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Case report: Clearance of longstanding, immune-deficiency-associated, vaccine-derived polio virus infection following remdesivir therapy for chronic SARS-CoV-2 infection

The global polio eradication campaign has had remarkable success in reducing wild-type poliovirus infection, largely built upon the live attenuated Sabin oral poliovirus vaccine. Whilst rare, vaccine poliovirus strains may cause infection and subsequently revert to a neurovirulent type, termed vacci...

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Autores principales: Bermingham, William Hywel, Canning, Benjamin, Wilton, Thomas, Kidd, Michael, Klapsa, Dimitra, Majumdar, Manasi, Sooriyakumar, Kavitha, Martin, Javier, Huissoon, Aarnoud P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022663/
https://www.ncbi.nlm.nih.gov/pubmed/36936936
http://dx.doi.org/10.3389/fimmu.2023.1135834
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author Bermingham, William Hywel
Canning, Benjamin
Wilton, Thomas
Kidd, Michael
Klapsa, Dimitra
Majumdar, Manasi
Sooriyakumar, Kavitha
Martin, Javier
Huissoon, Aarnoud P.
author_facet Bermingham, William Hywel
Canning, Benjamin
Wilton, Thomas
Kidd, Michael
Klapsa, Dimitra
Majumdar, Manasi
Sooriyakumar, Kavitha
Martin, Javier
Huissoon, Aarnoud P.
author_sort Bermingham, William Hywel
collection PubMed
description The global polio eradication campaign has had remarkable success in reducing wild-type poliovirus infection, largely built upon the live attenuated Sabin oral poliovirus vaccine. Whilst rare, vaccine poliovirus strains may cause infection and subsequently revert to a neurovirulent type, termed vaccine-derived poliovirus (VDPV). Persistent, vaccine derived infection may occur in an immunocompromised host (iVDPV), where it is a recognised complication following receipt of the Sabin vaccine. This has significant implications for the global polio eradication campaign and there is currently no agreed global strategy to manage such patients.Here we describe a case of a 50-year-old man with common variable immune deficiency, persistently infected with a neurovirulent vaccine-derived type 2 poliovirus following vaccination in childhood. iVDPV infection had proven resistant to multiple prior attempts at treatment with human breast milk, ribavirin and oral administration of a normal human pooled immunoglobulin product. His iVDPV infection subsequently resolved after 12 days treatment with remdesivir, an adenosine analogue prodrug that is an inhibitor of viral RNA-dependent RNA polymerase, administered as treatment for a prolonged, moderate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. iVDPV from the patient, isolated prior to treatment, was subsequently demonstrated to be sensitive to remdesivir in vitro. Based on the observations made in this case, and the mechanistic rationale for use with iVDPV, there is strong justification for further clinical studies of remdesivir treatment as a potentially curative intervention in patients with iVDPV infection.
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spelling pubmed-100226632023-03-18 Case report: Clearance of longstanding, immune-deficiency-associated, vaccine-derived polio virus infection following remdesivir therapy for chronic SARS-CoV-2 infection Bermingham, William Hywel Canning, Benjamin Wilton, Thomas Kidd, Michael Klapsa, Dimitra Majumdar, Manasi Sooriyakumar, Kavitha Martin, Javier Huissoon, Aarnoud P. Front Immunol Immunology The global polio eradication campaign has had remarkable success in reducing wild-type poliovirus infection, largely built upon the live attenuated Sabin oral poliovirus vaccine. Whilst rare, vaccine poliovirus strains may cause infection and subsequently revert to a neurovirulent type, termed vaccine-derived poliovirus (VDPV). Persistent, vaccine derived infection may occur in an immunocompromised host (iVDPV), where it is a recognised complication following receipt of the Sabin vaccine. This has significant implications for the global polio eradication campaign and there is currently no agreed global strategy to manage such patients.Here we describe a case of a 50-year-old man with common variable immune deficiency, persistently infected with a neurovirulent vaccine-derived type 2 poliovirus following vaccination in childhood. iVDPV infection had proven resistant to multiple prior attempts at treatment with human breast milk, ribavirin and oral administration of a normal human pooled immunoglobulin product. His iVDPV infection subsequently resolved after 12 days treatment with remdesivir, an adenosine analogue prodrug that is an inhibitor of viral RNA-dependent RNA polymerase, administered as treatment for a prolonged, moderate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. iVDPV from the patient, isolated prior to treatment, was subsequently demonstrated to be sensitive to remdesivir in vitro. Based on the observations made in this case, and the mechanistic rationale for use with iVDPV, there is strong justification for further clinical studies of remdesivir treatment as a potentially curative intervention in patients with iVDPV infection. Frontiers Media S.A. 2023-03-03 /pmc/articles/PMC10022663/ /pubmed/36936936 http://dx.doi.org/10.3389/fimmu.2023.1135834 Text en Copyright © 2023 Bermingham, Canning, Wilton, Kidd, Klapsa, Majumdar, Sooriyakumar, Martin and Huissoon https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Bermingham, William Hywel
Canning, Benjamin
Wilton, Thomas
Kidd, Michael
Klapsa, Dimitra
Majumdar, Manasi
Sooriyakumar, Kavitha
Martin, Javier
Huissoon, Aarnoud P.
Case report: Clearance of longstanding, immune-deficiency-associated, vaccine-derived polio virus infection following remdesivir therapy for chronic SARS-CoV-2 infection
title Case report: Clearance of longstanding, immune-deficiency-associated, vaccine-derived polio virus infection following remdesivir therapy for chronic SARS-CoV-2 infection
title_full Case report: Clearance of longstanding, immune-deficiency-associated, vaccine-derived polio virus infection following remdesivir therapy for chronic SARS-CoV-2 infection
title_fullStr Case report: Clearance of longstanding, immune-deficiency-associated, vaccine-derived polio virus infection following remdesivir therapy for chronic SARS-CoV-2 infection
title_full_unstemmed Case report: Clearance of longstanding, immune-deficiency-associated, vaccine-derived polio virus infection following remdesivir therapy for chronic SARS-CoV-2 infection
title_short Case report: Clearance of longstanding, immune-deficiency-associated, vaccine-derived polio virus infection following remdesivir therapy for chronic SARS-CoV-2 infection
title_sort case report: clearance of longstanding, immune-deficiency-associated, vaccine-derived polio virus infection following remdesivir therapy for chronic sars-cov-2 infection
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022663/
https://www.ncbi.nlm.nih.gov/pubmed/36936936
http://dx.doi.org/10.3389/fimmu.2023.1135834
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