Ganciclovir resistance: a matter of time and titre

Abstract

As the availability of antiviral agents for herpesviruses increases, so does not only knowledge of their efficacy but also the problems associated with their use. The development of antiviral resistance has been of much concern but resistance of herpes simplex virus (HSV) to aciclovir has been essentially restricted to immunocompromised patients and attributed to the high concentrations of virus in these patients and the consequent opportunity for selection of a resistant mutant. 1 Safrin S Clinical manifestations of antiviral resistance in herpes simplex. in: Richman DD Antiviral drug resistance. John Wiley and Sons, Chichester1996: 103-122 Google Scholar There has been only one report of HSV resistance to aciclovir in an immunocompetent patient, and this case may have occurred as a result of transmission of aciclovir-resistant virus from an AIDS patient to an immunocompetent sexual contact. 2 Kost RG Hill EL Tigges M Straus SE Brief report: recurrent acyclovir-resistant genital herpes in an immunocompetent patient. N Engl J Med. 1993; 329: 1777-1782 Crossref PubMed Scopus (131) Google Scholar Emergence of ganciclovir-resistant cytomegalovirus disease among recipients of solid-organ transplantsGanciclovir-resistant cytomegalovirus is an important cause of late morbidity among D+/R− transplant recipients who have had lengthened exposure to ganciclovir and have received highly potent immunosuppression. Strategies to reduce this complication, especially among D+/R− patients, are warranted. Full-Text PDF