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https://www.readbyqxmd.com/read/29407298/high-dose-valganciclovir-treatment-for-resistant-cytomegalovirus-colitis-due-to-ul97-and-ul54-mutations
#1
K M Baradhi, R L Aure, J-M El-Amm
We report the first case of a ganciclovir-resistant cytomegalovirus (CMV) involving the gastrointestinal tract that was successfully treated with high-dose valganciclovir. A kidney transplant recipient developed drug-resistant CMV colitis which was initially treated with valganciclovir, but his CMV was found to have major resistance to ganciclovir and cidofovir due to UL97 and UL54 mutations. The patient was switched to intravenous foscarnet 40 mg/kg given every twelve hours. However, foscarnet had to be discontinued after 4 days of treatment due to acute kidney injury...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29407294/prevention-of-late-onset-cytomegalovirus-infection-and-disease-in-donor-positive-recipient-negative-kidney-transplant-recipients-using-low-dose-valganciclovir
#2
K Nanmoku, T Shinzato, T Kubo, T Shimizu, T Kimura, T Yagisawa
BACKGROUND: The main challenge with cytomegalovirus (CMV) prophylaxis in IgG donor-positive/recipient-negative (D+/R-) kidney transplant recipients is late-onset CMV disease. We evaluated a novel protocol for the prevention of late-onset CMV infection and disease in D+/R- organ recipients. METHODS: Our prospective, observational, cohort study included 100 adult kidney transplant recipients. Prophylaxis with low-dose valganciclovir (450 mg/d, 3 times a week for 6 months) was administered to D+/R- recipients...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29397198/valganciclovir-use-among-commercially-and-medicaid-insured-infants-with-congenital-cmv-infection-in-the-united-states-2009-2015
#3
Jessica Leung, Sheila C Dollard, Scott D Grosse, Winnie Chung, ThuyQuynh Do, Manisha Patel, Tatiana M Lanzieri
PURPOSE: The aim of this study was to assess the clinical characteristics and trends in valganciclovir use among infants diagnosed with congenital cytomegalovirus (CMV) disease in the United States. METHODS: We analyzed data from medical claims dated 2009-2015 from the Truven Health MarketScan® Commercial Claims and Encounters and Medicaid databases. We identified infants with a live birth code in the first claim who were continuously enrolled for at least 45 days...
January 31, 2018: Clinical Therapeutics
https://www.readbyqxmd.com/read/29363584/neurogenesis-during-abstinence-is-necessary-for-context-driven-methamphetamine-related-memory
#4
Melissa H Galinato, Yoshio Takashima, McKenzie J Fannon, Leon W Quach, Roberto J Morales Silva, Karthik K Mysore, Michael J Terranova, Rahul R Dutta, Ryan W Ostrom, Sucharita S Somkuwar, Chitra D Mandyam
Abstinence from methamphetamine addiction enhances proliferation and differentiation of neural progenitors and increases adult neurogenesis in the dentate gyrus (DG). We hypothesized that neurogenesis during abstinence contributes to context-driven drug-seeking behaviors. To test this hypothesis, the pharmacogenetic rat model (GFAP-TK rats) was used to conditionally and specifically ablate neurogenesis in the DG. Male GFAP-TK rats were trained to self-administer methamphetamine or sucrose and were administered the antiviral drug valganciclovir (Valcyte) to produce apoptosis of actively dividing GFAP-type 1 stem-like cells to inhibit neurogenesis during abstinence...
January 23, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29360250/impact-of-electronic-health-record-based-pharmacist-driven-valganciclovir-dose-optimization-in-solid-organ-transplant-recipients
#5
David Hensler, Chad L Richardson, Joslyn Brown, Christine Tseng, Phyllis J DeCamp, Amy Yang, Anna Pawlowski, Bing Ho, Michael G Ison
BACKGROUND: Prophylaxis with valganciclovir reduces the incidence of cytomegalovirus (CMV) infection following solid organ transplant (SOT). Under-dosing of valganciclovir is associated with an increased risk of CMV infection and development of ganciclovir-resistant CMV. METHODS: An automated electronic health record (EHR)-based, pharmacist-driven program was developed to optimize dosing of valganciclovir in solid organ transplant recipients at a large transplant center...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29306112/predictive-factors-of-spontaneous-cmv-dnaemia-clearance-in-kidney-transplantation
#6
Johan Noble, Philippe Gatault, Bénédicte Sautenet, Catherine Gaudy-Graffin, Agnes Beby-Defaux, Antoine Thierry, Marie Essig, Jean-Michel Halimi, Eliza Munteanu, Sophie Alain, Matthias Buchler
Cytomegalovirus (CMV) infection occurs frequently after solid organ transplantation. Therapeutic strategies, in particular when to start a curative treatment, has not yet been defined. The purpose of this study was to assess predictive factors associated with spontaneous clearance of CMV DNAemia in kidney transplant recipients. METHODS: All kidney recipients of a single center were recruited. Patients with at least one positive CMV DNAemia during the first year post transplantation were included in our analysis...
December 29, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/29222255/non-chemotherapy-drug-induced-neutropenia-key-points-to-manage-the-challenges
#7
REVIEW
Brian R Curtis
Non-chemotherapy idiosyncratic drug-induced neutropenia (IDIN) is a relatively rare but potentially fatal disorder that occurs in susceptible individuals, with an incidence of 2.4 to 15.4 cases per million population. Affected patients typically experience severe neutropenia within several weeks to several months after first exposure to a drug, and mortality is ∼5%. The drugs most frequently associated with IDIN include metamizole, clozapine, sulfasalazine, thiamazole, carbimazole, amoxicillin, cotrimoxazole, ticlopidine, and valganciclovir...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29215460/comparison-of-preemptive-therapy-and-antiviral-prophylaxis-for-prevention-of-cytomegalovirus-in-seropositive-liver-transplant-recipients
#8
Amy W Liu, Kamonwan Jutivorakool, Cynthia E Fisher, Robert M Rakita, Jorge D Reyes, Renuka B Bhattacharya, Keith R Jerome, Ajit P Limaye
BACKGROUND: Few studies have directly compared preemptive therapy (PET) and antiviral prophylaxis (AP) for prevention of cytomegalovirus disease in CMV seropositive (R+) orthotopic liver transplant (OLT) recipients. METHODS: We prospectively assessed CMV disease and clinical outcomes among 160 consecutive R+ OLT recipients who received PET (weekly plasma CMV PCR for 3 months, oral valganciclovir 900 mg twice daily for CMV viremia >250 IU/mL, until 2 consecutive negative weekly PCR results) and compared them to a historical cohort of 156 R+ recipients who received AP (valganciclovir 900 mg daily for 3 months)...
December 5, 2017: Transplantation
https://www.readbyqxmd.com/read/29201472/severe-cytomegalovirus-reactivation-in-patient-with-low-grade-non-hodgkin-s-lymphoma-after-standard-chemotherapy
#9
Lena Modvig, Ciaran Boyle, Katie Randall, Anton Borg
Clinically significant cytomegalovirus (CMV) reactivation is not uncommon in patients with severe immunodeficiency secondary to underlying medical disorders or following aggressive immunosuppressive therapy. However, it is less frequently found in patients with low-grade haematological malignancies after nonintensive chemotherapy. We treated a patient at our centre for stage IVB follicular lymphoma with standard chemotherapy who successively developed CMV colitis associated with a CMV viral load of >3 million copies/ml...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/29198661/prolonged-low-dose-prophylaxis-with-valganciclovir-in-cytomegalovirus-negative-recipients-of-kidney-transplants-from-cytomegalovirus-positive-donors-allows-seroconversion-and-prevents-cytomegalovirus-disease
#10
F Halleck, D Khadzhynov, E Schrezenmeier, L Lehner, K Budde, O Staeck
BACKGROUND: Cytomegalovirus-negative recipients of kidneys from cytomegalovirus (CMV)-positive donors (D+/R-) are at high risk to develop severe clinical manifestations of CMV disease. Long-term data about incidence and timing of CMV seroconversion, CMV disease, and the influence of prolonged valganciclovir prophylaxis on the clinical course of CMV infection are missing. METHODS: We conducted a retrospective long-term study of 89 consecutive CMV D+/R- kidney transplant recipients transplanted between 2003 and 2012...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29191574/-collapsing-focal-segmental-glomerulosclerosis-induced-by-cytomegalovirus-a%C3%A2-case-report
#11
Clarisse Grèze, Cyril Garrouste, Jean-Louis Kemeny, Carole Philipponnet, Julien Aniort, Anne-Élisabeth Heng
Focal segmental glomerulosclerosis (FSGS) is a common cause of nephrotic syndrome in child and adult. The collapsing forms are of poor renal prognosis and are usually secondary to viral infections with, first and foremost, the human immunodeficiency virus. Among other viral etiologies, cytomegalovirus (CMV) is an uncommon cause. We report a case of a 32years-old patient with collapsing focal segmental glomerulosclerosis induced by cytomegalovirus with initial acute renal failure and proteinuria at 12.4g/24h...
November 27, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29166336/valganciclovir-prophylaxis-versus-preemptive-therapy-in-cytomegalovirus-positive-renal-allograft-recipients-long-term-results-after-7-years-of-a-randomized-clinical-trial
#12
Oliver Witzke, Martin Nitschke, Michael Bartels, Heiner Wolters, Gunter Wolf, Petra Reinke, Ingeborg A Hauser, Ulrich Alshuth, Volker Kliem
BACKGROUND: The VIPP study compared valganciclovir prophylaxis with preemptive treatment regarding efficacy, safety and long-term graft outcome in CMV-positive (R+) renal transplant recipients. METHODS: Multicenter, open-label, randomized clinical study with a 12-month study phase and a follow-up of up to 84 months. Patients in the prophylaxis group received 2x450 mg/day oral valganciclovir for 100 days adjusted to renal function. Preemptive treatment with 2x900 mg/day valganciclovir was initiated at a viral load of ≥400 CMV copies/mL (PCR) and maintained over ≥14 days, followed by secondary prophylaxis...
November 22, 2017: Transplantation
https://www.readbyqxmd.com/read/29157621/treatment-of-kaposi-sarcoma-herpesvirus-associated-multicentric-castleman-disease
#13
REVIEW
Kathryn Lurain, Robert Yarchoan, Thomas S Uldrick
Kaposi sarcoma herpesvirus (KSHV)-associated multicentric Castleman disease (MCD) is a rare, polyclonal lymphoproliferative disorder characterized by flares of inflammatory symptoms, edema, cytopenias, lymphadenopathy, and splenomegaly. Diagnosis requires a lymph node biopsy. Pathogenesis is related to dysregulated inflammatory cytokines, including human and viral interleukin-6. Rituximab alone or in combination with chemotherapy, such as liposomal doxorubicin, has led to an overall survival of over 90% at 5 years...
February 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/29118508/treatment-of-unilateral-zone-i-cytomegalovirus-retinitis-in-acute-lymphoblastic-leukemia-with-oral-valganciclovir-and-intravitreal-ganciclovir
#14
Koushik Tripathy, Kanhaiya Mittal, Pradeep Venkatesh, Sameer Bakhshi, Rohan Chawla
Cytomegalovirus retinitis (CMVR) is an opportunistic infection seen in immunocompromised patients, especially suffering from acquired immune deficiency syndrome. It is uncommonly seen in hematological malignancies and in patients on immunosuppressants. The authors present a 12-year-old girl with unilateral CMVR who was on maintenance phase therapy for mixed phenotype (B/myeloid) leukemia. Serology for human immunodeficiency virus was negative. The child was successfully treated with oral valganciclovir and repeated intravitreal ganciclovir injections...
September 2017: Oman Journal of Ophthalmology
https://www.readbyqxmd.com/read/29028114/trichodysplasia-spinulosa-associated-with-hiv-infection-clinical-response-to-acitretin-and-valganciclovir
#15
M Aleissa, M P Konstantinou, M Samimi, L Lamant, P Gaboriaud, A Touze, C Ceppi, C Bulai Livideanu, C Paul
No abstract text is available yet for this article.
October 13, 2017: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/29021960/relapsing-ebv-encephalitis-in-a-renal-transplant-recipient
#16
Joshua A Stone, Bettina M Knoll, Dimitrios Farmakiotis
In solid organ transplant recipients, Epstein-Barr virus (EBV) can cause active central nervous system (CNS) infection or malignant transformation of latently infected cells in the CNS, known as post-transplant lymphoproliferative disease (PTLD). Reduction of T-cell immunosuppression is the cornerstone of management. The role of antivirals with in-vitro activity against herpesviruses in EBV-related CNS syndromes is controversial, as they have no effect on latent virus. We report an unusual case of relapsing EBV encephalitis in a donor-positive, EBV-negative renal transplant recipient, with response to valganciclovir...
2017: IDCases
https://www.readbyqxmd.com/read/29020220/role-of-secondary-prophylaxis-with-valganciclovir-in-the-prevention-of-recurrent-cytomegalovirus-disease-in-solid-organ-transplant-recipients
#17
Bradley J Gardiner, Jennifer K Chow, Lori Lyn Price, Natalie E Nierenberg, David M Kent, David R Snydman
Background: Cytomegalovirus (CMV) is a major contributor to morbidity and mortality in solid organ transplant recipients (SOTRs). Ganciclovir and valganciclovir are highly effective antiviral drugs with a well-established role in primary prophylaxis and treatment of CMV disease. Our objective in this study was to examine the effect of secondary prophylaxis (SP) on the risk of relapse in SOTRs following an episode of CMV disease. Methods: We performed a retrospective cohort study of SOTRs from 1995 to 2015 and used propensity score-based inverse probability of treatment weighting methodology to control for confounding by indication...
November 29, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28986189/prevention-of-cytomegalovirus-reactivation-in-haploidentical-stem-cell-transplantation
#18
Aimee E Hammerstrom, Lindsey R Lombardi, Sai Ravi Pingali, Gabriela Rondon, Julianne Chen, Denái R Milton, Roy F Chemaly, Richard E Champlin, Alison Gulbis, Stefan O Ciurea
Cytomegalovirus (CMV) infection can increase the morbidity and mortality after allogeneic hematopoietic cell transplantation (HCT). Because of a higher degree of immunosuppression, haploidentical transplant recipients may be at an increased risk of viral infections, particularly CMV. We retrospectively analyzed 86 haploidentical HCT recipients at our institution to determine whether a more intensified antiviral strategy would reduce the incidence of CMV reactivation compared with a traditional antiviral prophylaxis regimen...
October 3, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28940831/low-dose-valganciclovir-prophylaxis-for-cytomegalovirus-in-intermediate-risk-r-renal-transplant-recipients-single-center-experience
#19
Salman Khan, Clara Fischman, Shirish Huprikar
Renal transplant recipients (RTR) who are seropositive for CMV (R+) are considered to be at intermediate risk for CMV disease. Current guidelines recommend high-dose valganciclovir (VGCV) prophylaxis because of limited data on the efficacy of low-dose VGCV. We describe our experience with using low-dose VGCV in R+ RTR. We retrospectively reviewed a cohort of 316 R+ RTR at our institution between 2002 and 2006. The primary endpoint was CMV disease at 1 year post transplant. The incidence of CMV disease at 12 months after transplantation was only 3% (6/221) in the D+R+ and 4% (4/95) in the D-R+ RTR...
September 22, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28937523/cytomegalovirus-retinitis-associated-with-occlusive-vasculopathy-in-an-elderly-human-immunodeficiency-virus-negative-man
#20
Kareem Moussa, Thuy Doan, Jay M Stewart, Jessica Shantha, John Gonzales, Nisha Acharya, Emmett T Cunningham
PURPOSE: To present a case of cytomegalovirus (CMV) retinitis associated with occlusive vasculopathy presenting as sudden unilateral loss of vision in a human immunodeficiency virus-negative elderly man. METHODS: Clinical case report and literature review. RESULTS: An 84-year-old Chinese man with diabetes mellitus and primary open-angle glaucoma was seen in consultation by our uveitis service for evaluation of sudden vision loss in the right eye...
September 20, 2017: Retinal Cases & Brief Reports
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