Low-dose cidofovir for the treatment of polyomavirus-associated nephropathy: two case reports and review of the literature.

Details

Serval ID
serval:BIB_9B931842FA7E
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Low-dose cidofovir for the treatment of polyomavirus-associated nephropathy: two case reports and review of the literature.
Journal
Antiviral Therapy
Author(s)
Lamoth Frederic, Pascual Manuel, Erard Veronique, Venetz Jean-Pierre, Nseir Ghaleb, Meylan Pascal
ISSN
1359-6535
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
13
Number
8
Pages
1001-1009
Language
english
Abstract
BACKGROUND: Polyomavirus-associated nephropathy (PVAN) is a serious complication and cause of graft loss in kidney transplant recipients. In the absence of specific antiviral drugs, early detection of the disease and reduction of immunosuppressive regimen is the cornerstone of therapy. Cidofovir, a nucleoside analogue, has been found to inhibit BK virus (BKV) replication in vitro and has been proposed as treatment of refractory PVAN at low doses; however, its efficacy has never been demonstrated in randomized controlled trials. METHODS: Cidofovir therapy (0.5 mg/kg at a 2-week interval for eight consecutive doses) was initiated in two patients with biopsy-proven PVAN and persistent BKV DNA viraemia (> or = 10,000 copies/ml despite sustained reduction of the immunosuppressive regimen). In addition to these two case reports, we performed a critical review of the literature on the use of cidofovir in PVAN. RESULTS: No significant decrease of BKV viral load in blood was observed during cidofovir therapy and in follow-up of the two patients treated with cidofovir. Our literature review identified 21 publications reporting the use of cidofovir for the treatment of PVAN. All were case reports or small series. The efficacy of cidofovir therapy could not be assessed in 17 of these publications because of lack of data or concomitant reduction of immunosuppressive regimen. The four remaining publications were case reports. CONCLUSIONS: In vitro and clinical data to support the efficacy of cidofovir in the treatment of PVAN are currently lacking. More promising compounds should be identified for further clinical studies.
Keywords
Antiviral Agents, BK Virus, Cytosine, Female, Humans, Male, Middle Aged, Phosphonic Acids, Polyomavirus Infections, Tumor Virus Infections
Pubmed
Web of science
Create date
29/05/2009 9:14
Last modification date
20/08/2019 15:02
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