Management of acyclovir-resistant herpes simplex and varicella-zoster virus infections

Henry H. Balfour, Constance Benson, James Braun, Brett Cassens, Alejo Erice, Alvin Friedman-Kien, Thomas Klein, Bruce Polsky, Sharon Safrin

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148 Scopus citations


Persons with AIDS who have CD4+ counts ⩽100 and transplant patients, especially bone marrow allograft recipients, may experience clinically significant infections with acyclovir-resistant herpes simplex virus (HSV) or varicella-zoster virus (VZV). Patients who have received prior repeated acyclovir treatment appear to be at the highest risk of harboring acyclovir-resistant strains. Algorithms for the management of these infections were developed at a recent roundtable symposium. The consensus of the panelists was that treatment with foscarnet should be initiated within 7-10 days in patients suspected to have acyclovir-resistant HSV or VZV infections. Foscarnet therapy should be continued for at least 10 days or until lesions are completely healed. Recurrences may respond to either foscarnet or, occasionally, acyclovir.

Original languageEnglish (US)
Pages (from-to)254-260
Number of pages7
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number3
StatePublished - Mar 1994


  • Acyclovir
  • Foscarnet
  • Herpes simplex virus (HSV)
  • Resistance
  • Varicella-zoster virus (VZV)


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