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Quindoline-derivatives display potent G-quadruplex-mediated antiviral activity against herpes simplex virus 1. Antiviral Res 2022; 208:105432. [PMID: 36228762 PMCID: PMC9720158 DOI: 10.1016/j.antiviral.2022.105432] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 12/14/2022]
Abstract
G-quadruplexes (G4s) are non-canonical nucleic acid structures that regulate key biological processes, from transcription to genome replication both in humans and viruses. The herpes simplex virus-1 (HSV-1) genome is prone to form G4s that, along with proteins, regulate its viral cycle. General G4 ligands have been shown to hamper the viral cycle, pointing to viral G4s as original antiviral targets. Because cellular G4s are also normally present in infected cells, the quest for improved anti-HSV-1 G4 ligands is still open. Here, we evaluated a series of new quindoline-derivatives which showed high binding to and stabilization of the viral G4s. They displayed nanomolar-range anti-HSV-1 activity paralleled by negligible cytotoxicity in human cells, thus proving remarkable selectivity. The best-in-class compound inhibited the viral life cycle at the early times post infection up to the step of viral genome replication. In infected human cells, it reduced expression of ICP4, the main viral transcription factor, by stabilizing the G4s embedded in ICP4 promoter. Quindoline-derivatives thus emerge as a new class of G4 ligands with potent dual anti HSV-1 activity.
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Shiraki K, Takemoto M, Daikoku T. Emergence of varicella-zoster virus resistance to acyclovir: epidemiology, prevention, and treatment. Expert Rev Anti Infect Ther 2021; 19:1415-1425. [PMID: 33853490 DOI: 10.1080/14787210.2021.1917992] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Introduction: Acyclovir has led to the development of successful systemic therapy for herpes simplex virus and varicella-zoster virus (VZV) infection, and the use of valacyclovir and famciclovir has improved treatment. Additionally, the use of a helicase-primase (HP) inhibitor (HPI), amenamevir, is changing the treatment of herpes zoster (HZ).Area covered: VZV infection is prevented by vaccines and is treated with antiviral agents. Acyclovir and penciclovir are phosphorylated by viral thymidine kinase and work as chain terminators. Improvements in the management of immunocompromised patients have reduced severe and prolonged immunosuppression and chronic VZV infection with acyclovir-resistant mutants has become rarer. The HP is involved in the initial step of DNA synthesis and amenamevir has novel mechanisms of action, efficacy to acyclovir-resistant mutants, and pharmacokinetic characteristics. The literature search for PUBMED was conducted on 10 April 2020 and updated on 4 November 2020.Expert opinion: Amenamevir has been used to treat HZ in Japan. Although the number of patients with VZV infection will decrease owing to the use of vaccines, the addition of HPI will improve treatment and treatment options for resistant viruses. The clinical use of HPIs in addition to current nucleoside analogs opens a new era of antiherpes therapy.
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Affiliation(s)
- Kimiyasu Shiraki
- Senri Kinran University & Department of Virology, University of Toyama, Toyama, Japan
| | - Masaya Takemoto
- Department of Microbiology, Faculty of Pharmaceutical Sciences, Hokuriku University, Kanazawa, Japan
| | - Tohru Daikoku
- Department of Microbiology, Faculty of Pharmaceutical Sciences, Hokuriku University, Kanazawa, Japan
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Fajfr M, Pliskova L, Bolehovská R, Uhlířová Z, Vrbacký F. Herpes simplex virus resistant to acyclovir: A single-centre experience from the Czech Republic. J Glob Antimicrob Resist 2019; 19:269-273. [PMID: 31100505 DOI: 10.1016/j.jgar.2019.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 04/01/2019] [Accepted: 05/06/2019] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION AND AIM Infections caused by herpes simplex viruses (HSV) are frequent in the human population. Because of the widespread use of long-term treatment or prophylaxis by anti-herpetic antivirals in various specific medical contexts (immunosuppression, recurrent infections), the level of antiviral resistance is increasing. According to previous studies, there is a low resistance level in immunocompetent populations but a relatively high level in populations with immunodeficiency. However, there has been no study from the Czech Republic. This study presents results of a single-centre retrospective study from the Czech Republic. MATERIALS AND METHODS Deep frozen DNA from patients with suspected clinical antiviral failure over a long time period (2009-2016) - a total of 15 isolates of HSV1 and seven of HSV2 - were examined for the presence of mutations associated with antiviral resistance. Sequence analysis was performed using an ABI PRISM 3500xL Genetic Analyzer (Applied Biosystems®). RESULTS There were no mutations associated with resistance to antivirals inside the UL23 gene in HSV1 isolates. However, resistant mutation D672N (nucleotide change G2014A) was found inside the UL30 gene in seven of the isolates. One mutation associated with resistance to acyclovir (M183stop) was found inside the UL23 gene in one HSV2 isolate. Resistant mutation E678G (nucleotide change A2033G) was identified inside the UL30 gene in six of the HSV2 isolates. CONCLUSIONS This study confirmed the presence of resistance mutations within the Czech population, but it will be necessary to examine a higher number of isolates for further conclusions.
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Affiliation(s)
- Miroslav Fajfr
- Institute of Clinical Microbiology, University Hospital in Hradec Kralove, Czech Republic; Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic.
| | - Lenka Pliskova
- Department of Molecular Biology, Institute of Clinical Biochemistry and Diagnostics, University Hospital in Hradec Kralove, Czech Republic
| | - Radka Bolehovská
- Department of Molecular Biology, Institute of Clinical Biochemistry and Diagnostics, University Hospital in Hradec Kralove, Czech Republic
| | - Zuzana Uhlířová
- Institute of Clinical Microbiology, University Hospital in Hradec Kralove, Czech Republic
| | - Filip Vrbacký
- 4th Department of Internal Medicine - Haematology, Charles University, University Hospital Hradec Kralove, Czech Republic
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Shiraki K. Antiviral Drugs Against Alphaherpesvirus. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1045:103-122. [PMID: 29896665 DOI: 10.1007/978-981-10-7230-7_6] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The discovery of acyclovir and penciclovir has led to the development of a successful systemic therapy for treating herpes simplex virus infection and varicella-zoster virus infection, and the orally available prodrugs, valacyclovir and famciclovir, have improved antiviral treatment compliance. Acyclovir and penciclovir are phosphorylated by viral thymidine kinase and are incorporated into the DNA chain by viral DNA polymerase, resulting in chain termination. Helicase-primase plays an initial step in DNA synthesis to separate the double strand into two single strands (replication fork) and is a new target of antiviral therapy. The helicase-primase inhibitors (HPIs) pritelivir and amenamevir have novel mechanisms of action, drug resistance properties, pharmacokinetic characteristics, and clinical efficacy for treating genital herpes. The clinical study of amenamevir in herpes zoster has been completed, and amenamevir has been submitted for approval for treating herpes zoster in Japan. The clinical use of HPIs will be the beginning of a new era of anti-herpes therapy.
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Yajima M, Yamada H, Takemoto M, Daikoku T, Yoshida Y, Long T, Okuda T, Shiraki K. Profile of anti-herpetic action of ASP2151 (amenamevir) as a helicase-primase inhibitor. Antiviral Res 2017; 139:95-101. [DOI: 10.1016/j.antiviral.2016.12.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 12/07/2016] [Accepted: 12/12/2016] [Indexed: 11/26/2022]
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Donovan CP, Levison AL, Lowder CY, Martin DF, Srivastava SK. Delayed recurrence of acute retinal necrosis (ARN): A case series. J Clin Virol 2016; 80:68-71. [PMID: 27179886 DOI: 10.1016/j.jcv.2016.04.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 03/17/2016] [Accepted: 04/29/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE To report five cases of acute retinal necrosis (ARN) that reactivated in the same eye or presented in the contralateral eye between two and nineteen years after the initial episode of acute retinal necrosis. CASES Five patients with a previous history of ARN developed recurrent ARN infection following a lengthy latency period. In all five patients who initially presented with unilateral disease, four developed infection in the contralateral eye and one developed recurrent infection in the ipsilateral eye. Latency periods ranged from two to nineteen years, and final visual acuity in the affected eyes ranged from 20/30 to no light perception. Each patient was treated with antiviral medication for both the initial infection and for subsequent reactivations, but was not on long-term prophylaxis at the time of recurrent disease. CONCLUSION Although rare, delayed onset reactivation of ARN can occur in either the same eye or contralateral eye despite adequate treatment. While contralateral spread of initial infection is fairly common, these reactivations rarely occur more than six weeks after initial infection. Currently there are no guidelines for use of prophylactic antiviral medication to prevent late recurrence of ARN.
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Affiliation(s)
- Christopher P Donovan
- Case Western Reserve School of Medicine, 10900 Euclid Avenue, Room T408, Cleveland, OH 44106-4968, United States.
| | - Ashleigh L Levison
- Cleveland Clinic Foundation, Cole Eye Institute, 9500 Euclid Ave i32, Cleveland, OH 44195, United States.
| | - Careen Y Lowder
- Cleveland Clinic Foundation, Cole Eye Institute, 9500 Euclid Ave i32, Cleveland, OH 44195, United States
| | - Daniel F Martin
- Cleveland Clinic Foundation, Cole Eye Institute, 9500 Euclid Ave i32, Cleveland, OH 44195, United States
| | - Sunil K Srivastava
- Cleveland Clinic Foundation, Cole Eye Institute, 9500 Euclid Ave i32, Cleveland, OH 44195, United States.
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Daikoku T, Tannai H, Honda M, Onoe T, Matsuo K, Onoye Y, Nishizawa M, Kawana T, Okuda T, Hasegawa T, Shiraki K. Subclinical generation of acyclovir-resistant herpes simplex virus with mutation of homopolymeric guanosine strings during acyclovir therapy. J Dermatol Sci 2016; 82:160-5. [PMID: 26917345 DOI: 10.1016/j.jdermsci.2016.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 01/07/2016] [Accepted: 02/12/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Suppressive therapy in patients with genital herpes has been used in Japan since 2006. Susceptibility and resistance of herpes simplex virus (HSV)-2 to acyclovir were examined in genital isolates from patients receiving suppressive therapy and compared with those from those naïve to acyclovir and receiving episodic treatment with acyclovir. OBJECTIVE The aim of this study was to analyze the effect of acyclovir use on the susceptibility to acyclovir and analysis of the thymidine kinase gene by acyclovir treatment. METHODS Genital HSV isolates were obtained from three patients groups. Susceptibility to acyclovir, the frequency of acyclovir-resistant clones and mutations in the thymidine kinase gene of acyclovir-resistant clones were determined. RESULTS Susceptibility to ACV was significantly higher in isolates from patients receiving suppressive therapy than those naïve to acyclovir and receiving episodic treatment, but the frequencies of resistant clones were similar among the three groups. Mutation in guanosine homopolymeric strings (G-string mutation) was significantly more frequent in clones during episodic treatment and suppressive therapy than clones from patients naïve to ACV. The frequency of G-string mutation was significantly less frequent in isolates from patients naïve to ACV than those experienced ACV therapy. CONCLUSION The frequency of acyclovir-resistant mutants was not increased by episodic and suppressive therapy, but exposure to acyclovir significantly generated G-string mutations, possibly induced by acyclovir. Acyclovir therapy had no substantial effects on the susceptibility of HSV-2 or frequency of resistant virus but did generate subclinical G-string mutants in patients' HSV-2.
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Affiliation(s)
- Tohru Daikoku
- Department of Virology, University of Toyama, Toyama 930-0194, Japan
| | - Hidenori Tannai
- Department of Virology, University of Toyama, Toyama 930-0194, Japan
| | - Mariko Honda
- Department of Dermatology, The Jikei University School of Medicine, Tokyo 105-8471, Japan
| | - Tomohiko Onoe
- Department of Dermatology, The Jikei University School of Medicine, Tokyo 105-8471, Japan
| | - Koma Matsuo
- Department of Dermatology, The Jikei University School of Medicine, Tokyo 105-8471, Japan
| | - Yasuhiko Onoye
- Miyamoto Central Clinic, Kawasaki, Kanagawa 210-0004, Japan
| | - Mika Nishizawa
- Mizonokuchi Hospital, School of Medicine, Teikyo University, Kanagawa 213-8507, Japan
| | - Takashi Kawana
- Mizonokuchi Hospital, School of Medicine, Teikyo University, Kanagawa 213-8507, Japan
| | - Tomoko Okuda
- Department of Virology, University of Toyama, Toyama 930-0194, Japan
| | - Tomomi Hasegawa
- Division of Maternal Nursing, University of Toyama, Toyama 930-0194, Japan
| | - Kimiyasu Shiraki
- Department of Virology, University of Toyama, Toyama 930-0194, Japan.
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van Velzen M, Missotten T, van Loenen FB, Meesters RJW, Luider TM, Baarsma GS, Osterhaus ADME, Verjans GMGM. Acyclovir-resistant herpes simplex virus type 1 in intra-ocular fluid samples of herpetic uveitis patients. J Clin Virol 2013; 57:215-21. [PMID: 23582986 DOI: 10.1016/j.jcv.2013.03.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 03/17/2013] [Accepted: 03/18/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Acyclovir (ACV) is the antiviral drug of choice to treat patients with herpes simplex virus type 1 (HSV-1) uveitis. The prevalence of intra-ocular ACV-resistant (ACV(R)) HSV-1 in herpetic uveitis is unknown and may have clinical consequences. In addition to its predictive value on ACV susceptibility, the polymorphic HSV-1 thymidine kinase (TK) gene facilitates differentiation between HSV-1 strains. OBJECTIVES The objective of this study was to determine the genetic composition and ACV susceptibility of the causative virus in intra-ocular fluid samples (IOF) of HSV-1 uveitis patients. STUDY DESIGN The intra-ocular HSV-1 pool from 11 HSV-1 uveitis patients was determined by sequencing IOF-derived viral TK genes. The ACV susceptibility profile of the cloned intra-ocular TK variants was defined by mass spectrometry. In addition, the ganciclovir (GCV) susceptibility of the ACV(R) HSV-1 TK variants was defined. RESULTS Intra-ocular fluid samples of HSV-1 uveitis patients contain HSV-1 quasispecies, principally consisting of one major and multiple genetically related minor patient-specific TK variants. Four of 10 patients analyzed had an intra-ocular ACV(R) HSV-1 of which 3 were cross-resistant to GCV. The ACV(R) profile of intra-ocular HSV-1 did not correlate with symptomatic ACV treatment. CONCLUSIONS Affected eyes of HSV-1 uveitis patients are commonly infected with a patient-specific HSV-1 quasispecies, including one major and multiple genetically related minor variants. A relatively high prevalence of intra-ocular ACV(R) HSV-1, mainly ACV/GCV cross-resistant viruses, was detected in HSV-1 uveitis patients.
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Affiliation(s)
- Monique van Velzen
- Viroscience Lab, Erasmus MC, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
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Tan DHS, Raboud JM, Kaul R, Grinsztejn B, Cahn P, Walmsley SL. Can herpes simplex virus type 2 suppression slow HIV disease progression: a study protocol for the VALacyclovir In Delaying Antiretroviral Treatment Entry (VALIDATE) trial. Trials 2010; 11:113. [PMID: 21106086 PMCID: PMC3002348 DOI: 10.1186/1745-6215-11-113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Accepted: 11/24/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although highly active antiretroviral therapy (HAART) has dramatically decreased HIV-related morbidity and mortality, the associated costs, toxicities, and resistance risks make the potential delay of HAART initiation an attractive goal. Suppression of herpes simplex virus type 2 (HSV-2) may be a novel strategy for achieving this goal because HSV-2 is associated with clinically significant increases in HIV viral load, the primary driver of HIV disease progression. METHODS/DESIGN The VALacyclovir In Delaying Antiretroviral Treatment Entry (VALIDATE) trial is a multicentre, randomized, fully blinded, clinical trial of twice daily valacyclovir 500 mg versus placebo for delaying the need for initiating HAART among HIV-1, HSV-2 co-infected HAART-naïve adults. 480 participants from Canada, Brazil and Argentina will undergo quarterly clinical follow-up until reaching the composite primary endpoint of having a CD4+ T-cell count ≤ 350 cells/mm(3) or initiation of HAART for any reason, whichever occurs first. The primary analysis will use a proportional hazards model, stratified by site, to estimate the relative risk of progression to this endpoint associated with valacyclovir. Secondary analyses will compare the rates of change in CD4 count, median log10 HIV viral load, drug-related adverse events, frequency of HSV reactivations, rate of acyclovir-resistant HSV, and quality of life between study arms. DISCUSSION Although HIV treatment guidelines continue to evolve, with some authorities recommending earlier HAART among asymptomatic individuals, the potential delay of HAART remains a clinically relevant goal for many. If shown to be of benefit, implementation of the VALIDATE intervention will require careful consideration of both individual patient-level and public health implications. TRIAL REGISTRATION Current Controlled Trials ISRCTN66756285. ClinicalTrials.gov NCT00860977.
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Affiliation(s)
- Darrell HS Tan
- University Health Network, 585 University Ave., 13N - 1323, Toronto, Ontario, M5G 2N2 Canada
| | - Janet M Raboud
- University Health Network, 585 University Ave., 13N - 1323, Toronto, Ontario, M5G 2N2 Canada
| | - Rupert Kaul
- University Health Network, 585 University Ave., 13N - 1323, Toronto, Ontario, M5G 2N2 Canada
| | - Beatriz Grinsztejn
- Instituto de Pesquisa Clínica Evandro Chagas (IPEC), Fundação Oswaldo Cruz, Avenida Brasil, 4365 - Manguinhos, 21040-900, Rio de Janeiro - RJ - Brazil
| | - Pedro Cahn
- Fundación Huesped, Angel Peluffo 3932, Buenos Aires, Argentina, C1202ABB
| | - Sharon L Walmsley
- University Health Network, 585 University Ave., 13N - 1323, Toronto, Ontario, M5G 2N2 Canada
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Batalden K, Bria C, Biro FM. Genital herpes and the teen female. J Pediatr Adolesc Gynecol 2007; 20:319-21. [PMID: 18082851 DOI: 10.1016/j.jpag.2007.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2007] [Accepted: 04/14/2007] [Indexed: 11/29/2022]
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Shimada Y, Suzuki M, Shirasaki F, Saito E, Sogo K, Hasegawa M, Takehara K, Phromjai J, Chuhjo T, Shiraki K. Genital herpes due to acyclovir-sensitive herpes simplex virus caused secondary and recurrent herpetic whitlows due to thymidine kinase-deficient/temperature-sensitive virus. J Med Virol 2007; 79:1731-40. [PMID: 17854045 DOI: 10.1002/jmv.20990] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Herpes simplex virus (HSV)-2 caused a genital ulcer in a 40-year-old allogenic stem cell recipient, and a secondary herpetic whitlow appeared during 2 months of acyclovir (ACV) therapy. Both genital ulcer, and whitlow were cured 3 months later, but 6 months after recovery the whitlow alone recurred. DNA of the genital, first, and recurrent whitlow isolates showed similar endonuclease digestion fragment profiles. The genital virus was ACV-sensitive, and the two whitlow isolates were ACV-resistant/thymidine kinase (TK)-deficient. The TK gene of the whitlow isolates had the same frame shift from the 274th amino acid and termination at the 347th amino acid due to the deletion of a cytosine at the 819th nucleotide. Because the temperature of the thumb is 33/34 degrees C or lower, the temperature sensitivity of the isolates were compared, and both whitlow isolates were significantly more temperature-sensitive (ts) at 39 degrees C than the genital isolate. The two whitlow isolates showed cutaneous pathogenicity in mouse ear pinna but not midflank, while the genital isolate was pathogenic at both sites, suggesting that temperature adaptation was an important element of pathogenicity in the whitlow. The virus populations of isolates of the genital, and first whitlow were examined by 31, and 82 clones, respectively, and the clones from genital, and whitlow isolates were ACV-sensitive, and -resistant, respectively, showing their homogeneity. The acyclovir-sensitive genital lesion had spread as a TK-deficient/ts herpetic whitlow during ACV treatment, and an apparently TK-deficient virus adapted to the local temperature might have caused the whitlow recurrence.
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Affiliation(s)
- Yuka Shimada
- Department of Dermatology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan
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Strick LB, Wald A, Celum C. HIV/AIDS: Management of Herpes Simplex Virus Type 2 Infection in HIV Type 1–Infected Persons. Clin Infect Dis 2006; 43:347-56. [PMID: 16804851 DOI: 10.1086/505496] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2006] [Accepted: 04/04/2006] [Indexed: 11/04/2022] Open
Abstract
Human immunodeficiency virus type 1 (HIV-1)-infected persons have high rates of herpes simplex virus type 2 (HSV-2) infection, ranging from 50% to 90% in studies of HIV-infected populations from different parts of the world. Genital herpes in persons with HIV type 1 (HIV-1) infection is associated with more-severe and chronic lesions, as well as increased rates of asymptomatic genital shedding of HSV-2. Nucleoside analogues (acyclovir, valacyclovir, and famciclovir) decrease the frequency and severity of HSV-2 recurrences and asymptomatic HSV-2 reactivation and are effective, safe, well-tolerated drugs in patients with HIV-1 infection. These anti-HSV drugs may result in additional clinical and public health benefits for persons with HIV-1 and HSV-2 coinfection by decreasing HIV-1 levels in the blood and genital tract. Given these benefits, HIV-1-infected persons should be routinely tested for HSV-2 infection using type-specific serologic tests. Persons with HSV-2 infection should be offered HSV-2 education and treatment options. Studies to quantify the potential clinical and public health benefits of treating individuals who have HIV-1 and HSV-2 coinfection with anti-HSV therapy are underway.
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Affiliation(s)
- Lara B Strick
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA 98104, USA.
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Wolf R, Wolf D, Orion E, Matz H. Long-term prophylactic antiviral therapy for recurrent herpes simplex: the controversy goes on. Clin Dermatol 2003; 21:164-7. [PMID: 12706334 DOI: 10.1016/s0738-081x(02)00262-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Ronni Wolf
- Dermatology Unit, Kaplan Medical Center, Rechovot, Israel.
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Okuda T, Kurokawa M, Matsuo K, Honda M, Niimura M, Shiraki K. Suppression of generation and replication of acyclovir-resistant herpes simplex virus by a sensitive virus. J Med Virol 2003; 72:112-20. [PMID: 14635018 DOI: 10.1002/jmv.10562] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The role of acyclovir-sensitive herpes simplex virus (HSV) was analyzed in the process of its replacement by a resistant virus in vitro and in vivo in the aspect of acyclovir therapy. The mode of replacement of acyclovir-sensitive HSV with acyclovir-resistant HSV was examined by the passages of acyclovir-sensitive wild type HSV in Vero cells under acyclovir-treatment. The development of resistance was monitored more adequately by counting the number of acyclovir-resistant viruses in 10,000 plaque forming units than by the conventional susceptibility assay. The resistance increased with the proportion of thymidine kinase-deficient (TK(-)) viruses, when the susceptibilities of acyclovir-treated HSV population to 5'-iodo-2'deoxyuridine and phosphonoacetic acid were examined. The increased resistance was due to the increased proportion of acyclovir-resistant virus but not intermediately resistant virus. Infection with mixtures of TK(-) and acyclovir-sensitive strains rendered TK(-) sensitive to acyclovir, and virus yields were reduced to the levels of acyclovir-sensitive virus in Vero cells. Their yield reduction depended on the proportion of acyclovir-sensitive viruses and induction of TK activity. This reduction in virus yields of the mixture of TK(-) and acyclovir-sensitive strains was confirmed by acyclovir treatment in the skin of mice with cutaneous infection. Acyclovir treatment combined with superinfection of acyclovir-sensitive virus delayed the development of herpetic skin lesions due to acyclovir-resistant virus and reduced virus yields in the infected skin. Acyclovir-sensitive virus plays an important role in suppressing the generation and replication of acyclovir-resistant virus during acyclovir therapy.
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Affiliation(s)
- Tomoko Okuda
- Department of Virology, Toyama Medical and Pharmaceutical University, Sugitani, Toyama, Japan
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