Frequency and significance of acyclovir-resistant herpes simplex virus isolated from marrow transplant patients receiving multiple courses of treatment with acyclovir.
Frequency and significance of acyclovir-resistant herpes simplex virus isolated from marrow transplant patients receiving multiple courses of treatment with acyclovir.
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DOI：
10.1093/infdis/148.6.1077
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发表时间：
1983-12
期刊：
影响因子：
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通讯作者：
J. Wade;C. Mclaren;J. Meyers
中科院分区：
文献类型：
--
作者：
J. Wade;C. Mclaren;J. Meyers
对52例接受无环鸟苷治疗单纯疱疹病毒感染的骨髓移植患者的病毒分离物进行了体外药敏试验。在第一、第二、第三和第四次复发期间获得的病毒的中位敏感性相似，第一和第二个疗程的病毒阳性的中位持续时间（3天）相同。然而，在初始治疗过程中，从52例患者中的1例（1.9%）和22例第二次复发治疗的患者中的2例（9.1%）中回收了阿昔洛韦耐药病毒。所有三种菌株的胸苷激酶活性均降低。无一例发生严重感染。另外三名患者在治疗期间保持病毒阳性，尽管对阿昔洛韦敏感的病毒分离。虽然继续监测是必要的，这些数据可能表明，阿昔洛韦耐药病毒不会是免疫抑制患者的重大临床疾病的原因。此外，并非所有的“耐药”（定义为治疗期间病毒的持续存在）都是由体外对阿昔洛韦耐药的病毒株引起的。
The sensitivity to acyclovir of virus isolates from 52 consecutive marrow transplant patients who received acyclovir for herpes simplex virus infections was studied in vitro. The median sensitivity of viruses obtained during first, second, third, and fourth recurrences was similar, and the median duration of virus positivity (three days) was the same for first and second treatment courses. However, acyclovir-resistant virus was recovered from one of 52 patients (1.9%) during the initial treatment course and from two of 22 patients (9.1%) treated for second recurrences. All three strains had reduced thymidine kinase activity. None caused severe infection. Three other patients remained virus-positive during treatment despite the isolation of acyclovir-sensitive virus. Although continuing surveillance is necessary, these data may suggest that acyclovir-resistant virus will not be the cause of significant clinical illness among immunosuppressed patients. In addition, not all instances of "resistance," defined by the persistence of virus during treatment, will be caused by virus strains that are resistant to acyclovir in vitro.