- |||||||||| Cytovene (ganciclovir) / Roche
Journal: Acute Liver Failure Due to Toxoplasmosis After Orthotopic Liver Transplantation. (Pubmed Central) - Oct 20, 2021
Though prophylaxis with trimethoprim-sulfamethoxazole may prevent infections with Toxoplasma, it is often held for renal dysfunction, hyperkalemia, or other side effects, placing patients at risk. With 13 cases now reported, routine screening of donor and recipient for toxoplasma exposure may be warranted.
- |||||||||| Cytovene (ganciclovir) / Roche
[VIRTUAL] CMV-Associated Thrombosis in a Kidney Transplant Recipient () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_3887;
IV ganciclovir treatment was initiated with appropriate response seen...In short, acute CMV infection should be considered as a risk factor for venous thromboembolism. Therefore, diagnosis of acute CMV infection in patients with an acute thrombosis should redefine the thrombotic event as provoked rather than unprovoked, limiting the duration of anticoagulation treatment.
- |||||||||| Cytovene (ganciclovir) / Roche
[VIRTUAL] Autoimmune Encephalitis with Concurrent Epstein-Barr Virus Infection in a Renal Transplant Patient () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_3327;
Immunosuppression included tacrolimus, mycophenolate mofetil, and prednisone...Patient initially received ganciclovir, amBisome, and broad-spectrum antibiotics...The relationship between EBV infection and AE remains unclear; however, EBV infection may play a role in the pathogenicity of NMDAR antibodies. AE can occur in the setting of chronic immunosuppression and should not be overlooked to avoid delay in diagnosis and treatment.
- |||||||||| Thymoglobulin (anti-thymocyte globulin (rabbit)) / Sanofi
[VIRTUAL] A Rare Case of Collapsing Focal Segmental Glomerulosclerosis Caused by Cytomegalovirus in a Renal Transplant Recipient () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_3323;
He completed valganciclovir prophylaxis for CMV, and soon after presented to an outside hospital with hypotension, lower extremity swelling, and diarrhea of 2 weeks duration...A presumptive diagnosis of FSGS was made and he received IV Solumedrol...He was treated with IV ganciclovir, and both viremia and proteinuria resolved (Figure 1)...This may be a cytokine related injury to podocytes in the setting of a viral infection. Our patient had complete recovery following treatment with renal function returning to baseline.
- |||||||||| [VIRTUAL] Resistant Cytomegalovirus After Kidney Transplant: Reduced Immunosuppression, High-Dose Valganciclovir, and Letermovir Prophylaxis Guided by T Cell Immunity Assessment () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_3302;
IS included Thymoglobulin, followed by tacrolimus, mycophenolate (MMF), and prednisone...CMV resistance testing (VGCV treatment day 62) found wild-type and mutated virus (UL54 T503I mutation and UL97 H520Q mutation) with predicted resistance to ganciclovir and cidofovir, but susceptibility to foscarnet...Once CMV viral load was negligible, a newer agent with novel mechanism of action, letermovir, was used for prophylaxis. Letermovir has been continued based on a low level of anti-CMV CD4 response, predicting high-risk for CMV recurrence.
- |||||||||| Vistide (cidofovir) / Gilead, Neupogen (filgrastim) / Kyowa Kirin, Amgen
[VIRTUAL] Rare Oral Lesions from Cytomegalovirus in Kidney Transplant () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_3300;
Early diagnosis is important because CMV increases other opportunistic infection and allograft rejection. Saliva and periodontal packets serve as reservoirs for CMV infection and frequent monitoring of periodontal health is needed post-transplant 3X3 cm elevated, adherent tongue lesions
- |||||||||| Thymoglobulin (anti-thymocyte globulin (rabbit)) / Sanofi
[VIRTUAL] Cytomegalovirus Infection in Renal Transplant Recipients: Incidence, Clinical Profile and Outcome () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_3280;
rATG as induction was given in 11.1%, Basiliximab in 37.1% and 51.8% received no induction therapy, all of them received triple immunosuppression with steroid, tacrolimus and MMF as maintenance immunosuppression...All patients received iv Ganciclovir for 14-21days followed by oral valganciclovir for 90 days as treatment of infection episode...Conclusion Changing immunosuppressive regimen with early withdrawal of steroid and use of valganciclovir prophylaxis has been associated with lower incidence and milder form of CMV disease in our population. There seems to be a change in the traditional risk factors for CMV infection which needs to be further studied.
- |||||||||| Cytovene (ganciclovir) / Roche
[VIRTUAL] Minimal Change Disease as a Novel Manifestation of Cytomegalovirus () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_2620;
Six weeks after starting treatment with ganciclovir and tapering steroids, CMV viral load was undetectable and renal function recovered to baseline...To prevent tissue invasive CMV in a chronically immune suppressed patient one needs to maintain clinical suspicion for infectious pathogens and perform tissue biopsy. PAS of glomerulus showing giant cell
- |||||||||| Cytovene (ganciclovir) / Roche
Clinical, Journal: Optimization of Ganciclovir use in allogeneic hematopoietic cell transplant recipients - the role of therapeutic drug monitoring. (Pubmed Central) - Oct 15, 2021
Alternative TDM targets such as the intracellular ganciclovir triphosphate should be explored as they may prove to have better correlation with clinical outcomes and adverse effects. With recent advances in CMV immune monitoring, novel approaches integrating TDM with specific CMV immune phenotyping in a predictive model will be advantageous in optimizing ganciclovir dosing by combining TDM with a risk stratification approach.
- |||||||||| Cytovene (ganciclovir) / Roche
Journal: Differential Impact of Various Substitutions at Codon 715 in Region II of HSV-1 and HCMV DNA Polymerases. (Pubmed Central) - Oct 14, 2021
Finally, we showed by three-dimensional modeling that the differential impact of these mutations on the viral replicative capacity and drug resistance profile was related to different hydrophobic local environments for V715 in the DNA pol of the two viruses. Furthermore, we hypothesize that the DNA pol of HSV-1 is more tolerant to changes at this residue compared to that of HCMV because of a more hydrophobic environment stabilizing the region.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo, Cytovene (ganciclovir) / Roche
[VIRTUAL] HYPERAMMONEMIA SYNDROME AFTER LUNG TRANSPLANTATION: A CALL FOR BROADENING OF THE PERI-OPERATIVE ANTIMICROBIAL COVERAGE () - Oct 13, 2021 - Abstract #CHEST2021CHEST_2457;
Furthermore, she developed generalized tonic clonic seizures on POD 17 requiring initiation of levetiracetam and lacosamide...Patient was transitioned to dual therapy treatment with azithromycin and levofloxacin given the severity of illness and risk of resistance... We, therefore, recommend including antibiotics with efficacy against atypical infections in the post-operative period among all LT patients.
- |||||||||| Cytovene (ganciclovir) / Roche
Journal: TGF-β/Alk5 signaling prevents osteoarthritis initiation via regulating the senescence of articular cartilage stem cells. (Pubmed Central) - Oct 9, 2021
In addition, mice were injected intra-articularly with ganciclovir to limit the detrimental roles of senescent cells (SnCs)...We further found that local limitation of the detrimental roles of SnCs can attenuate the development of posttraumatic OA. Taken together, our findings suggest that Alk5 signaling acts as an important regulator of the SnCs in the superficial layer during AC maintenance and OA initiation.
- |||||||||| Valcyte (valganciclovir) / Roche, Mitsubishi Tanabe, Cytovene (ganciclovir) / Roche
Clinical, Journal: Cytomegalovirus retinitis in patients of non-Hodgkin's lymphoma: clinical presentations and outcomes. (Pubmed Central) - Oct 7, 2021
CMV retinitis in NHL patients is usually of an indolent or granular type and can occur even in the presence of high CD4 counts as compared to patients with HIV. These patients may require a long term maintenance in view of frequent recurrences after discontinuation of treatment.
- |||||||||| Prevymis (letermovir) / Merck (MSD), Valcyte (valganciclovir) / Roche, Mitsubishi Tanabe, Cytovene (ganciclovir) / Roche
[VIRTUAL] Cytomegalovirus (CMV) Retinitis during Maintenance Chemotherapy for Acute Lymphoblastic Leukemia () - Oct 6, 2021 - Abstract #IDWeek2021IDWeek_1814;
Early identification of the disease is imperative as delay can result in blindness or further systemic CMV disease. Treatment is challenging, involving systemic and intravitreal antiviral therapy, serial ophthalmologic exams, serum CMV monitoring, and close coordination with the treating hematologist.
- |||||||||| Cytovene (ganciclovir) / Roche
[VIRTUAL] Peptidebased carriers with anionic coating as a delivery system for gene therapy of uterine leiomyoma. () - Oct 2, 2021 - Abstract #ESGCT2021ESGCT_376;
Suicidal gene therapy with pPTK1 and subsequent ganciclovir treatment was held for primary UL cells at early passages...The study shows that the utilization of peptide carriers modified with cycloRGDligand and negatively charged peptides is a promising approach for the development of DNA delivery systems for UL gene therapy. The study was supported by RSF grant 211500111.
- |||||||||| Prevymis (letermovir) / Merck (MSD), Cytovene (ganciclovir) / Roche
Clinical, Review, Journal: Prevention and therapy of viral infections in patients with solid organ transplantation. (Pubmed Central) - Oct 1, 2021
This review offers an overview of the most relevant viral infections in the SOT population, with a focus on herpesviruses (cytomegalovirus, Epstein-Barr virus, varicella-zoster virus, and herpes simplex virus 1 and 2) and polyomaviruses (human BK polyomavirus). In addition, the currently recommended prophylactic and treatment approaches are summarized, as well as the new antiviral agents in different phases of clinical development.
- |||||||||| Cytovene (ganciclovir) / Roche
Clinical, Journal: CMV Presenting as a Skin Growth in Renal Transplant Patient. (Pubmed Central) - Sep 24, 2021
Patient was treated with Ganciclovir, however he succumbed to death due to severe sepsis secondary to bacterial infection. Thus, CMV disease should always be kept in mind in immunocompromised patients like post RAR patients who present with cutaneous features like ulcerative lesions or fungating growth.
- |||||||||| Valcyte (valganciclovir) / Roche, Mitsubishi Tanabe, Cytovene (ganciclovir) / Roche
POSTTRANSPLANT LYMPHOPROLIFERATIVE DISORDER (PTLD): IS THE SECRET HIDDEN IN THE SPLEEN? () - Sep 23, 2021 - Abstract #ESOT2021ESOT_1853;
Immunosuppression (IS) consisted in anti-thymocyte globulin, tacrolimus (TAC), mycophenolate mofetil and prednisolone...During valganciclovir prophylaxis, he was diagnosed with CMV gastrointestinal disease from a resistant strain which was successfully treated with high dose ganciclovir, anti-CMV immunoglobulin and IS reduction...IS was switched to everolimus and low dose TAC...As an early-onset T-cell PTLD confined to the spleen, this case is remarkable for its rarity and difficult diagnosis. Due to the immunomodulatory effect of CMV, we also hypothesize that it may have contributed to this rare form of PTLD.
- |||||||||| foscarnet / Generic mfg.
FOSCARNET INDUCED GENITAL LESIONS IN A KIDNEY TRANSPLANT RECIPIENT: A CASE REPORT () - Sep 23, 2021 - Abstract #ESOT2021ESOT_1820;
FOS is the empiric choice to treat a Ganciclovir resistant CMV infection in immunocompromised patients, allowing recovery with both graft and patients survival. Penile ulcerations are reported as an important cause of therapy discontinuation and clinicians should be aware of the problem in order to get an early recognition, ruling out of alternative diagnoses and a correct management.
- |||||||||| Cytovene (ganciclovir) / Roche
THE FIRST REPORT OF HIV-POSITIVE KIDNEY TRANSPLANTATION IN THAILAND: PROVIDING THE OPPORTUNITY AND ACCESSIBILITY TO TRANSPLANTATION () - Sep 23, 2021 - Abstract #ESOT2021ESOT_1815;
Pretransplantation ART was abacavir 300 mg/day, lamivudine 150 mg/day, and nevirapine 200 mg/day, which could control his HIV viral load to <20 copies/mL and CD4+ T lymphocyte 604 cells/μL...The maintenance regimen included tacrolimus, mycophenolate mofetil, and prednisolone...Posttransplantation complications were experienced, including perinephric collection which was treated conservatively, and CMV viremia that needed 1-month course of ganciclovir...Table 1. Posttransplant clinical course
- |||||||||| Prevymis (letermovir) / Merck (MSD)
Letermovir reduces the risk of CMV reactivation after allogeneic stem cell transplantation (A5) - Sep 20, 2021 - Abstract #DGHO2021DGHO_416;
Although ganciclovir and valganciclovir are well known prophylaxis for CMV reactivation in solid-organ transplantation, the use of these drugs induces unacceptable side effects like myelosuppression in stem cell recipients...Letermovir was applied at a dose of 480 mg once a day or 240 mg once a day if cyclosporine was used as an initial immunosuppressive drug... The use of letermovir prophylaxis is associated with a significant lower risk of CMV reactivation after allogeneic stem cell transplantation.
- |||||||||| Remicade (infliximab) / Merck (MSD), Mitsubishi Tanabe, J&J, Opdivo (nivolumab) / Ono Pharma, BMS, Yervoy (ipilimumab) / Ono Pharma, BMS
Protracted autoimmune colitis with development of CMV colitis under combination therapy for metastatic melanoma with ipilimumab and nivolumab (Stream 4) - Sep 20, 2021 - Abstract #ADO2021ADO_393;
However, since there was no sufficient improvement, the patient received infliximab once...IV therapy with ganciclovir was switched to oral administration of valganciclovir after two weeks; if there was no improvement, the therapy escalated to foscarnet...This should be ruled out immunohistochemically and, if in doubt, the diagnosis should also be repeated. In this case report it could be shown that a reactivation of CMV only occurred during the course and that the patient suffered from both autoimmune-mediated and CMV colitis.
- |||||||||| Valcyte (valganciclovir) / Roche, Mitsubishi Tanabe, Cytovene (ganciclovir) / Roche
The role cytomegalovirus detection in active inflammatory bowel disease () - Sep 19, 2021 - Abstract #IDDF2021IDDF_248;
Conclusions Colonic CMV was detected in 28.8% of patients with active IBD, but the large majority does not need CMV treatment. Positive IHC was associated with refractory disease as compared to PCR and CMV cultures.
- |||||||||| Cytovene (ganciclovir) / Roche
Journal: Ganciclovir Treatment Contributes to Mutagenesis Post-Transplant. (Pubmed Central) - Sep 19, 2021
Positive IHC was associated with refractory disease as compared to PCR and CMV cultures. Nucleoside analogue treatment post-transplant induces a novel mutation signature that can drive malignancy.
- |||||||||| Cytovene (ganciclovir) / Roche, Dovato (dolutegravir/lamivudine) / ViiV Healthcare, Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide) / Gilead
A case of mycobacterial infection complicated by CMV-driven haemophagocytic lymphohistiocytosis (eLibrary) - Sep 18, 2021 - Abstract #EACS2021EACS_858;
He was commenced on Bictegravir/Emtricitabine/Tenofovir alafenamide and PCP prophylaxis...He was commenced on IV ganciclovir and IV Immunoglobulin to treat HLH-MAS secondary to CMV infection...Broad spectrum anti-mycobacterial treatment was commenced whilst characterisation was awaited and ART was simplified to Lamivudine/Dolutegravir to avoid drug-drug interactions...Blood parameters for HLH resolved quickly with CMV treatment and limited immunomodulation. The case also illustrates the value of Bone Marrow biopsy in diagnosing opportunistic infections and the ongoing need for education around HIV acquisition in traditionally well informed groups.
- |||||||||| Cytovene (ganciclovir) / Roche, Dovato (dolutegravir/lamivudine) / ViiV Healthcare, Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide) / Gilead
A case of mycobacterial infection complicated by CMV-driven haemophagocytic lymphohistiocytosis (eLibrary) - Sep 18, 2021 - Abstract #EACS2021EACS_391;
He was commenced on Bictegravir/Emtricitabine/Tenofovir alafenamide and PCP prophylaxis...He was commenced on IV ganciclovir and IV Immunoglobulin to treat HLH-MAS secondary to CMV infection...Broad spectrum anti-mycobacterial treatment was commenced whilst characterisation was awaited and ART was simplified to Lamivudine/Dolutegravir to avoid drug-drug interactions...Blood parameters for HLH resolved quickly with CMV treatment and limited immunomodulation. The case also illustrates the value of Bone Marrow biopsy in diagnosing opportunistic infections and the ongoing need for education around HIV acquisition in traditionally well informed groups.
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