McGrath B J, Newman C L
Department of Pharmacy, College of Pharmacy, University of Georgia, Augusta.
Pharmacotherapy. 1994 Sep-Oct;14(5):529-42.
On August 14, 1987, the Centers for Disease Control revised the surveillance case definition for the acquired immunodeficiency syndrome (AIDS) to include several indicator diseases. The addition of herpes simplex virus (HSV) infections to the definition reemphasized the increasing frequency of severe HSV infections in patients also infected with the human immunodeficiency virus (HIV). These infections in patients with AIDS are associated with considerable morbidity similar to reports of HSV in other immunocompromised populations. Their spectrum can include persistent or recurrent genital disease, severe visceral involvement, and disseminated infection. Patients with AIDS also are at increased risk of drug toxicities when receiving treatment for HSV infections in addition to antiretroviral therapy. Acyclovir, a selective and specific inhibitor of HSV replication, has been the mainstay of safe and effective treatment for HSV for more than a decade. However, reports of acyclovir-resistant strains of HSV in patients with AIDS have been steadily increasing since 1989. Although foscarnet has been successful in treating acyclovir-resistant strains, foscarnet-resistant strains have also been isolated. The search to find novel approaches for the treatment and suppression of HSV in patients with AIDS has become an added challenge in the management of this devastating disease.
1987年8月14日，美国疾病控制中心修订了获得性免疫缺陷综合征（艾滋病）的监测病例定义，纳入了几种指示性疾病。将单纯疱疹病毒（HSV）感染纳入该定义，再次强调了在同时感染人类免疫缺陷病毒（HIV）的患者中，严重HSV感染的频率不断增加。艾滋病患者中的这些感染与相当高的发病率相关，这与其他免疫功能低下人群中HSV的报告情况类似。其范围可包括持续性或复发性生殖器疾病、严重的内脏受累以及播散性感染。艾滋病患者在接受抗逆转录病毒治疗之外，接受HSV感染治疗时发生药物毒性的风险也会增加。阿昔洛韦是一种选择性和特异性的HSV复制抑制剂，十多年来一直是治疗HSV安全有效的主要药物。然而，自1989年以来，艾滋病患者中HSV对阿昔洛韦耐药菌株的报告一直在稳步增加。虽然膦甲酸钠已成功用于治疗阿昔洛韦耐药菌株，但膦甲酸钠耐药菌株也已被分离出来。寻找治疗和抑制艾滋病患者HSV的新方法，已成为管理这种毁灭性疾病的一项额外挑战。
