Leflunomide in the Treatment of a Pseudotumoral Genital Herpes Simplex Virus Infection in an HIV Patient

Joint Authors

Roger, Marie R.
Anstead, Gregory M.

Source

Case Reports in Infectious Diseases

Issue

Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-5, 5 p.

Publisher

Hindawi Publishing Corporation

Publication Date

2017-03-08

Country of Publication

Egypt

No. of Pages

5

Main Subjects

Diseases

Abstract EN

The patient is a 52-year-old African American man with a past medical history of HIV infection (on antiretroviral therapy, CD4 count 399 cells/µL, and undetectable HIV viral load) and recurrent genital herpes.

While on valacyclovir, the patient presented with four tumorous lesions on the perineum and scrotum.

A biopsy specimen stained positively with HSV-1 and HSV-2 immunostains and displayed a lymphoplasmacytic infiltrate.

The patient received foscarnet and imiquimod for two weeks with minimal improvement.

Based on the previous activity of leflunomide, which has both antiviral and immunomodulatory properties, in cytomegalovirus and herpes simplex infections, leflunomide 20 mg orally twice daily was started.

The patient received 23 days of foscarnet, 14 days of topical imiquimod, and 11 days of leflunomide with approximately 80% reduction in the size of the perineal lesion.

After nine months on leflunomide there was complete regression of the large perineal lesion and only two small ulcerations remained on the scrotum.

Pseudotumoral herpes lesions in HIV patients represent an immune reconstitution event and are poorly responsive to the usual anti-herpes agents.

This report demonstrates the successful use of leflunomide in the treatment of an HIV patient with pseudotumoral herpes.

Thalidomide has also been used with some success.

American Psychological Association (APA)

Roger, Marie R.& Anstead, Gregory M.. 2017. Leflunomide in the Treatment of a Pseudotumoral Genital Herpes Simplex Virus Infection in an HIV Patient. Case Reports in Infectious Diseases،Vol. 2017, no. 2017, pp.1-5.
https://search.emarefa.net/detail/BIM-1146224

Modern Language Association (MLA)

Roger, Marie R.& Anstead, Gregory M.. Leflunomide in the Treatment of a Pseudotumoral Genital Herpes Simplex Virus Infection in an HIV Patient. Case Reports in Infectious Diseases No. 2017 (2017), pp.1-5.
https://search.emarefa.net/detail/BIM-1146224

American Medical Association (AMA)

Roger, Marie R.& Anstead, Gregory M.. Leflunomide in the Treatment of a Pseudotumoral Genital Herpes Simplex Virus Infection in an HIV Patient. Case Reports in Infectious Diseases. 2017. Vol. 2017, no. 2017, pp.1-5.
https://search.emarefa.net/detail/BIM-1146224

Data Type

Journal Articles

Language

English

Notes

Includes bibliographical references

Record ID

BIM-1146224