The management of Herpes Simplex virus infections in HIV infected patients: Current issues and the role of cidofovir

Herpes simplex virus (HSV) type 1 and 2 are among the most common transmitted viral infections causing a spectrum of mucocutaneous and other syndromes. Treatment of these infections has primarily been with acyclovir (ACV) and prodrugs valacyclovir and famcyclovir. Immunocompromised hosts either due to human immunodeficiency virus (HIV) or other factors have given rise to an increase in ACV resistant viruses most commonly due to a mutation in the cellular thymidine kinase enzyme. This review focuses on the spectrum of disease caused by HSV 1 and 2, the emergence of ACV resistant disease, and the role of alternative agents including cidofovir in the treatment of ACV resistant disease.