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Meningoradiculoneuritis due to acyclovir‐resistant varicella zoster virus in an acquired immune deficiency syndrome patient
Author(s) -
Snoeck R.,
Gérard M.,
SadzotDelvaux C.,
Andrei G.,
Balzarini J.,
Reymen D.,
Ahadi N.,
De Bruyn J. M.,
Piette J.,
Rentier B.,
Clumeck N.,
De Clercq E.
Publication year - 1994
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.1890420404
Subject(s) - virology , varicella zoster virus , virus , medicine , immune system , immunology , biology
Abstract Varicella zoster virus (VZV) is recognized as one of the major viral pathogens reactivated in patients with the acquired immune deficiency syndrome (AIDS). We report the case of meningora‐diculoneuritis in an AIDS patient, associated with the isolation in the cerebrospinal fluid (CSF) of a thymidine kinase (TK)‐deficient, acyclovir (ACV)‐resistant strain of VZV. Although the virus was sensitive in vitro to phosphonoformate (PFA), the patient did not improve during PFA therapy and finally died. Several VZV strains isolated from this patient (including two isolates from the patient's CSF) were analyzed for their TK activity and subsequently the viral TK gene was sequenced showing a major deletion leading to a truncated protein. Their susceptibility to several antiviral agents including ACV, PFA, (E)‐5‐(2‐bro‐movinyl)‐2′‐deoxyuridine (BVDU), 9‐β‐D‐ara‐binofuranosyladenine (vidarabine), (S)‐1‐(3‐hy‐droxy ‐ 2 ‐ phosphonylmethoxypropyl) cytosine (HPMPC), and (S)‐9‐(3‐hydroxy‐2‐phosphonyl‐methoxypropyl)adenine (HPMPA) was evaluated. All the virus strains isolated from this patient remained sensitive to HPMPA and HPMPC, pointing to the potential usefulness of these acyclic nucleoside phosphonates for the treatment of ACV‐resistant VZV infections in immunocom‐promised patients. © 1994 Wiley‐Liss, Inc.