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bioRxiv · 10.1101/808303

Phenotypic and Genotypic Antiviral Resistance Testing of HSV-1 Causing Recurrent Cutaneous Lesions in a Patient with DOCK8 Deficiency

Casto, A. M.·Stout, S. C.·Selvarangan, R.·Freeman, A. F.·Newell, B. D.·Stahl, E. D.·Greninger, A. L.·Yin, D. E.
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Abstract

Antiviral resistance frequently complicates treatment of herpes simplex virus (HSV) infections in immunocompromised patients. Here we review the case of an adolescent boy with dedicator of cytokinesis 8 (DOCK8) deficiency, who experienced recurrent infections with resistant HSV-1. We used both phenotypic and genotypic methodologies to characterize the resistance profile of HSV-1 in the patient and conclude that genotypic testing outperformed phenotypic testing. We also present the first analysis of intrahost HSV-1 evolution in an immunocompromised patient. While HSV-1 can remain static in an immunocompetent individual for decades, the virus from this patient rapidly acquired genetic changes throughout its genome.

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Casto, A. M., Stout, S. C., Selvarangan, R., Freeman, A. F., Newell, B. D., Stahl, E. D., Greninger, A. L., Yin, D. E.. 2019-10-17. Phenotypic and Genotypic Antiviral Resistance Testing of HSV-1 Causing Recurrent Cutaneous Lesions in a Patient with DOCK8 Deficiency. https://doi.org/10.1101/808303

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