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Acyclovir-resistant herpes simplex virus (HSV) infections are an uncommon but debilitating complication of advanced HIV disease. Such resistant strains are usually of the thymidine kinase negative phenotype, making acyclovir therapy ineffective since the drug is not converted to its active form. While foscarnet is effective treatment for acyclovir-resistant HSV, the drug must be given IV and can have adverse effects. This is a pilot study of trifluridine, an ophthalmic topical antiviral, for clinically-resistant HSV disease.
Patients were eligible for this study if they had mucocutaneous HSV disease that persisted despite oral or IV acyclovir. Twenty-six patients with AIDS were enrolled; of these, 24 were evaluable for efficacy and 25 for to…