Document 0802
 DOCN  M9480802
 TI    Successful treatment of progressive mucocutaneous infection due to
       acyclovir- and foscarnet-resistant herpes simplex virus with
       (S)-1-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine (HPMPC).
 DT    9410
 AU    Snoeck R; Andrei G; Gerard M; Silverman A; Hedderman A; Balzarini J;
       Sadzot-Delvaux C; Tricot G; Clumeck N; De Clercq E; Rega Institute for
       Medical Research, Katholieke Universiteit; Leuven, Belgium.
 SO    Clin Infect Dis. 1994 Apr;18(4):570-8. Unique Identifier : AIDSLINE
       MED/94312555
 AB    The acyclic nucleoside phosphonate
       (S)-1-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine (HPMPC) was used
       topically for the treatment of persistent mucocutaneous infections in
       two cases. One patient with AIDS suffered from a perineal lesion due to
       infection with herpes simplex virus type 2 (HSV-2) and did not respond
       to acyclovir and was intolerant of foscarnet. A bone marrow transplant
       recipient developed orofacial lesions due to infection with herpes
       simplex virus type 1 (HSV-1) that failed to respond to therapy with both
       acyclovir and foscarnet. After topical application of HPMPC, the HSV-2
       lesions completely resolved. However, the lesions recurred 3 weeks
       later, and, upon subsequent treatment with HPMPC, regressed. On
       recurrence, the virus was found to be sensitive to acyclovir, which the
       patient was given. Again HSV-2, which was resistant to acyclovir,
       emerged; similar observations were made after another cycle of HPMPC
       therapy. The HSV-1 isolates were resistant to acyclovir and foscarnet.
       Following local HPMPC treatment, the lesions regressed, but after 1
       week, a second course of topical HPMPC therapy had to be instituted for
       recurrent infection. The lesions again regressed, and as the recurrent
       virus was sensitive to acyclovir, the patient was successfully treated
       with the drug. The results of this study point to the potential
       usefulness of topical HPMPC in the treatment of immunocompromised
       patients with HSV-related mucocutaneous infections that are refractory
       to therapy with acyclovir and/or foscarnet.
 DE    Acyclovir/PHARMACOLOGY  Administration, Topical  Adult  Antiviral
       Agents/ADMINISTRATION & DOSAGE/*THERAPEUTIC USE  AIDS-Related
       Opportunistic Infections/COMPLICATIONS/DRUG THERAPY  Case Report
       Cytosine/*ANALOGS & DERIVATIVES/ADMINISTRATION & DOSAGE/  THERAPEUTIC
       USE  Drug Resistance, Microbial  DNA Restriction Enzymes  DNA,
       Viral/GENETICS  Foscarnet/PHARMACOLOGY  Herpes
       Genitalis/COMPLICATIONS/*DRUG THERAPY  Herpes
       Simplex/COMPLICATIONS/*DRUG THERAPY  Herpesvirus 1, Human/DRUG
       EFFECTS/ENZYMOLOGY/GENETICS  Herpesvirus 2, Human/DRUG
       EFFECTS/ENZYMOLOGY/GENETICS  Human  Leukemia, Myeloid,
       Chronic/COMPLICATIONS  Male  Opportunistic Infections/COMPLICATIONS/DRUG
       THERAPY  Organophosphorus Compounds/ADMINISTRATION & DOSAGE/*THERAPEUTIC
       USE  Skin Diseases, Viral/COMPLICATIONS/*DRUG THERAPY  Support, Non-U.S.
       Gov't  Thymidine Kinase/ANTAGONISTS & INHIB  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).