Challenges of aciclovir-resistant HSV infection in allogeneic bone marrow transplant recipients.

•Emergence of HSV resistance to Aciclovir (ACV) has been increasingly reported in immunocompromised patients.•This study describes patient characteristics and management of ACV-resistant HSV infection in allogeneic bone marrow transplant patients.•Prolonged immunosuppression, long-term ACV and graft versus host disease pose a challenge to the management of ACV-resistant HSV infection.•Early testing for ACV resistance on clinical suspicion using genotyping assays may help management.•Effective treatment options remain an unmet need in ACV-resistant HSV infection.