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

An Uncontrolled Trial

  1. Kim S. Erlich, MD;
  2. Mark A. Jacobson, MD;
  3. Jane E. Koehler, MD;
  4. Stephen E. Follansbee, MD;
  5. David P. Drennan, MD;
  6. Lisa Gooze, MD;
  7. Sharon Safrin, MD; and
  8. 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

    • From the University of California, and the Davies Medical Center, San Francisco, California. For current author addresses, see end of text.

    • 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.

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    1. Ann Intern Med May 1, 1989 vol. 110 no. 9 710-713
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