Journal Article

Resistant Herpes Simplex Virus Type 1 Infection: An Emerging Concern after Allogeneic Stem Cell Transplantation

Yolande Chen, Catherine Scieux, Valérie Garrait, Gérard Socié, Vanderson Rocha, Jean-Michel Molina, Danielle Thouvenot, Florence Morfin, Laurent Hocqueloux, Laurent Garderet, Hélène Espérou, Fadhéla Sélimi, Agnès Devergie, Ghislaine Leleu, Michèle Aymard, Frédéric Morinet, Eliane Gluckman and Patricia Ribaud

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 31, issue 4, pages 927-935
Published in print October 2000 | ISSN: 1058-4838
Published online October 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/314052
Resistant Herpes Simplex Virus Type 1 Infection: An Emerging Concern after Allogeneic Stem Cell Transplantation

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Fourteen cases of severe acyclovir-resistant herpes simplex virus type 1 (HSV-1) infection, 7 of which showed resistance to foscarnet, were diagnosed among 196 allogeneic stem cell transplant recipients within a 29-month period. Recipients of unrelated stem cell transplants were at higher risk. All patients received foscarnet; 8 subsequently received cidofovir. Strains were initially foscarnet-resistant in 3 patients and secondarily so in 4 patients. In vitro resistance to acyclovir or foscarnet was associated with clinical failure of these drugs; however, in vitro susceptibility to foscarnet was associated with complete response in only 5 of 7 patients. No strain from any of the 7 patients was resistant in vitro to cidofovir; however, only 3 of 7 patients achieved complete response. Therefore, acyclovir- and/or foscarnet-resistant HSV-1 infections after allogeneic stem cell transplantation have become a concern; current strategies need to be reassessed and new strategies must be evaluated in this setting.

Journal Article.  5499 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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