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

Détails

ID Serval
serval:BIB_9B931842FA7E
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Low-dose cidofovir for the treatment of polyomavirus-associated nephropathy: two case reports and review of the literature.
Périodique
Antiviral Therapy
Auteur(s)
Lamoth Frederic, Pascual Manuel, Erard Veronique, Venetz Jean-Pierre, Nseir Ghaleb, Meylan Pascal
ISSN
1359-6535
Statut éditorial
Publié
Date de publication
2008
Peer-reviewed
Oui
Volume
13
Numéro
8
Pages
1001-1009
Langue
anglais
Résumé
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.
Mots-clé
Antiviral Agents, BK Virus, Cytosine, Female, Humans, Male, Middle Aged, Phosphonic Acids, Polyomavirus Infections, Tumor Virus Infections
Pubmed
Web of science
Création de la notice
29/05/2009 9:14
Dernière modification de la notice
20/08/2019 15:02
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