HSV esophagitis presenting in a patient with impaired immunity represents a distinct clinical situation. Immune status directly influences how this infection is managed and how long treatment should continue.
This protocol applies specifically to HSV esophagitis occurring in the setting of impaired immunity — a sub-population in which the infection can be more difficult to control and may require a different therapeutic strategy than in immunocompetent hosts.
Management involves a targeted antiviral strategy — the agent selected and the rationale for its use in this immune context are specified in the full protocol.
DOI: 10.5114/pg.2013.39914
Patients with impaired immunity should be treated longer with a course of oral acyclovir therapy 400 mg five times a day for 2 to 3 weeks.
Patients who do not respond to therapy probably are infected with a virus strain resistant to acyclovir resulting from mutations within the thymidine kinase or the DNA polymerase gene of HSV.
In that case treatment with foscarnet can be an option.
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