SANDRA NUSINOFF LEHRMAN, M. D.; JOHN M. DOUGLAS, M.D.; LAWRENCE COREY, M.D.; DAVID W. BARRY, M.D.
To evaluate the association between in-vitro resistance of herpes simplex virus type 2 to acyclovir and breakthrough recurrences of herpes despite chronic suppressive therapy, we determined the in-vitro sensitivity of herpes simplex virus isolated before, during, and after therapy. One hundred eighty-three virus isolates from 107 patients were tested. Before therapy, the median amount of drug required to inhibit 50% of the virus in tissue culture (ID50) was 0.91 µg/mL. The median ID50 after therapy was 0.99. Six isolates from patients with culture-positive breakthrough recurrences were evaluated. The median ID50 was 0.90 µg/mL (range, 0.39 to 1.55). The development of breakthrough recurrences could not be correlated with infection with strains of herpes simplex virus type 2 that were resistant to acyclovir in vitro. Acyclovir-resistant strains are not commonly recovered from patients during acyclovir therapy, nor does there seem to be a high frequency of resistance after 4 months of chronic suppressive therapy.
LEHRMAN SN, DOUGLAS JM, COREY L, et al. Recurrent Genital Herpes and Suppressive Oral Acyclovir Therapy: Relation Between Clinical Outcome and In-Vitro Drug Sensitivity. Ann Intern Med. 1986;104:786–790. doi: 10.7326/0003-4819-104-6-786
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Published: Ann Intern Med. 1986;104(6):786-790.
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