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M9490070.TXT
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1994-09-03
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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).