Journal Article

Acyclovir-Resistant Herpes Zoster in Human Immunodeficiency Virus-Infected Patients: Results of Foscarnet Therapy

Guillaume Breton, Anne-Marie Fillet, Christine Katlama, François Bricaire and Eric Caumes

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 6, pages 1525-1527
Published in print December 1998 | ISSN: 1058-4838
Published online December 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515045
Acyclovir-Resistant Herpes Zoster in Human Immunodeficiency Virus-Infected Patients: Results of Foscarnet Therapy

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We retrospectively studied 18 consecutive cases of acyclovir-resistant zoster. All the patients had chronic skin lesions that failed to heal despite treatment with intravenous acyclovir (30 mg/[kg×d]) in 15 cases and oral acyclovir (4 g/d) in three cases for >10 days. The mean CD4+ cell count was 20 × 106/L. The mean number of previous zoster episodes was 1.53. Fifteen of the 16 patients evaluable for previous acyclovir treatment had received the drug. Thirteen patients were treated with intravenous foscarnet (200 mg/[kg·d]) for a mean of 17.8 days. Complete healing was observed in 10 (77%) of the 13 treated patients. Zoster relapsed after cessation of foscarnet therapy in five of the 10 responding patients. The median time to relapse was 110 days. Four patients died of varicella-zoster virus-associated visceral complications. These results show that acyclovir-resistant zoster has a poor prognosis but responds well to foscarnet therapy.

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

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