Tan C, Hardy D, Chafey S, Karol C; International Conference on AIDS.
Int Conf AIDS. 1990 Jun 20-23; 6: 233 (abstract no. Th.B.447).
UCLA School of Medicine, Los Angeles, CA, USA
OBJECTIVE: To determine the safety, clinical and virologic efficacy and maintenance therapy (Rx) requirements of PFA for ACV-R HSV infections in AIDS patients (pts). METHODS: Six AIDS pts with persistent HSV infections (5-perianal, 1-facial) clinically and virologically well-documented to be resistant to ACV (ID50 greater than 50 micromolar) were randomized by IV PFA induction (40 mg/kg q 8h X 14-35d) with (N=3) or without (N=3) IV PFA maintenance (40 mg/kg/d). Pts developing recurrence of lesions following initial induction or 10 wk maintenance were re-induced/re-maintained with PFA Rx. RESULTS: Cessation of HSV shedding was documented after 3-7 days of PFA Rx in all patients. Significant or complete crusting and healing of lesions was seen in all pts following induction Rx (14d, N=3; 21d, N=2; 35d, N=1). HSV lesions recurred within 1-3 wks in all 3 pts not receiving maintenance Rx. PFA maintenance Rx was effective in suppressing clinical recurrence of HSV lesions for up to 10 wks; recurrences occurred in all pts when maintenance Rx was discontinued. One pt required 60 mg/kg/d for effective maintenance Rx. Re-induction courses have been successful in all pts treated: 2 pts have been re-induced up to 4 times. One pt developed severe renal insufficiency after prolonged induction therapy; no other significant renal toxicity has been seen. Minor, reversible fluctuations in serum calcium, magnesium and phosphorus have been witnessed. No significant neurologic toxicities have been observed. On pt has developed a persistent penile lesion. CONCLUSION: PFA induction and maintenance Rx is safe and effective for ACV-R HSV infections. Maintenance PFA Rx is effective in the continued suppression of HSV and support of healed lesions. Re-induction Rx following recurrence is successful to suppress recurrent lesions. No clear evidence of PFA-resistant HSV infection has been seen to develop.
Publication Types:
Keywords:
- AIDS-Related Opportunistic Infections
- Acquired Immunodeficiency Syndrome
- Acyclovir
- Foscarnet
- Herpes Simplex
- Humans
- Infection
- Opportunistic Infections
- Simplexvirus
- therapy
Other ID:
UI: 102182024
From Meeting Abstracts