Foscarnet (Foscavir) is an inorganic pyrophosphate analogue that acts in vitro against HSV-1,HSV-2,VZV, CMV, EBV, HBV, and HIV. It acts as a noncompetitive inhibitor of viral DNA polymerase and reverse transcriptase by re-versibly binding to the pyrophosphate-binding site of the viral enzyme and preventing the cleavage of pyrophosphate from deoxynucleoside triphosphates.
Resistance to foscarnet may result from mutation of viral DNA polymerase. Because this drug does not require phosphorylation for activation, thymidine kinase-deficient mutants should not be resistant to fos-carnet.
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