作者: Cornelia D Sibrack , Laura T Gutman , Catherine M Wilfert , Colin Mclaren , David W Barry
DOI: 10.1203/00006450-198104001-01098
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摘要: The frequency and clinical significance of drug-resistant herpes viruses occurring in settings requires thorough investigation. We have studied over 100 HSV isolates from a variety sources found one group, 15 month boy with adenosine deaminase deficient type severe combined immunodeficiency, which was resistant to both ACV IUDR. During 6 week hospitalization he received topical ophthalmic, parenteral oral for treatment herpetic keratitis cutaneous lesions involving face, hands perirectal areas. Early courses resulted dramatic improvement but later recurrences were characterized by chronic unresponsive despite serum levels up mcg/ml. After death Pseudomonas sepsis pneumonia, postmortem tissues, although HSV-positive, showed no evidence viral cytopathic effect. A 100-fold decrease sensitivity noted between early late isolates. Thymidine kinase activity normal sensitive absent Reduced apparent pathogenicity man paralleled 100-1000-fold these their virulence (as determined PFU/LD50 PFU/MID50 ratios) normal, hairless nude mice intracerebral innoculation. Cutaneous infection caused the virus less or produced low-grade, chronic, rather than acutely fatal infections. Antiviral resistance can occur selected situations diminished may be associated virulence.