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Queratitis Herpética
21
un factor fundamental a considerar para
la necesidad de profilaxis con antivirales
sistémicos. Está demostrado que luego de la
resolución de la patología herpética corneal,
el uso de 12 meses de profilaxis antiviral
con Aciclovir 400mg 2 veces al día vía oral,
reduce la recurrencia en un 40% en patología
ocular por VHS y en un 50% en las queratitis
estromales si se compara con el placebo
24
.
Estudios recientes demuestran hasta un 26%
de cepas resistentes de VHS a Aciclovir en
pacientes con antecedentes de queratitis
estromales tratadas. Los principales factores
pronósticos asociados a la resistencia viral
son el uso mayor a 12 meses de tratamiento
con antivirales en dosis de profilaxis y la
duración mayor de 45 días de la recurrencia.
La resistencia del VHS es factor de riesgo
para compromisos corneales refractarios
25
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