ANTIMICROBIAL AGENTS: VIRAL: Edited by Michelle K. YongResistant herpes simplex virus infections – who, when, and what's new?Kotton, Benjamin D.; Kotton, Camille N. Author Information Benjamin Deane Kotton, Yale University, New Haven, Connecticut, USA Correspondence to Camille N. Kotton, MD, FIDSA, FAST, Clinical Director, Transplant and Immunocompromised Host Infectious Diseases Infectious Diseases Division Massachusetts General Hospital Harvard Medical School 55 Fruit Street, Cox 5 Boston, MA 02114, USA. Tel: +1 617 724 0082; fax: +1 617 726 7653; e-mail: [email protected] Current Opinion in Infectious Diseases: December 2022 - Volume 35 - Issue 6 - p 530-535 doi: 10.1097/QCO.0000000000000889 Buy Metrics Abstract Purpose of review This review summarizes the literature on acyclovir resistant herpes infections and the most recent data pertinent to diagnosis and treatment in the immunocompromised patient population. Recent findings Although fairly rare, acyclovir resistant herpes infections can be challenging to diagnose. Clinicians should be aware of this entity when facing refractory herpes infections. With updated diagnostics, the diagnosis is usually made through viral culture and sequencing. Therapeutic choices depend on the extent of disease. Topical therapy may be appropriate for mucocutaneous disease. Intravenous antiviral therapies such as foscarnet and cidofovir may be necessary for disseminated, ophthalmologic, central nervous system, or visceral disease. Experimental therapies such as pritelivir are in clinical trials. Summary Immunosuppressed patients are at risk for developing acyclovir-resistant herpes, which can be challenging to diagnose and treat, although emerging therapeutic options look promising. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.