High diversity of drug-resistance mutations during primary HSV-2 infection

We characterized 11 HSV-2 isolates recovered from various body sites of an immunocompromised patient suffering from a primary HSV-2 infection unresponsive to acyclovir and foscarnet. Targeted sequencing of the DNA polymerase was performed on the Illumina MiSeq. This study reveals a rapid evolution of heterogeneous drug-resistant HSV-2 populations under antiviral therapy, highlighting the need for alternative treatment options and resistance surveillance, especially in severe infections.