Shin Young Kyoo, Weinberg Adriana, Spruance Spotswood, Bernard Mariann, Bacon Teresa H, Boon Ron J, Levin Myron J
Section of Pediatric Infectious Diseases, School of Medicine, University of Colorado, Denver, Colorado, USA.
J Infect Dis. 2003 Apr 15;187(8):1241-5. doi: 10.1086/373993. Epub 2003 Mar 26.
Subjects received topical penciclovir for 4 days during successive episodes of recurrent herpes labialis. Isolation of herpes simplex virus (HSV) was attempted from lesions obtained before initiation of treatment and on each day of therapy. Isolates remained sensitive to penciclovir when tested by a plaque reduction assay, and there was no significant change in sensitivity during any treatment course or between successive treatments. The proportion of nucleoside-resistant variants present within a subset of these isolates was further investigated using a more-sensitive plating efficiency assay. Although the proportion of antiviral-resistant HSV variants increased on successive days, it invariably remained a minor subpopulation. Moreover, isolates from successive episodes obtained before treatment showed no change in the proportion of resistant HSV variants. We conclude that antiviral-resistant variants, which are readily detected in HSV isolates from peripheral lesions, do not accumulate in the sensory ganglia of immunocompetent patients receiving multiple courses of nucleoside analogues.
复发性唇疱疹连续发作期间，受试者接受了4天的喷昔洛韦局部治疗。在开始治疗前以及治疗的每一天，均尝试从病变部位分离单纯疱疹病毒（HSV）。通过蚀斑减少试验检测时，分离株对喷昔洛韦仍敏感，且在任何治疗疗程期间或连续治疗之间，敏感性均无显著变化。使用更敏感的平板接种效率试验进一步研究了这些分离株亚群中存在的核苷抗性变体的比例。尽管抗病毒抗性HSV变体的比例在连续几天有所增加，但它始终只是一个较小的亚群。此外，治疗前连续发作分离得到的分离株中，抗性HSV变体的比例没有变化。我们得出结论，在接受多个疗程核苷类似物治疗的免疫功能正常患者的感觉神经节中，在外周病变的HSV分离株中容易检测到的抗病毒抗性变体不会积累。
