Didier Raoult, B. Chanzy, A E Le Faou, F. Morinet, G. Agius, Patrice Morand, M. Aymard, Catherine Scieux, B. Picard, L. Finkielsztejn, Hervé Fleury, M. E. Lafon, Sylviane Billaudel, R. Teyssou, Catherine Mengelle, Michel Segondy, Florence Morfin, C. Danve-Szatanek, M.-C. Legrand, Cécile Henquell, T. Hadou, H. Lafeuille, L. Maille, Elisabeth Nicand, D. Thouvenot, J. Puel, Bruno Pozzetto, Christine Zandotti, Jean-Marie Seigneurin, I. Bertin, M. Coste-Burel, Shabir Omar, CHU Lyon, Hospices Civils de Lyon (HCL), Virologie et pathogenèse virale (VPV), Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, CHU Jean Bernard, Laboratoire GlaxoSmithKline [ Marly-le-Roi], Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Annecy, CHU Pellegrin, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Clermont-Ferrand, CHU Morvan, CHU Purpan, Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Hôpital Michallon, CHU Saint Louis, Hôpital d'Instruction des Armées du Val de Grâce, Service de Santé des Armées, Hôpital de la Timone [CHU - APHM] (TIMONE), CHU Saint-Eloi, CHU Nord, We thank GlaxoSmithKline laboratories for financial support. We thank S. Lambert and S. Mundweiler for excellent technical assistance., and Rollin, Bertrand
Herpes simplex virus (HSV) infections are very common in the general population and among immunocompromised patients. Acyclovir (ACV) is an effective treatment which is widely used. We deemed it essential to conduct a wide and coordinated survey of the emergence of ACV-resistant HSV strains . We have formed a network of 15 virology laboratories which have isolated and identified, between May 1999 and April 2002, HSV type 1 (HSV-1) and HSV-2 strains among hospitalized subjects. The sensitivity of each isolate to ACV was evaluated by a colorimetric test (C. Danve, F. Morfin, D. Thouvenot, and M. Aymard, J. Virol. Methods 105:207-217, 2002). During this study, 3,900 isolated strains among 3,357 patients were collected; 55% of the patients were immunocompetent. Only six immunocompetent patients excreted ACV-resistant HSV strains (0.32%), including one female patient not treated with ACV who was infected primary by an ACV-resistant strain. Among the 54 immunocompromised patients from whom ACV-resistant HSV strains were isolated (3.5%), the bone marrow transplantation patients showed the highest prevalence of resistance (10.9%), whereas among patients infected by human immunodeficiency virus, the prevalence was 4.2%. In 38% of the cases, the patients who excreted the ACV-resistant strains were treated with foscarnet (PFA), and 61% of them developed resistance to PFA. The collection of a large number of isolates enabled an evaluation of the prevalence of resistance of HSV strains to antiviral drugs to be made. This prevalence has remained stable over the last 10 years, as much among immunocompetent patients as among immunocompromised patients.