Reactivation of Multidrug-Resistant HSV-1 in a Post-Allogenic Hematopoietic Stem Cell Transplant Patient: Dynamic Detection of the Rare A605V Mutation by Next-Generation Sequencing

Shuxuan Zheng; Lidewij L W Rümke; Bruno Tello Rubio; Malbert R C Rogers; Geerte L van Sluis; Jürgen H E Kuball; Annelies Riezebos-Brilman; Robert Jan Lebbink; Frans M Verduyn Lunel

doi:10.1093/ofid/ofae250

Reactivation of Multidrug-Resistant HSV-1 in a Post-Allogenic Hematopoietic Stem Cell Transplant Patient: Dynamic Detection of the Rare A605V Mutation by Next-Generation Sequencing

Open Forum Infect Dis. 2024 May 3;11(5):ofae250. doi: 10.1093/ofid/ofae250. eCollection 2024 May.

Authors

Shuxuan Zheng¹, Lidewij L W Rümke¹, Bruno Tello Rubio¹, Malbert R C Rogers¹, Geerte L van Sluis², Jürgen H E Kuball², Annelies Riezebos-Brilman¹, Robert Jan Lebbink¹, Frans M Verduyn Lunel¹

Affiliations

¹ Department of Medical Microbiology, UMC Utrecht, Utrecht, The Netherlands.
² Department of Haematology UMC Utrecht, Utrecht, The Netherlands.

Abstract

We present an immunocompromised patient with a multiresistant herpes simplex virus-1 reactivation with a rare mutation (A605V) in the viral DNA polymerase gene. Next-generation sequencing suggests the presence of multiple drug-resistant strains before treatment and altered ratios during treatment, affecting the clinical response to aciclovir and foscarnet.

Keywords: HSV-1; aciclovir; foscarnet; multidrug resistance; stem cell transplantation.