Acyclovir-Resistant Corneal HSV-1 Isolates from Patients with Herpetic Keratitis

• Published in: The Journal of infectious diseases Vol. 198; no. 5; pp. 659 - 663
• Main Authors: Duan, Rui, de Vries, Rory D., Osterhaus, Albert D. M. E., Remeijer, Lies, Verjans, Georges M. G. M.
• Format: Journal Article
• Language: English
• Published: United States The University of Chicago Press 01-09-2008
• Subjects: Acyclovir - pharmacology; Acyclovir - therapeutic use; Adult; Aged; Antiviral Agents - pharmacology; Antiviral Agents - therapeutic use; Cohort Studies; Cornea - virology; Drug Resistance, Multiple, Viral - genetics; Female; Foscarnet - pharmacology; Ganciclovir - pharmacology; Herpes simplex virus 1; Herpesvirus 1, Human - drug effects; Herpesvirus 1, Human - enzymology; Herpesvirus 1, Human - isolation & purification; Humans; Keratitis, Herpetic - drug therapy; Keratitis, Herpetic - virology; Male; Middle Aged; Prevalence; Thymidine Kinase - chemistry; Thymidine Kinase - genetics
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/590668

The prevalence and molecular characteristics of isolates from 173 immunocompetent patients with herpetic keratitis (HK) who were infected with acyclovir (ACV)-resistant (ACVR) corneal herpes simplex virus (HSV)-1 was determined. Isolates from 11 (6.4%) of the patients were ACVR, and 9 of these 11 patients were refractory to therapy with ACV; the ACVR isolates from 5 and 1 of these 9 patients were cross-resistant to gancyclovir and to both gancyclovir and foscarnet, respectively. Of the 11 ACVR isolates, 10 had, in the thymidine kinase gene, mutations that presumably conferred the ACVR phenotype. These data demonstrate a relatively high prevalence of corneal HSV-1 ACVR isolates in patients with HK, which emphasizes the need to monitor for ACV susceptibility in patients with HK who are refractory to therapy with ACV.