Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Case Report
  • Published:

Multiple herpes simplex virus infections with various resistance patterns in a matched unrelated donor transplant recipient

Bone Marrow Transplantation volume 28, pages 799–801 (2001)Cite this article

Abstract

A 45-year-old matched unrelated BMT recipient had sequential mucocutaneous herpes simplex virus (HSV) type 2 infections. Five months after BMT, a penile lesion occurred and was cured using acyclovir, as expected from in vitro susceptibility results. The same lesion recurred 1 month later but worsened with acyclovir. The HSV isolate was resistant to acyclovir (IC50 = 105 μM), and a nucleotide (G) was added to the thymidine kinase gene leading to a premature stop codon. The lesion improved markedly with foscarnet. During this treatment a second HSV infection occurred on the buttocks 2 weeks after the first one and healed completely with acyclovir. This course correlated with in vitro results of the buttock HSV isolate which was foscarnet-resistant (IC50 = 300 μg/ml) and acyclovir-sensitive. Surprisingly, no mutation gene of the foscarnet-resistant isolate was detected in the DNA polymerase gene. This case shows that an HSV acyclovir-resistant infection may be followed by an acyclovir-sensitive one. Determination of antiviral susceptibility is needed to monitor the treatment of various HSV infections in immunocompromised BMT recipients. Bone Marrow Transplantation (2001) 28, 799–801.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Christophers J, Clayton J, Craske J et al. Survey of resistance of herpes simplex virus to acyclovir in Northwest England Antimicrob Agents Chemother 1998 42: 868–872

    Article  CAS  Google Scholar 

  2. Safrin S, Kemmerly S, Betsy P et al. Foscarnet-resistant herpes simplex virus infection in patients with AIDS J Infect Dis 1994 169: 193–196

    Article  CAS  Google Scholar 

  3. Erice A . Resistance of human cytomegalovirus to antiviral drugs J Microbial Rev 1999 12: 286–297

    Article  CAS  Google Scholar 

  4. Gaudreau A, Hill E, Balfour HHJ et al. Phenotypic and genotypic characterization of acyclovir-resistant herpes simplex viruses from immunocompromised patients J Infect Dis 1998 178: 297–303

    Article  CAS  Google Scholar 

  5. Nugier F, Colin JN, Aymard M, Langlois M . Occurrence and characterization of acyclovir-resistant herpes simplex virus isolates: report on a two-year sensitivity screening survey J Med Virol 1992 36: 1–12

    Article  CAS  Google Scholar 

  6. Verdonck LF, Cornelissen JJ, Smit J et al. Successful treatment with foscarnet on an acyclovir resistant mucocutaneous infection with herpes simplex virus in a recipient of allogeneic BMT Bone Marrow Transplant 1993 11: 177–179

    CAS  PubMed  Google Scholar 

  7. Blot N, Schneider P, Young P et al. Treatment of an acyclovir and foscarnet-resistant herpes simplex virus infection with cidofovir in a child after an unrelated bone marrow transplant Bone Marrow Transplant 2000 26: 903–905

    Article  CAS  Google Scholar 

  8. Chen Y, Scieux C, Garrait V et al. Resistant herpes simplex virus type 1 infection: an emerging concern after allogeneic stem cell transplantation Clin Infect Dis 2000 31: 927–935

    Article  CAS  Google Scholar 

  9. Chakrabarti S, Pillay D, Ratcliffe D et al. Resistance to antiviral drugs in herpes simplex virus infections among allogeneic stem cell transplant recipients: risk factors and prognostic significance J Infect Dis 2000 181: 2055–2058

    Article  CAS  Google Scholar 

  10. Schmit I, Boivin I . Characterization of DNA polymerase and thymidine kinase genes of herpes simplex virus isolates from AIDS patients in whom acyclovir and foscarnet therapy sequentially failed J Infect Dis 1999 180: 487–490

    Article  CAS  Google Scholar 

  11. Roizman B . Herpes simplex virus and its replication. In: Fields BN, Knipe DM, Howley PM (eds) Fields Virology, 3rd edn Lippincott-Raven Publishers: Philadelphia 1996 2231–2296

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hematology Department, Necker Hospital, Paris, France

    B Arnulf, F Lefrere & B Varet

  2. Virology Department, Pitié-Salpêtrière Hospital, Paris, France

    F Chebbi, Z Ait Arkoub & AM Fillet

Authors
  1. B Arnulf
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F Chebbi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F Lefrere
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Z Ait Arkoub
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B Varet
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. AM Fillet
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Arnulf, B., Chebbi, F., Lefrere, F. et al. Multiple herpes simplex virus infections with various resistance patterns in a matched unrelated donor transplant recipient. Bone Marrow Transplant 28, 799–801 (2001). https://doi.org/10.1038/sj.bmt.1703233

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1703233

Keywords

Search

Advanced search

Quick links