Acyclovir‐Resistant Herpes Simplex Virus in Pediatric Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplant: A Case Series

Acyclovir-resistant HSV infection in pediatric HSCT recipients is associated with high morbidity and mortality, limited therapeutic options, and significant treatment-related nephrotoxicity. Early recognition, early resistance testing, prompt initiation of second-line therapy, and weaning of immunosuppression are critical. Emerging therapies, such as helicase-primase inhibitors and adoptive T-cell therapy, hold promise but remain limited by access and pediatric data.