Selective defect in plasmacyoid dendritic cell function in a patient with AIDS-associated atypical genital herpes simplex vegetans treated with imiquimod

We report a case of acquired immunodeficiency syndrome ( AIDS) - associated, acyclovir- refractory genital herpes infection treated with topical imidazoquinoline therapy. The patient's plasmacytoid dendritic cells made a robust interferon-alpha response following in vitro stimulation with imidazoquinolinebut not with herpes simplex virus. We hypothesize that disease resulting from defective herpes simplex virus-stimulated interferona may be overcome by stimulating intact alternative pathways.