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Foscarnet Therapy for Severe Acyclovir-Resistant Herpes Simplex Virus Type-2 Infections in Patients with the Acquired Immunodeficiency Syndrome (AIDS): An Uncontrolled Trial

Kim S. Erlich, MD; Mark A. Jacobson, MD; Jane E. Koehler, MD; Stephen E. Follansbee, MD; David P. Drennan, MD; Lisa Gooze, MD; Sharon Safrin, MD; and John Mills, MD
[+] Article, Author, and Disclosure Information

Grant Support: Kim S. Erlich was supported by training grant 5-T32-AI07234 from the National Institutes of Health.

Requests for Reprints: John Mills, MD, Division of Infectious Diseases, San Francisco General Hospital, Building 80, Ward 84, 995 Potrero Avenue, San Francisco, CA 94110.

Current Author Addresses: Drs. Jacobson, Koehler, Gooze, Safrin, and Mills: Division of Infectious Diseases, San Francisco General Hospital, San Francisco, CA 94110.

Dr. Erlich: Seton Medical Center, Daly City, CA 94015.

Dr. Follansbee: 3620 Army Street, San Francisco, CA 94110.

Dr. Drennan: Davies Medical Center, San Francisco, CA 94114.

©1989 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1989;110(9):710-713. doi:10.7326/0003-4819-110-9-710
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Study Objective: To determine whether trisodium phosphonoformate (foscarnet) is efficacious in treating severe mucocutaneous disease due to acyclovir-resistant herpes simplex virus type-2 (HSV-2) infection in patients with the acquired immunodeficiency syndrome (AIDS).

Design: Open-labeled drug administration to patients with AIDS and severe ulcerative disease due to acyclovir-resistant HSV-2 infection.

Setting: Medical floors of acute care hospital.

Patients: Four patients with AIDS who developed progressive ulcerative mucocutaneous lesions of the genitals, perineum, perianal region, or finger due to acyclovir-resistant, thymidine-kinase (TK)-negative strains of HSV-2.

Intervention: Foscarnet, 60 mg/kg body weight intravenously every 8 hours (with reduced dosage for renal impairment), for 12 to 50 days.

Measurement and Main Results: All patients receiving foscarnet had dramatic improvement in their clinical findings with marked clearing of mucocutaneous lesions and eradication of HSV from mucosal surfaces.

Conclusion: Foscarnet may be an effective treatment for severe mucocutaneous disease due to acyclovir-resistant, TK-negative strains of HSV-2.





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