Cargando…

Use of cidofovir in pediatric patients with adenovirus infection

Background: Adenoviruses contribute to morbidity and mortality among immunocompromised pediatric patients including stem cell and solid organ transplant recipients. Cidofovir (CDV), an antiviral compound approved by the FDA in 1996, is used for treatment of adenoviral (ADV) infections in immunocompr...

Descripción completa

Detalles Bibliográficos
Autores principales: Ganapathi, Lakshmi, Arnold, Alana, Jones, Sarah, Patterson, Al, Graham, Dionne, Harper, Marvin, Levy, Ofer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: F1000Research 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4863673/
https://www.ncbi.nlm.nih.gov/pubmed/27239277
http://dx.doi.org/10.12688/f1000research.8374.2
_version_ 1782431514318864384
author Ganapathi, Lakshmi
Arnold, Alana
Jones, Sarah
Patterson, Al
Graham, Dionne
Harper, Marvin
Levy, Ofer
author_facet Ganapathi, Lakshmi
Arnold, Alana
Jones, Sarah
Patterson, Al
Graham, Dionne
Harper, Marvin
Levy, Ofer
author_sort Ganapathi, Lakshmi
collection PubMed
description Background: Adenoviruses contribute to morbidity and mortality among immunocompromised pediatric patients including stem cell and solid organ transplant recipients. Cidofovir (CDV), an antiviral compound approved by the FDA in 1996, is used for treatment of adenoviral (ADV) infections in immunocompromised patients despite concern of potential nephrotoxicity.   Methods: We conducted a retrospective 5-year review at Boston Children’s Hospital of 16 patients (mean age = 6.5 years) receiving 19 courses of CDV. During therapy all pertinent data elements were reviewed to characterize potential response to therapy and incidence of renal dysfunction.   Results: Of the 19 CDV courses prescribed, 16 courses (84%) were in patients who had a positive blood ADV Polymerase chain reaction (PCR) alone or in combination with positive ADV PCR/ Direct Immunofluorescence Assay (DFA) at another site. Respiratory symptoms with or without pneumonia were the most common presentation (10/19, 53%). In the majority of blood positive courses (10/16, 63%), viral clearance was also accompanied by clinical response. This was not the case in four courses where patients expired despite viral clearance, including one in which death was directly attributable to adenovirus. There was reversible renal dysfunction observed during the use of CDV. Conclusions:  CDV appeared safe and reasonably tolerated for treatment of ADV in this pediatric population and was associated with viral response and clinical improvement in the majority of patients but reversible renal dysfunction was a side effect. Further studies of the efficacy of CDV for immunocompromised children with ADV infection are warranted.
format Online
Article
Text
id pubmed-4863673
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher F1000Research
record_format MEDLINE/PubMed
spelling pubmed-48636732016-05-26 Use of cidofovir in pediatric patients with adenovirus infection Ganapathi, Lakshmi Arnold, Alana Jones, Sarah Patterson, Al Graham, Dionne Harper, Marvin Levy, Ofer F1000Res Research Note Background: Adenoviruses contribute to morbidity and mortality among immunocompromised pediatric patients including stem cell and solid organ transplant recipients. Cidofovir (CDV), an antiviral compound approved by the FDA in 1996, is used for treatment of adenoviral (ADV) infections in immunocompromised patients despite concern of potential nephrotoxicity.   Methods: We conducted a retrospective 5-year review at Boston Children’s Hospital of 16 patients (mean age = 6.5 years) receiving 19 courses of CDV. During therapy all pertinent data elements were reviewed to characterize potential response to therapy and incidence of renal dysfunction.   Results: Of the 19 CDV courses prescribed, 16 courses (84%) were in patients who had a positive blood ADV Polymerase chain reaction (PCR) alone or in combination with positive ADV PCR/ Direct Immunofluorescence Assay (DFA) at another site. Respiratory symptoms with or without pneumonia were the most common presentation (10/19, 53%). In the majority of blood positive courses (10/16, 63%), viral clearance was also accompanied by clinical response. This was not the case in four courses where patients expired despite viral clearance, including one in which death was directly attributable to adenovirus. There was reversible renal dysfunction observed during the use of CDV. Conclusions:  CDV appeared safe and reasonably tolerated for treatment of ADV in this pediatric population and was associated with viral response and clinical improvement in the majority of patients but reversible renal dysfunction was a side effect. Further studies of the efficacy of CDV for immunocompromised children with ADV infection are warranted. F1000Research 2016-12-16 /pmc/articles/PMC4863673/ /pubmed/27239277 http://dx.doi.org/10.12688/f1000research.8374.2 Text en Copyright: © 2016 Ganapathi L et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Note
Ganapathi, Lakshmi
Arnold, Alana
Jones, Sarah
Patterson, Al
Graham, Dionne
Harper, Marvin
Levy, Ofer
Use of cidofovir in pediatric patients with adenovirus infection
title Use of cidofovir in pediatric patients with adenovirus infection
title_full Use of cidofovir in pediatric patients with adenovirus infection
title_fullStr Use of cidofovir in pediatric patients with adenovirus infection
title_full_unstemmed Use of cidofovir in pediatric patients with adenovirus infection
title_short Use of cidofovir in pediatric patients with adenovirus infection
title_sort use of cidofovir in pediatric patients with adenovirus infection
topic Research Note
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4863673/
https://www.ncbi.nlm.nih.gov/pubmed/27239277
http://dx.doi.org/10.12688/f1000research.8374.2
work_keys_str_mv AT ganapathilakshmi useofcidofovirinpediatricpatientswithadenovirusinfection
AT arnoldalana useofcidofovirinpediatricpatientswithadenovirusinfection
AT jonessarah useofcidofovirinpediatricpatientswithadenovirusinfection
AT pattersonal useofcidofovirinpediatricpatientswithadenovirusinfection
AT grahamdionne useofcidofovirinpediatricpatientswithadenovirusinfection
AT harpermarvin useofcidofovirinpediatricpatientswithadenovirusinfection
AT levyofer useofcidofovirinpediatricpatientswithadenovirusinfection