RESISTANCE TO ANTIVIRAL DRUGS OF HERPES-SIMPLEX VIRUS ISOLATED FROM A PATIENT TREATED WITH ACYCLOVIR
RESISTANCE TO ANTIVIRAL DRUGS OF HERPES-SIMPLEX VIRUS ISOLATED FROM A PATIENT TREATED WITH ACYCLOVIR
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DOI：
10.1056/nejm198202113060606
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发表时间：
1982-01-01
影响因子：
158.5
通讯作者：
LEVIN, MJ
中科院分区：
文献类型：
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作者：
CRUMPACKER, CS;SCHNIPPER, LE;LEVIN, MJ
一名7岁的男孩患有无丙种球蛋白血症和进行性肾衰竭，发展为唇疱疹，扩散到面部和口腔。无环鸟苷250 mg/m23次，每周1次，静脉滴注，疗程2周。随后的两次复发反应相似，但患者随后死亡。尸检显示为间质性肾炎和大脑隐球菌感染。在疾病过程中的不同时间从病变中分离出1型疱疹病毒。体外试验表明，这些分离株对阿昔洛韦完全敏感，直到第三疗程中期，此时ID 50从0.05 μg/ml上升到2.5 μg/ml。该分离物对E-5-（2-溴乙烯基）-2 '-脱氧尿苷也有耐药性，但对膦酰乙酸和阿糖腺苷仍敏感。它诱导的胸苷激酶活性显著降低，这一发现与对阿昔洛韦的抗性的发展一致。J·鲍尔
A boy aged 7 years with agammaglobulinaemia and progressive renal failure developed labial herpes which spread on the face and into the buccal cavity. The lesions resolved after treatment with acyclovir given intravenously in a dose of 250 mg/m23 times weekly for 2 weeks. Two subsequent relapses responded similarly, but the patient then died. The autopsy revealed interstitial nephritis and cryptococcal infection of the brain. Type 1 herpes virus was isolated from the lesions at various times during the course of the disease. Testsin vitroshowed that the isolates were fully sensitive to acyclovir until the middle of the 3rd course, when the ID50 had risen from 0.05 µg/ml to 2.5 µg/ml. This isolate was also resistant to E-5-(2-bromovinyl)-2'-deoxyuridine, but was still sensitive to phosphonoacetic acid and vidarabine. There was a marked decrease in the thymidine kinase activity induced by it, a finding in accordance with the development of resistance to acyclovir.D. J. Bauer.