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Resistance of Herpesviruses to Antiviral Agents

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Antimicrobial Resistance in the 21st Century

Part of the book series: Emerging Infectious Diseases of the 21st Century ((EIDC))

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Abstract

Acyclovir is the prototype of a series of antivirals which are effective against herpesviruses. However, resistance to this class of drugs can occur and is being seen mainly in immunocompromised patients with herpes simplex virus (HSV) and varicella-zoster virus (VZV) infections. Clinical use of intravenous ganciclovir began in 1984 for the treatment of life-threatening and sight-threatening human cytomegalovirus (HCMV) infections in immunocompromised patients. A few years later, emergence of ganciclovir-resistant HCMV strains was reported in AIDS patients with HCMV retinitis and, thereafter, in organ or bone marrow transplant recipients. Foscarnet and cidofovir became available subsequently, and resistance to these agents has also been described.

In this chapter, we review the available antiviral drugs for the prevention and treatment of HCMV, HSV, and VZV infections, the methods for detecting antiviral resistance, the clinical significance of infections caused by drug-resistant strains, and their management.

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Acknowledgments

This study was supported by a Foundation Grant from the Canadian Institutes of Health Research (grant no. 148361 to G.B.). G.B. is the holder of the Canada research chair on emerging viruses and antiviral resistance.

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Authors and Affiliations

  1. Departments of Pathology and Laboratory Medicine, University of California, San Francisco, CA, USA

    William L. Drew

  2. Research Center in Infectious Diseases of the CHU of Quebec- Laval University, Quebec City, Canada

    Jocelyne Piret & Guy Boivin

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  1. William L. Drew
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  2. Jocelyne Piret
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  3. Guy Boivin
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Correspondence to Guy Boivin .

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  1. Department of Medicine, University of Toronto, Toronto, ON, Canada

    I. W. Fong

  2. Anti-infectives Consulting, LLC, Stonington, CT, USA

    David Shlaes

  3. Public Health Research Institute, New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, NJ, USA

    Karl Drlica

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Drew, W.L., Piret, J., Boivin, G. (2018). Resistance of Herpesviruses to Antiviral Agents. In: Fong, I., Shlaes, D., Drlica, K. (eds) Antimicrobial Resistance in the 21st Century. Emerging Infectious Diseases of the 21st Century. Springer, Cham. https://doi.org/10.1007/978-3-319-78538-7_8

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