous acyclovir. Antiviral susceptibilities were obtained for this isolate. RESULTS: Using a VERO tissue culture and plaque reduction assay, the virus was shown to be resistant to acyclovir in-vitro, but susceptible to vidarabine and foscarnet. Despite two weeks of intravenous vidarabine the lesion failed to respond. Therapy was changed to intravenous foscarnet (40 mg/kg every eight hours). After a three week course of treatment the lesion had completely re-epithelialized except for a residual peripheral crust. However, the lesion recurred once foscarnet was discontinued and herpes simplex was again cultured. CONCLUSION: Intravenous foscarnet has efficacy in the treatment of clinically significant acyclovir-resistant herpes simplex infection, but chronic suppressive therapy may be required.

Publication Types:
  • Meeting Abstracts
Keywords:
  • Acquired Immunodeficiency Syndrome
  • Acyclovir
  • Antiviral Agents
  • Foscarnet
  • Herpes Simplex
  • Humans
  • Male
  • Vidarabine
  • therapy
Other ID:
  • 00101289
UI: 102176902

From Meeting Abstracts




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