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  • Title: Resistant herpes simplex virus type 1 infection: an emerging concern after allogeneic stem cell transplantation.
    Author: Chen Y, Scieux C, Garrait V, Socié G, Rocha V, Molina JM, Thouvenot D, Morfin F, Hocqueloux L, Garderet L, Espérou H, Sélimi F, Devergie A, Leleu G, Aymard M, Morinet F, Gluckman E, Ribaud P.
    Journal: Clin Infect Dis; 2000 Oct; 31(4):927-35. PubMed ID: 11049772.
    Abstract:
    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.
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