{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:52:53Z","timestamp":1792093973870,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T00:00:00Z","timestamp":1690502400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004844","name":"National Cheng Kung University Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004844","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Herpes simplex virus type 1 (HSV\u20101) can establish latency in humans and easily relapse in immunocompromised patients, with significant mortality. Treatment with acyclovir (ACV) can result in the emergence of HSV resistance. A total of 440 frozen HSV\u20101 isolates collected from 318 patients from January 2014 to July 2019 were obtained from National Cheng Kung University Hospital in southern Taiwan. These 440 isolates were subjected to phenotypic studies for ACV\u2010resistance by initial screening with the plaque reduction assay (PRA) and further validation by the DNA reduction assay (DRA). The ACV\u2010resistant strains were further investigated by Sanger sequencing for the full\u2010length UL23 and UL30 genes, which encode thymidine kinase and DNA polymerase, respectively. Hematological malignancies or hematopoietic stem\u2010cell transplantation patients accounted for 56.9% (124\/218) among the immunocompromised patients (218\/318) in this study. Repeated sampling for HSV testing was 50% (109\/218) in immunocompromised patients. Only 1.38% (3\/218) of immunocompromised patients and 0.9% (3\/318) of all patients developed ACV\u2010resistant HSV\u20101 as measured by phenotypic screening assays. It is noteworthy that a novel Y248D mutation in the UL23 gene from an immunocompromised patient was found by both PRA and DRA. In 3D protein predicting analysis, uncharged Y248 was located at an alpha\u2010helix and substituted by negative\u2010charged D248, which may alter the function of viral thymidine kinase. Besides, three unreported mutations related to natural polymorphism were found in virus isolates from two immunocompetent patients, including 683\u2212688 deletion, R227H, and A351D in the UL30 gene. These data show that the prevalence of ACV\u2010resistant HSV\u20101 among immunocompromised patients in southern Taiwan is low. These results will be helpful for the clinical management and treatment of HSV infections.<\/jats:p>","DOI":"10.1002\/jmv.28985","type":"journal-article","created":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T14:55:00Z","timestamp":1690556100000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Acyclovir\u2010resistant HSV\u20101 isolates among immunocompromised patients in southern Taiwan: Low prevalence and novel mutations"],"prefix":"10.1002","volume":"95","author":[{"given":"Jhao\u2010You","family":"Kuo","sequence":"first","affiliation":[{"name":"Department of Medical Laboratory Science and Biotechnology, College of Medicine National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9567-2552","authenticated-orcid":false,"given":"Chun\u2010Sheng","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of 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