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Resolution of Resistant Chronic Herpetic Lesions With Zidovudine in a Patient With the Acquired Immunodeficiency Syndrome

Resolution of Resistant Chronic Herpetic Lesions With Zidovudine in a Patient With the Acquired... Abstract To the Editor.— Chronic ulcerative herpes infections are a well-recognized complication of immunosuppression. Recently, chronic herpetic ulcerations have been reported in association with infection with the human immunodeficiency virus (HIV).1,2 These infections are being reported at an increasing rate as the current HIV epidemic progresses. We report a chronic herpetic infection with a resistant herpes simplex type 2 virus that healed only after starting therapy with zidovudine (Retrovir). Report of a Case.— A 27-year-old homosexual presented who first had culture-positive perirectal herpes diagnosed in October 1985. His monthly recurrences cleared with oral administration of acyclovir sodium (200 mg, five times per day for five days). In March 1986, he was diagnosed as having the acquired immunodeficiency syndrome (AIDS)-related complex. His herpetic outbreaks became more difficult to control, not responding to extended therapeutic courses of acyclovir sodium, administered in doses of up to 1 g, five times per day, over References 1. Siegal FP, Lopez C, Hammer GS, et al: Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions . N Engl J Med 1981;305:1439-1444.Crossref 2. Pennys NS, Hicks B: Unusual cutaneous lesions associated with acquired immunodeficiency syndrome . J Am Acad Dermatol 1985;13:845-852.Crossref 3. Westheim AI, Tenser RB, Marks JG: Acyclovir resistance in a patient with chronic mucocutaneous herpes simplex infection . J Am Acad Dermatol 1987;17:875-880.Crossref 4. Parris DS, Harrington JE: Herpes simplex virus variants resistant to high concentrations of acyclovir exist in clinical isolates . Antimicrob Agents Chemother 1982;22:71-77.Crossref 5. Sibrack CD, Gutman LT, Wilfert CM, et al: Pathogenicity of acyclovir-resistant herpes simplex virus type I from an immunodeficient child . J Infect Dis 1982;146:673-681.Crossref 6. Surbone A, Yarchoan R, McAtee N, et al: Treatment of the acquired immunodeficiency syndrome (AIDS) and AIDS-related complex with a regimen of 3-azido-2,3-dideoxythymidine (azidothymidine or zidovudine) and acyclovir . Ann Intern Med 1988;108:534-540.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Resolution of Resistant Chronic Herpetic Lesions With Zidovudine in a Patient With the Acquired Immunodeficiency Syndrome

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Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1988.01670100069023
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor.— Chronic ulcerative herpes infections are a well-recognized complication of immunosuppression. Recently, chronic herpetic ulcerations have been reported in association with infection with the human immunodeficiency virus (HIV).1,2 These infections are being reported at an increasing rate as the current HIV epidemic progresses. We report a chronic herpetic infection with a resistant herpes simplex type 2 virus that healed only after starting therapy with zidovudine (Retrovir). Report of a Case.— A 27-year-old homosexual presented who first had culture-positive perirectal herpes diagnosed in October 1985. His monthly recurrences cleared with oral administration of acyclovir sodium (200 mg, five times per day for five days). In March 1986, he was diagnosed as having the acquired immunodeficiency syndrome (AIDS)-related complex. His herpetic outbreaks became more difficult to control, not responding to extended therapeutic courses of acyclovir sodium, administered in doses of up to 1 g, five times per day, over References 1. Siegal FP, Lopez C, Hammer GS, et al: Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions . N Engl J Med 1981;305:1439-1444.Crossref 2. Pennys NS, Hicks B: Unusual cutaneous lesions associated with acquired immunodeficiency syndrome . J Am Acad Dermatol 1985;13:845-852.Crossref 3. Westheim AI, Tenser RB, Marks JG: Acyclovir resistance in a patient with chronic mucocutaneous herpes simplex infection . J Am Acad Dermatol 1987;17:875-880.Crossref 4. Parris DS, Harrington JE: Herpes simplex virus variants resistant to high concentrations of acyclovir exist in clinical isolates . Antimicrob Agents Chemother 1982;22:71-77.Crossref 5. Sibrack CD, Gutman LT, Wilfert CM, et al: Pathogenicity of acyclovir-resistant herpes simplex virus type I from an immunodeficient child . J Infect Dis 1982;146:673-681.Crossref 6. Surbone A, Yarchoan R, McAtee N, et al: Treatment of the acquired immunodeficiency syndrome (AIDS) and AIDS-related complex with a regimen of 3-azido-2,3-dideoxythymidine (azidothymidine or zidovudine) and acyclovir . Ann Intern Med 1988;108:534-540.Crossref

Journal

Archives of Dermatology – American Medical Association

Published: Oct 1, 1988

References

  • Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions
    Siegal FP, Lopez C, Hammer GS, et al
  • Unusual cutaneous lesions associated with acquired immunodeficiency syndrome
    Pennys NS, Hicks B
  • Acyclovir resistance in a patient with chronic mucocutaneous herpes simplex infection
    Westheim AI, Tenser RB, Marks JG
  • Herpes simplex virus variants resistant to high concentrations of acyclovir exist in clinical isolates
    Parris DS, Harrington JE
  • Pathogenicity of acyclovir-resistant herpes simplex virus type I from an immunodeficient child
    Sibrack CD, Gutman LT, Wilfert CM, et al
  • Treatment of the acquired immunodeficiency syndrome (AIDS) and AIDS-related complex with a regimen of 3-azido-2,3-dideoxythymidine (azidothymidine or zidovudine) and acyclovir
    Surbone A, Yarchoan R, McAtee N, et al