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Cutaneous ManifestationsQuestion 2/10

A 43-year-old man with HIV and a CD4 count of 67 cells/mm3 presents with a painful ulcerated genital lesion that he noticed about 3 weeks prior. He has a history of genital herpes simplex virus (HSV) infection and has frequently taken acyclovir in the past. With this current episode of herpes, he has been taking oral acyclovir for 10 days with no improvement. Culture of a lesion demonstrates HSV-2 and susceptibility testing shows acyclovir resistance.

Which one of the following statements is TRUE regarding acyclovir-resistant HSV in persons with HIV?

Abbreviations: ACV = acyclovir; P = phosphate
Figure 1. Acyclovir: Mechanism of Action.
Abbreviations: ACV = acyclovir; P = phosphate
The most common form of acyclovir resistance results from decreased or absent production of viral thymidine kinase, which prevents acyclovir from reaching the activated triphosphate state. Abbreviations: ACV = acyclovir; P = phosphate
Figure 2. Mechanisms of Acyclovir Resistance
The most common form of acyclovir resistance results from decreased or absent production of viral thymidine kinase, which prevents acyclovir from reaching the activated triphosphate state. Abbreviations: ACV = acyclovir; P = phosphate
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Question Last Updated
January 28th, 2025

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