SUCCESSFUL ORAL ACYCLOVIR DESENSITIZATION

A 65-year-old woman with the acquired immunodeficiency syndrome (AIDS) complicated by recurrent mucocutaneous herpes simplex virus (HSV) inf ection developed angioedema on the initiation of her second course of oral acyclovir therapy. Oral rechallenge in hospital three days later confirmed acyclovir hypersensitivity. Vidarabine and foscarnet therapi es were abandoned after treatment failure and unacceptable toxicity. A cyclovir desensitization was accomplished using a protocol derived fro m oral penicillin desensitization regimens. Mucocutaneous HSV infectio n responded to intravenous acyclovir followed by chronic oral suppress ion without recurrences of HSV or hypersensitivity. This report is an example of acyclovir hypersensitivity and successful oral desensitizat ion.