- |||||||||| Cytovene (ganciclovir) / Roche
[VIRTUAL] Using CMV -QuantiFERON Assay to Assess CMV Specific Immune Reconstitution in Early Post Hematopoietic Stem Cell Transplant (HSCT) Phase (CHANNEL B) - Sep 12, 2021 - Abstract #ICBMT2021ICBMT_311;
Two allogeneic -HSCT (1 ALL and 1 AML) who developed acute GVHD, continued to have indeterminate reactivity and had high CMV viral copies/ml (maximum-30,400 and 94,300 respectively) requiring ganciclovir therapy while two cases who became CMV-QuantiFERON positive had lesser rise in CMV viral copies (up to 150 cps/ml) and cleared spontaneously...Conclusion : This small case series showed that CMV reactivation occurred by third week and in the absence of acute GVHD, CMV specific T cell immunity started appearing by third month post HSCT. Those with positive CMV-QuantiFERON assay had less viral load and cleared virus spontaneously viz-a-viz those with indeterminate/nonreactive results who can accumulate significant viral copies numbers warranting CMV specific therapy.
- |||||||||| Cytovene (ganciclovir) / Roche
Journal: Cytomegalovirus viral load kinetics as surrogate endpoints after allogeneic transplantation. (Pubmed Central) - Sep 10, 2021
There are a limited number of studies investigating GCV and MMF. Our results support using CMV VL kinetics as surrogates for CMV disease, provide a framework for developing CMV preventative and therapeutic agents, and support reductions in viral load as the mechanism through which antivirals reduce CMV disease.
- |||||||||| Zirgan (ganciclovir ophthalmic gel) / Bausch Health, Thea Laboratories, Cytovene (ganciclovir) / Roche
Journal: Reactivation of herpes simplex keratitis following vaccination for COVID-19. (Pubmed Central) - Sep 9, 2021
A diagnosis of herpetic stromal keratitis was made, requiring systemic aciclovir, topical prednisolone, moxifloxacin and atropine, and oral doxycycline...Clearly, public and personal health benefits from vaccination are hugely important and we would not suggest avoiding vaccination in such patients. It is, however, important for ophthalmic providers to be aware of the rare potential for reactivation of herpetic eye disease following vaccination to enable prompt diagnosis and treatment.
- |||||||||| Stelara (ustekinumab) / J&J, Cytovene (ganciclovir) / Roche
Can SARS-CoV-2 Enterocolitis Trigger New Onset Inflammatory Bowel Disease ? (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_3090;
SARS-CoV-2 infection triggered an inflammatory cascade in the intestinal tract leading to altered or increased immune response, probably on a background of genetic predisposition, in our patient. Initiation of Ustekinumab, IL-23/IL-12 inhibitor, likely resulted in suppression of the severe systemic inflammatory response, resulting in clinical, endoscopic and pathological response.Figure: (a) demonstrates endoscopic appearance of transverse colon with erythema, friability and hemorrhages prior to treatment with biologic(b) demonstrates epithelial denudation with minimal acute inflammation in colonic mucosa prior to treatment with biologic(c) demonstrates endoscopic appearance of transverse colon with resolving erythema after treatment with biologic(d) demonstrates chronic inflammatory changes with crypt architectural distortion and pyloric gland metaplasia after induction of remission with biologic, many months after initial presentation
- |||||||||| Thymoglobulin (anti-thymocyte globulin (rabbit)) / Sanofi, Cytovene (ganciclovir) / Roche
An Unusual Case of Donor-related Disseminated Histoplasmosis with Systemic Complications Due to Patient Noncompliance (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_3063;
He concurrently developed C. difficile colitis which resolved with vancomycin...He remained on itraconazole for the following 4 years with continued stability...While early monitoring and antifungal treatment can improve outcomes, it is also important to manage treatment noncompliance. This case emphasizes the need for early discussions with patients about prophylactic therapy compliance to avoid complications.
- |||||||||| dexamethasone / Generic mfg.
A Rare Presentation of GI Bleeding Associated With Hemophagocytic Lymphohistiocytosis (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_2988;
The plan was to start dose adjusted etoposide when bilirubin improved; however, the patient developed a massive GIB with hemorrhagic shock with no extravasation on CT angiogram...Emergent surgery or angioembolization for GIB has been partially successful in a few patients. We present a patient with secondary HLH complicated with GIB and multiorgan failure, despite early treatment.
- |||||||||| Valcyte (valganciclovir) / Roche, Mitsubishi Tanabe, Cytovene (ganciclovir) / Roche
A Case of Cytomegalovirus Proctocolitis in an Immunocompetent Patient (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_2922;
This is a unique and rare case of an immunocompetent patient who developed CMV proctocolitis occurring in the setting of mucosal disruption from anal intercourse resulting in sexual transmission of CMV. This case demonstrates the importance of considering CMV as a rare cause of proctocolitis in an immunocompetent patient.
- |||||||||| Valcyte (valganciclovir) / Roche, Mitsubishi Tanabe, Cytovene (ganciclovir) / Roche
Sporadic Infectious Proctitis From Cytomegalovirus in an Immunocompetent Patient (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_2539;
The 30-day mortality rate was reported as 7.8% in this study. A high degree of suspicion with early diagnosis through biopsy and pathologic studies; and early initiation of treatment with ganciclovir can lead to significant improvement in morbidity and mortality.
- |||||||||| Cytovene (ganciclovir) / Roche
This Fistula Just Went Viral (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_2379;
She initiated oral vancomycin with improvement of her diarrhea...We would recommend initiation of antivirals, such as ganciclovir, with consideration of surgical intervention after completion of treatment...In summary, we present the first reported case of AIDS-related CMV colitis leading to a colorenal fistula. Early multidisciplinary discussion is imperative for optimal treatment.
- |||||||||| Remicade (infliximab) / Merck (MSD), Mitsubishi Tanabe, J&J, Humira (adalimumab) / Eisai, AbbVie
Human Cytomegalovirus and Epstein-Barr Virus Co-Infection-Induced Colitis Superimposed Upon Ulcerative Colitis (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_1895;
Previously the patient’s UC had been well controlled with mesalamine and azathioprine, but eventual escalation to adalimumab was required...The patient was started on IV solumedrol and biologic therapy was escalated to infliximab loading dose with plans for 10mg/kg maintenance dosing for presumed UC flare...Ganciclovir was added to the steroid and infliximab regimen with significant reduction in abdominal pain, diarrhea and hematochezia with a resultant DAI of 3/12...(C) Confirmatory CMV immunohistochemical stain reveals scattered positive cells (200x magnification). (D) In situ hybridization stain for EBV encoded RNA reveals scattered EBV positive cells (200x magnification).
- |||||||||| Cytovene (ganciclovir) / Roche
Giant HIV-Associated Idiopathic Esophageal Ulcers: A Mimicker of CMV Esophagitis (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_1682;
Empiric CMV treatment with ganciclovir was initiated...Complete resolution of symptoms with thalidomide was seen in 73% of patients.Figure: Figure 1 Index upper endoscopy, revealing one of several punched-out large non-bleeding esophageal ulcers in the middle third of the esophagus...Image obtained following four week treatment of prednisolone. Figure 4 Endoscopic view of middle third of esophagus, healing ulcer with scar tissue (post-treatment).
- |||||||||| Revlimid (lenalidomide) / BMS
Looking past a Positive Clostridioides difficile Test (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_767;
Stool PCR for C. difficile had been positive two months prior and diarrhea persisted despite multiple courses of vancomycin and fidaxomicin...She was discharged home on valganciclovir and seen in clinic six weeks later with complete resolution of her diarrhea...Other causes of colitis should be considered when symptoms persist despite anti-CDI therapies, especially in immunocompromised patients. We present two cases of CMV colitis masquerading as CDI.Figure: Colonic ulceration secondary to CMV colitis
- |||||||||| Cytovene (ganciclovir) / Roche
Esophageal Stricture Caused by Cytomegalovirus in a Renal Transplant Patient Not Infected by Human Immune Deficiency Virus (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_332;
His medications included omeprazole, mycophenolate, tacrolimus and prednisone...He responded with ganciclovir/valacyclovir and serial esophageal dilatation with no residual dysphagia...This stresses the importance of diagnosis through histologic examination of biopsies with adequate sampling. Thus, an esophageal stricture in an immunocompromised individual should raise the suspicion of CMV.Figure: Mid-esophageal focal necrotic lesion and severe non-traversable distal stricture
- |||||||||| Remicade (infliximab) / Merck (MSD), Mitsubishi Tanabe, J&J, Entyvio (vedolizumab) / Takeda
An Interesting Case of Immune Mediated and Infectious Colitis (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_213;
Unfortunately, he received another cycle of pembrolizumab infusion at an outside facility two weeks after the vedolizumab, missed the 2nd-week induction dose, and presented with a recurrent episode of hematochezia two weeks later...Clinical diagnosis of CMV colitis on the background of immune checkpoint inhibitor colitis was made with the initiation of ganciclovir; while infliximab induction was continued...Given the paucity of identical cases upon literature review, the key point, in this case, was the diagnosis of CMV colitis on the background of IMC and treatment therapy for both with goal of negative viral load and resolution of symptoms. The treatment goal is a potential area for future research.Figure: Colonoscopy showing diffuse inflammation and ulcerations, pathology showing acute and chronic inflammation, IHC positive for CMV
- |||||||||| Valcyte (valganciclovir) / Roche, Mitsubishi Tanabe
CMV Esophagitis in Immunocompetent Person Treated With Oral Valganciclovir (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_198;
While only few cases of successful treatment of upper GI CMV with oral valganciclovir in immunocompetent infant have been reported, no such report exists for adults. We describe first case of CMV esophagitis successfully treated with Oral valganciclovir.Figure: EGD (Figure A) showing esophageal ulcers, Figure B showing inclusion bodies on histology, repeat EGD (Figure C) showing healed ulcers
- |||||||||| Cytovene (ganciclovir) / Roche
A Rare Cause of Repeat Hemorrhage: When Cytomegalovirus Hides in the Small Bowel (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_18;
Stool testing was positive for C. diff and oral vancomycin and IV zosyn were started...Sepsis continued to worsen, and antibiotics were broadened to meropenem and vancomycin...Recurrent bleeding subsequently resolved, and patient was discharged to subacute rehabilitation to complete a course of IV ganciclovir...Clinical improvement was seen only once the underlying infection was treated and illustrates the need to consider CMV infection in the differential for recurrent gastrointestinal bleeding.Figure: Figure 1A: Immunohistochemical stain of tissue from duodenal biopsy identifying CMV. Figure 1B: Histology of duodenal tissue biopsy under high power showing CMV inclusions.
- |||||||||| Cytovene (ganciclovir) / Roche
Journal: Combination gene therapy for HIV using a conditional suicidal gene with CCR5 knockout. (Pubmed Central) - Sep 4, 2021
Since our in vitro system did not include any of the immune mechanisms that could provide additional antitumor activity, the chemo-gene treatments amplified by these delivery bags of therapeutic agents offer a great clinical potential. Our study demonstrates proof of principle that a combination gene therapy for HIV is a viable strategy and can overcome the limitation of editing CCR5 gene alone.
- |||||||||| dexamethasone / Generic mfg., sirolimus / Generic mfg., cyclosporine / Generic mfg.
KAPOSI’S SARCOMA (KS) IN PEDIATRIC LIVER TRANSPLANTATION (LT) – 3 CLINICAL CASES (Room I - White 2) - Aug 28, 2021 - Abstract #ESOT2021ESOT_862;
Hemophagocytic lymphohistiocytosis criteria were met and etoposide, cyclosporine, dexamethasone and ganciclovir were initiated...Sirolimus and chemotherapy were started with good response...In the reported cases this strategy allowed good outcomes. In the absence of a response, chemotherapy should be added.
- |||||||||| pentostatin / Generic mfg.
Journal: Pentostatin Antagonizes the Antiviral Activity of MBX-2168 by Inhibiting the Biosynthesis of the Active Compound. (Pubmed Central) - Aug 28, 2021
As expected, incubation with dCF resulted in the accumulation of MBX-2168-MP in both HFF (9.8±0.9 pmol MBX-2168-MP/10 cells at 120 hours) and Vero cells (4.7±0.3 pmol MBX-2168-MP/10 cells at 24 hours) while no detectable levels of monophosphate were observed in cultures not incubated with dCF. We conclude that dCF antagonizes the anti-viral effect of MBX-2168 by inhibiting the production of triphosphate, the active compound.
- |||||||||| Cytovene (ganciclovir) / Roche
Journal: Resistance to a Nucleoside Analog Antiviral Drug from More Rapid Extension of Drug-Containing Primers. (Pubmed Central) - Aug 28, 2021
Certain nucleoside analogs, such as ganciclovir (GCV), a leading therapy for human cytomegalovirus (HCMV), contain the equivalent of a 3'-hydoxyl moiety, yet their triphosphates can terminate genome synthesis (nonobligate chain termination)...The substitution also induces more rapid extension of RNA primers, a function that had not previously been reported for HCMV polymerase. Thus, these results provide a novel resistance mechanism with potential implications for related nucleoside analogs that act against established and emerging viruses, and shed light on DNA polymerase functions.
- |||||||||| Cytovene (ganciclovir) / Roche
[VIRTUAL] Adrenal insufficiency masquerading as biliary atresia in an infant () - Aug 27, 2021 - Abstract #ESPE2021ESPE_644;
A clinical diagnosis of congenital adrenal hypoplasia was made and genetic confirmation was not feasible. Adrenal insufficiency can present with severe neonatal hepatitis and mimic biliary atresia, and should always be excluded in a neonate with prolonged cholestatic jaundice and can prevent unnecessary complex surgery.
- |||||||||| Cytovene (ganciclovir) / Roche
Preclinical, Journal: A novel HBV infection mouse model using herpes simplex virus type-1 thymidine kinase transgenic mice. (Pubmed Central) - Aug 27, 2021
Adrenal insufficiency can present with severe neonatal hepatitis and mimic biliary atresia, and should always be excluded in a neonate with prolonged cholestatic jaundice and can prevent unnecessary complex surgery. A novel HBV infection mouse model will help to understand the mechanisms of HBV tolerance similar to human chronic HBV-infected patients and can be used to develop a new strategy to treat chronic HBV infection.
- |||||||||| Vistide (cidofovir) / Gilead
Clinical, Review, Journal: Small Molecules-Prospective Novel HCMV Inhibitors. (Pubmed Central) - Aug 27, 2021
The list of novel small molecules that might have anti-HCMV activity has grown in recent years. In this short review, a selection of compounds in clinical trials and novel inhibitors targeting host-cell factors or viral proteins is presented, and their modes of action, described.
- |||||||||| Cytovene (ganciclovir) / Roche
Journal: ApoE-modified liposomes mediate the antitumour effect of survivin promoter-driven HSVtk in hepatocellular carcinoma. (Pubmed Central) - Aug 20, 2021
Here, we evaluated a gene therapy strategy that targets HCC using the herpes simplex virus thymidine kinase/ganciclovir (HSVtk/GCV) suicide gene system in HCC cell lines and in an in vivo human HCC xenograft mouse model...In addition, tail vein injection of ApoE-HSVtk significantly suppressed the growth of xenograft tumours through an apoptosis-dependent pathway and extended the survival time of tumour-bearing mice. In summary, this study illustrates an effective cancer-specific gene therapy strategy for HCC that can be further developed for future clinical trials.
- |||||||||| Cytovene (ganciclovir) / Roche
Journal: Induction of interleukin-11 mediated by RhoA GTPase during human cytomegalovirus lytic infection. (Pubmed Central) - Aug 11, 2021
Finally, infection of cells in the presence of the HCMV DNA replication inhibitor, ganciclovir, significantly reduced the secretion of IL-11, strongly associating its induction with active viral DNA replication. Collectively, these data demonstrate, for the first time, a novel role of RhoA GTPase during HCMV lytic infection, regulating the activation of an immune response through IL-11.
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