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
Abstract
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.
Article and Author Information
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From the University of California, and the Davies Medical Center, San Francisco, California. For current author addresses, see end of text.
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Grant Support: Kim S. Erlich was supported by training grant 5-T32-AI07234 from the National Institutes of Health.
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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.
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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 Physicians
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