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https://www.readbyqxmd.com/read/28822107/successful-treatment-and-fdg-pet-ct-monitoring-of-hhv-6-encephalitis-in-a-non-neutropenic-patient-case-report-and-literature-review
#1
Elda Righi, Alessia Carnelutti, Daniele Muser, Francesco Zaja, Elisa Lucchini, Federico Pea, Fernando Di Gregorio, Abass Alavi, Matteo Bassetti
Human herpesvirus (HHV)-6 reactivation is associated with severe forms of encephalitis among patients undergoing hematopoietic stem cell transplantation. Cases in non-neutropenic patients are uncommon. The efficacy of ganciclovir and other compounds that are used for the treatment of HHV-6 encephalitis remains suboptimal and linked to toxicity. Valganciclovir, the oral prodrug of ganciclovir, could be practical to treat outpatients, but it is not commonly used for severe cases. We report a case of HHV-6 encephalitis in a non-neutropenic patient successfully treated with valganciclovir and undergoing therapeutic drug monitoring in plasma and in the cerebrospinal fluid...
August 18, 2017: Journal of Neurovirology
https://www.readbyqxmd.com/read/28781310/severe-thrombocytopenia-during-dolutegravir-containing-antiretroviral-therapy
#2
Kazuhiko Nakaharai, Makiko Miyajima, Hiroaki Kobayashi, Akihiro Shimizu, Yumiko Hosaka, Tetsuya Horino, Seiji Hori
A 56-year-old Japanese man diagnosed with acquired immunodeficiency syndrome, Pneumocystis jirovecii pneumonia and cytomegalovirus infection presented with thrombocytopenia after starting antiretroviral therapy, which included dolutegravir (DTG). Although good control of the human immunodeficiency virus and cytomegalovirus infections was achieved, the patient's thrombocytopenia persisted. The patient's platelet count decreased to ≤50,000 /μL even after the cessation of valganciclovir, which can cause bone marrow suppression...
August 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28736953/neutropenia-in-kidney-and-liver-transplant-recipients-risk-factors-and-outcomes
#3
Thomas A Mavrakanas, Marie-Andrée Fournier, Sarah Clairoux, Jacques-Alexandre Amiel, Marie-Eve Tremblay, Donald C Vinh, Christian Coursol, Daniel J G Thirion, Marcelo Cantarovich
No studies have directly compared the key characteristics and outcomes of kidney (KTx) and liver transplantation (LTx) recipients with neutropenia. In this single-center, retrospective, cohort study, we enrolled all adult patients who received a KTx or LTx between 2000 and 2011. Neutropenia was defined as two consecutive absolute neutrophil count (ANC) values <1500/mm(3) in patients without preexisting neutropenia. The first neutropenia episode occurring during the first-year posttransplantation was analyzed...
July 24, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28734808/-congenital-cytomegalovirus-infection-manifesting-as-neonatal-respiratory-distress-in-an-hiv-exposed-uninfected-newborn
#4
A Pham, H El Mjati, N Nathan, F Kieffer, D Mitanchez
BACKGROUND: Cytomegalovirus (CMV) is one of the most common intrauterine infections, affecting approximately 1% of all live births. There are few reports on congenital CMV infections manifesting as isolated pneumonitis. CASE REPORT: We report a case of congenital CMV with neonatal respiratory distress affecting an HIV-exposed uninfected infant. This infant required noninvasive ventilation beginning within the first 15min of life. The initial chest X-ray showed diffuse bilateral ground-glass opacifications...
July 19, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28733760/intrauterine-therapy-of-cytomegalovirus-infection-with-valganciclovir-review-of-the-literature
#5
REVIEW
Vera Seidel, Cornelia Feiterna-Sperling, Jan-Peter Siedentopf, Jörg Hofmann, Wolfgang Henrich, Christoph Bührer, Katharina Weizsäcker
Congenital cytomegalovirus (CMV) infection is the leading cause for sensorineural hearing loss and mental retardation in children without genetic diseases worldwide. There is little evidence guiding therapeutic strategies during pregnancy when intrauterine fetal CMV infection is confirmed. We provide a systematic review of the use of ganciclovir (GCV) or VGCV during pregnancy discussing safety of its use for mother and fetus and describe two cases of intrauterine therapy of fetal CMV infection with valganciclovir (VGCV)...
July 21, 2017: Medical Microbiology and Immunology
https://www.readbyqxmd.com/read/28719361/effectiveness-of-valganciclovir-900mg-versus-450mg-for-cytomegalovirus-prophylaxis-in-renal-transplantation-a-systematic-review-and-meta-analysis
#6
Wang Xin, Yang Hui, Zhang Xiaodong, Cui Xiangli, Wang Shihui, Liu Lihong
OBJECTIVES: Valganciclovir 900 mg/day is approved for cytomegalovirus (CMV) prophylaxis, but 450 mg/day is seems also effective. We systematically reviewed the efficacy and safety of low-dose versus high-dose valganciclovir prophylaxis in renal transplantation recipients. METHODS: An electronic search was conducted up to November 29, 2016. The primary outcomes were incidences of CMV, CMV disease, mortality and opportunistic infection. The second outcomes were acute rejection, allograft loss, adverse drug reaction (ADR)...
2017: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28699311/ganciclovir-resistant-cytomegalovirus-infection-in-abdominal-solid-organ-transplant-recipients-case-series-and-review-of-the-literature
#7
K E Rolling, M R Jorgenson, J L Fose, D A Mandelbrot, R R Redfield, J A Smith
Ganciclovir-resistant cytomegalovirus (GR-CMV) is emerging as a significant infection in the abdominal transplant population. GR-CMV is difficult to manage, and treatment options are limited. We report a descriptive case series of 15 patients who had documented GR-CMV at our center and review the literature on treatment of GR-CMV. The first case in this series was detected in 2012; the majority of cases occurred after January 1, 2014, with approximately 50% occurring in 2015. UL97 and UL54 viral genome mutations were present in 100% and 40% of CMV-infected patients, respectively...
July 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28663679/cytomegalovirus-infection-in-liver-transplant-recipients-current-approach-to-diagnosis-and-management
#8
REVIEW
Sanjay K Yadav, Sanjiv Saigal, Narendra S Choudhary, Sujit Saha, Navin Kumar, Arvinder S Soin
Cytomegalovirus (CMV) infection is the most common viral infection in liver transplant recipients, affecting post-transplant patients and graft survival. Recent advances in diagnosis and management of CMV have led to marked reduction in incidence, severity, and its associated morbidity and mortality. CMV DNA assay is the most commonly used laboratory parameter to diagnose and monitor CMV infection. Current evidence suggests that both pre-emptive and universal prophylaxis approaches are equally justified in liver transplant recipients...
June 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28660653/cytomegalovirus-infection-in-hematologic-malignancy-settings-other-than-the-allogeneic-transplant
#9
REVIEW
F Marchesi, F Pimpinelli, F Ensoli, A Mengarelli
Cytomegalovirus (CMV) infection in clinical settings other than the allogeneic transplant represents a poorly explored issue. Thus, we performed a comprehensive review of the medical literature about CMV infection in patients undergoing autologous hematopoietic stem cell transplant and in other nontransplant-related hematologic patients. In autologous hematopoietic stem cell transplant, a CMV reactivation is reported to occur in up to 41% of CMV seropositive patients, when a prospective monitoring of antigenemia and/or viremia by polymerase chain reaction was adopted...
June 29, 2017: Hematological Oncology
https://www.readbyqxmd.com/read/28657962/a-common-anti-cytomegalovirus-drug-ganciclovir-inhibits-hiv-1-replication-in-human-tissues-ex-vivo
#10
Christophe Vanpouille, Jean A Bernatchez, Andrea Lisco, Anush Arakelyan, Elisa Saba, Matthias Götte, Leonid Margolis
BACKGROUND: Cytomegalovirus (CMV) is a common HIV-1 copathogen. Since CMV infection is an important contributor to immune activation, the driving force of HIV disease, an anti-CMV strategy might be beneficial to HIV-infected patients. Shin et al. (J Acquir Immune Defic Syndr 2014; 65:251-258) reported that anti-CMV therapy with valganciclovir in coinfected individuals results in a decrease of HIV viral load that is not accompanied by a decrease of immune activation. This suggests an alternative mechanism for HIV inhibition other than suppression of CMV-mediated inflammation...
July 17, 2017: AIDS
https://www.readbyqxmd.com/read/28614157/probable-donor-derived-cytomegalovirus-disease-after-keratolimbal-allograft-transplantation
#11
Albert Y Cheung, Amit Govil, Scott R Friedstrom, Edward J Holland
PURPOSE: To report a case of probable donor-derived cytomegalovirus (CMV) infection after keratolimbal allograft (KLAL) transplantation. METHODS: Observational case report. RESULTS: A 41-year-old man with a history of aniridic keratopathy and limbal stem cell deficiency underwent KLAL in his right eye. Preoperatively, he was negative for CMV IgG and IgM. Postoperatively, he was maintained on tacrolimus and mycophenolate mofetil for systemic immunosuppression; he was also on prophylactic valganciclovir (for CMV) and trimethoprim/sulfamethoxazole (for pneumocystis pneumonia) for 1 month...
August 2017: Cornea
https://www.readbyqxmd.com/read/28613442/the-effect-of-different-immunoprophylaxis-regimens-on-post-transplant-cytomegalovirus-cmv-infection-in-cmv-seropositive-liver-transplant-recipients
#12
Chian Yong Low, Seyed Mohammadmehdi Hosseini-Moghaddam, Coleman Rotstein, Eberhard L Renner, Shahid Husain
BACKGROUND: The effects of different immunoprophylaxis regimens on cytomegalovirus (CMV) infection in liver transplant recipients (LTRs) have not been compared. METHODS: In a cohort, we studied 343 CMV-seropositive recipient (R+) and 83 seronegative donor/recipient (D-/R-) consecutive LTRs from 2004 to 2007. Immunoprophylaxis regimens included steroid-only, steroids plus rabbit anti-thymocyte globulin (rATG), and steroids plus basiliximab. Logistic regression analysis, Cox proportional hazards regression model, and log-rank test were performed for multivariate analysis as appropriate...
June 14, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28608847/hadv-c6-is-a-more-relevant-challenge-virus-than-hadv-c5-for-testing-antiviral-drugs-with-the-immunosuppressed-syrian-hamster-model
#13
Karoly Toth, Jacqueline F Spencer, Baoling Ying, Ann E Tollefson, William S M Wold
Adenovirus infections of immunocompromised patients can cause a severe multi-organ disease that often results in the patients' death. Presently, there are no drugs specifically approved to treat adenovirus infections, and clinicians resort to the off-label use of antivirals that are approved to treat other DNA virus infections, most frequently cidofovir (CDV). CDV, however, has considerable nephrotoxicity, thus it is recommended only for the most severe cases of adenovirus infections. To facilitate the development of effective, non-toxic antivirals against adenovirus, we have developed a permissive animal model based on the Syrian hamster that can be used to test the efficacy of antiviral compounds...
June 13, 2017: Viruses
https://www.readbyqxmd.com/read/28601128/expanded-valganciclovir-prophylaxis-in-kidney-transplant-recipients-is-associated-with-lower-incidence-of-cytomegalovirus-infection
#14
Željka Večerić-Haler, Boštjan Bizjak, Karmen Romozi, Miha Arnol
AIMS: The aim of this study was to compare the efficacy and safety of two subsequent CMV prophylaxis regimens for prevention of cytomegalovirus (CMV) infection and disease in our kidney transplant recipients (KTRs). METHODS: In an historic-cohort of KTRs, two CMV prophylaxis protocols were compared: short protocol in which CMV IgG seronegative recipients (R-) of CMV IgG seropositive donors (D+) received valganciclovir for 3 months post-transplant (group 1: 2005 - 2010); and expanded protocol in which prophylaxis for high-risk recipients was extended to 6 months, and a 3-month prophylaxis for D+/R+ and D-/R+ was introduced (group 2: 2011 - 2016)...
June 9, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28580733/case-report-of-a-primary-effusion-lymphoma-successfully-treated-with-oral-valganciclovir-after-failing-chemotherapy
#15
Juan Marquet, Kyra Velazquez-Kennedy, Sandra López, Amparo Benito, María-Jesús Blanchard, Jose Antonio Garcia-Vela
Primary effusion lymphoma is a rare non-Hodgkin lymphoma that presents with pleural effusions and lacking of tumour mass. It is universally associated with human herpesvirus 8 (HHV8) and is more frequent among immunosuppressed patients. There is no standard treatment, chemotherapy and anti-HIV therapy have been used with poor results, but there is still no strong evidence supporting the use of valganciclovir. We present the case of a HIV positive man that presented with pleural effusion compatible with primary effusion lymphoma and positivity for HHV8 DNA in blood...
June 4, 2017: Hematological Oncology
https://www.readbyqxmd.com/read/28524216/-update-on-congenital-and-neonatal-herpes-infections-infection-due-to-cytomegalovirus-and-herpes-simplex
#16
F Baquero-Artigao
Newborn infants are a population which is especially susceptible to viral infections that frequently affect the central nervous system. Herpes infections can be transmitted to the foetus and to the newborn infant, and give rise to severe clinical conditions with long-term sensory and cognitive deficits. Two thirds of newborn infants with encephalitis due to herpes simplex virus and half of the children with symptomatic congenital infection by cytomegalovirus develop sequelae, which results in high community health costs in the long term...
May 17, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28513810/epstein-barr-virus-encephalitis-in-solid-organ-transplantation
#17
Jillian SY Lau, Zhi Mei Low, Iain Abbott, Lani Shochet, John Kanellis, Arthur Richard Kitching, Tony M Korman
Epstein-Barr virus (EBV) is typically associated with post transplant lymphoproliferative disease (PTLD) after solid organ and stem cell transplantation. However, it is rarely associated with neurological complications. We report a case of severe encephalitis complicating primary EBV infection six months post renal transplantation, and review the literature on EBV encephalitis in solid organ transplantation in adults. A 55-year-old male presented 6 months post cadaveric renal transplant with headache, fever and confusion...
May 17, 2017: New Microbiologica
https://www.readbyqxmd.com/read/28489256/clinical-and-virologic-outcomes-in-high-risk-adult-epstein-barr-virus-mismatched-organ-transplant-recipients
#18
Deepali Kumar, Nikhil Patil, Shahid Husain, Cecilia Chaparro, Mamatha Bhat, S Joseph Kim, Atul Humar
Epstein-Barr virus (EBV) D+/R- organ transplant recipients are a high-risk group for developing post-transplant lymphoproliferative disease (PTLD). Little data are available for prevention in the adult EBV mismatched population. We conducted a retrospective study of EBV D+/R- organ transplants performed during 2002-2014. Of the 153 patients identified, 82.4% patients received antiviral prophylaxis with valganciclovir for a median of 4.5 months (range: 0.8-22 months) and 36.6% underwent viral load monitoring in the first post-transplant year...
May 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28481774/a-common-anti-cmv-drug-ganciclovir-inhibits-hiv-1-replication-in-human-tissues-ex-vivo
#19
Christophe Vanpouille, Jean A Bernatchez, Andrea Lisco, Anush Arakelyan, Elisa Saba, Matthias Götte, Leonid Margolis
: Cytomegalovirus (CMV) is a common HIV-1 copathogen. Since CMV infection is an important contributor to immune activation, the driving force of HIV disease, an anti-CMV strategy might be beneficial to HIV-infected patients. Shin et al. reported that anti-CMV therapy with valganciclovir in coinfected individuals results in a decrease of HIV viral load that is not accompanied by a decrease of immune activation. This suggests an alternative mechanism for HIV inhibition other than suppression of CMV-mediated inflammation...
May 5, 2017: AIDS
https://www.readbyqxmd.com/read/28437539/safety-and-efficacy-of-antiviral-therapy-for-prevention-of-cytomegalovirus-reactivation-in-immunocompetent-critically-ill-patients-a-randomized-clinical-trial
#20
RANDOMIZED CONTROLLED TRIAL
Nicholas J Cowley, Andrew Owen, Sarah C Shiels, Joanne Millar, Rebecca Woolley, Natalie Ives, Husam Osman, Paul Moss, Julian F Bion
Importance: Latent cytomegalovirus (CMV) infection is present in more than half the adult population, and a viral reactivation (ie, when the virus becomes measurable in body fluids such as blood) can occur in up to one-third of these individuals during episodes of critical illness. Objective: To determine whether antiviral therapy is safe and effective for preventing CMV reactivation in a general population of critically ill patients. Design, Setting, and Participants: A single-center, open-label, randomized, controlled clinical trial recruited 124 CMV-seropositive patients undergoing mechanical ventilation for at least 24 hours in the intensive care unit between January 1, 2012, and January 31, 2014...
June 1, 2017: JAMA Internal Medicine
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