Document 0070
 DOCN  M9490070
 TI    Meningoradiculoneuritis due to acyclovir-resistant varicella zoster
       virus in an acquired immune deficiency syndrome patient.
 DT    9411
 AU    Snoeck R; Gerard M; Sadzot-Delvaux C; Andrei G; Balzarini J; Reymen D;
       Ahadi N; De Bruyn JM; Piette J; Rentier B; et al; Rega Institute for
       Medical Research, Katholieke Universiteit; Leuven, Belgium.
 SO    J Med Virol. 1994 Apr;42(4):338-47. Unique Identifier : AIDSLINE
       MED/94322014
 AB    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 meningoradiculoneuritis 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-bromovinyl)-2'-deoxyuridine (BVDU),
       9-beta-D-arabinofuranosyladenine (vidarabine),
       (S)-1-(3-hydroxy-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 immunocompromised patients.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS
       Acyclovir/*THERAPEUTIC USE  Adult  Amino Acid Sequence  Base Sequence
       Drug Resistance  Female  Herpes Zoster/*COMPLICATIONS/DRUG THERAPY
       Human  Meningitis/*ETIOLOGY  Molecular Sequence Data  Neuritis/*ETIOLOGY
       Radiculitis/*ETIOLOGY  Support, Non-U.S. Gov't  Thymidine
       Kinase/METABOLISM  JOURNAL ARTICLE

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