Posts filed under ‘Antivirales no HIV’

The Race To Find Antivirals for Zika Virus

Antimicrob. Agents Chemother. June 2017 V.61 N.6

Juan-Carlos Saiz and Miguel A. Martín-Acebes

Department of Biotechnology, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), Madrid, Spain

Zika virus (ZIKV), a flavivirus transmitted by mosquitoes, was an almost neglected pathogen until its introduction in the Americas in 2015 and its subsequent explosive spread throughout the continent, where it has infected millions of people. The virus has caused social and sanitary alarm, mainly due to its association with severe neurological disorders (Guillain-Barré syndrome and microcephaly in fetuses and newborns). Nowadays, no specific antiviral therapy against ZIKV is available. However, during the past months, a great effort has been made to search for antiviral candidates using different approaches and methodologies, ranging from testing specific compounds with known antiviral activity to the screening of libraries with hundreds of bioactive molecules. The identified antiviral candidates include drugs targeting viral components as well as cellular ones. Here, an updated review of what has been done in this line is presented.

PDF

http://aac.asm.org/content/61/6/e00411-17.full.pdf+html

May 28, 2017 at 4:52 pm

Impact of Outpatient Neuraminidase Inhibitor Treatment in Patients Infected With Influenza A(H1N1)pdm09 at High Risk of Hospitalization: An Individual Participant Data Metaanalysis

Clin Inf Dis May 15, 2017 V.64 N.10

Sudhir Venkatesan; Puja R. Myles; Jo Leonardi-Bee; Stella G. Muthuri; Malak Al Masri …

Our findings suggest that in populations at high risk for hospital admission, patients with laboratory-confirmed or clinically diagnosed A(H1N1)pdm09 infection, NAI treatment in the community or outpatient settings is associated with reduced likelihood of subsequent hospital admission.

PDF

https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/cid/64/10/10.1093_cid_cix127/2/cix127.pdf?Expires=1494188549&Signature=C1lJwO5DTqetonZJ1EBrasGE02emxNtMuALRrsBqQASk87ncDxVT-OPeLlOr-9rWN89CcNGSB2E24n65kRl7Y0ull44SP2nt5mSsSVpC8Mr4fiTdhjhLypKXHCGXFAk4PG1C8pwTJmUJP1j9S82X0SEqvhoVEX4iTwPv8bD2We2Kj1Mm9q5aGgKwoEwtWn6ekecNWsppLlOyrqJyQO5BYvF3sokrTWwlK8yMvmNT0OG8HDDnjrE48tRu0-d8DWiqBRcvAHyruu3M-hQKWXsotEjl~HHnoiN-un1FagEPkIbkKLraR3YBW9qWgup7cJADyg5EUvK58Lm2R4-XfiYNYg__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q

May 6, 2017 at 3:56 pm

Cytomegalovirus DNA Detection by Polymerase Chain Reaction in Cerebrospinal Fluid of Infants With Congenital Infection: Associations With Clinical Evaluation at Birth and Implications for Follow-up

Clin Inf Dis May 15, 2017 V.64 N.10

EDITOR’S CHOICE

Walter-Alfredo Goycochea-Valdivia; Fernando Baquero-Artigao; Teresa del Rosal; Marie-Antoinette Frick; Pablo Rojo …

Human cytomegalovirus DNA detection in cerebrospinal fluid by polymerase chain reaction has been previously considered a risk factor for hearing loss or neurological sequelae in congenital infection. In the present study, it was not associated with neurological or audiological outcomes.

PDF

https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/cid/64/10/10.1093_cid_cix105/2/cix105.pdf?Expires=1494188648&Signature=elPbA59yOsLDv42fJeuboBpe631YEKWqspSj4kf3mzPsMd~Zd0IeAsGb9A-ILbYIQh-c2pKhS9E-sgQqX9aOaWGXSPGco04ApD9tTq0Z-kYH2riAlIanC9BhT0d4XxhBghuaN9pXVUQuUCRBeBLyt4iYkrY-wwV0w3tUUQdWfyjPRGYtMeI9GXJMOStAHBQ1t270LKCZPIgXtR-gk-JcHhDmM-eE4~TKgHDBIMod8c1JBgPY~~fcX43D6HiH8S2Xsg08WiEJAhvQasvUNIQwzxl-DzwPVSPgmQEZ0580~KyMXN3lO0DgvcSVZYBD3nIGk6QKKrH3Ery5-iDBGl1NkA__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q

May 6, 2017 at 3:54 pm

Atypical Presentation of Disseminated Zoster in a Patient with Rheumatoid Arthritis.

Case Rep Med. 2015;2015:124840.     

Patel N1, Singh D1, Patel K1, Ahmed S1, Anand P1.

Author information

1Department of Medicine, Nassau University Medical Center, East Meadow, NY 11554, USA.

Abstract

Patients with rheumatoid arthritis (RA) have 2-fold increased risk of herpes zoster. In literature, limited information exists about disseminated cutaneous zoster in RA patients. An 83-year-old African-American female with RA presented with generalized and widespread vesicular rash covering her entire body. Comorbidities include hypertension, type II diabetes, and dyslipidemia. Patient was on methotrexate 12.5 mg and was not receiving any corticosteroids, anti-TNF therapy, or other biological agents. The patient was afebrile (98F) with no SIRS criteria. Multiple vesicular lesions were present covering patient’s entire body including face. Lesions were in different stages, some umbilicated with diameter of 2-7cm. Many lesions have a rim of erythema with no discharge. On admission, patient was also pancytopenic with leukocyte count of 1.70k/mm(3). Biopsies of lesions were performed, which were positive for Varicella antigen. Subsequently, patient was started on Acyclovir. The patient’s clinical status improved and rash resolved. Our patient presented with “atypical” clinical picture of disseminated cutaneous zoster with no obvious dermatome involvement. Disseminated zoster is a potentially serious infection that can have an atypical presentation in patients with immunocompromised status. High index of suspicion is needed to make the diagnosis promptly and to initiate therapy to decrease mortality and morbidity.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4609790/pdf/CRIM2015-124840.pdf

April 9, 2017 at 7:29 pm

Incidence and mortality of herpes simplex encephalitis in Denmark: A nationwide registry-based cohort study

Journal of Infection January 2017 V.74 N.1

Laura Krogh Jørgensen a, *, Lars Skov Dalgaard a, Lars Jørgen Østergaard a, Mette Nørgaard b, Trine Hyrup Mogensen a,c

a Department of Infectious Diseases, Aarhus University Hospital, Palle Juul-Jensen Boulevard 99, 8200 Aarhus N, Denmark

b Department of Clinical Epidemiology, Aarhus University Hospital, Oluf Palmes Alle´ 43-45, 8200 Aarhus N, Denmark

cDepartment of Biomedicine, Aarhus University, Vennelyst Blvd. 4, 8000 Aarhus C, Denmark

Objectives: We aimed to investigate the incidence and mortality of herpes simplex encephalitis (HSE) in a nationwide cohort.

Methods: From the Danish National Patient Registry, we identified all adults hospitalised with a first-time diagnosis of HSE in Denmark during 2004e2014. The HSE diagnoses were verified using medical records and microbiological data. Patients were followed for mortality through the Danish Civil Registry System. We estimated age-standardised incidence rates of HSE and 30-day, 60-day, and 1-year cumulative mortality. Furthermore, we assessed whether calendar year, age, gender, level of comorbidity, virus type, and department type was associated with HSE mortality.

Results: We identified a total of 230 cases of HSE. Median age was 60.7 years (interquartile range: 49.3e71.6). The overall incidence rate was 4.64 cases per million population per year (95% confidence interval: 4.06e5.28). The cumulative mortality within 30 days, 60 days, and 1 year of the HSE admission was 8.3%, 11.3%, and 18.6%, respectively. Advanced age and presence of comorbidity were associated with increased 60-day and 1-year mortality.

Conclusions: This nationwide study of verified HSE found a higher incidence than reported in previous nationwide studies. Presence of comorbidity was identified as a novel adverse prognostic factor. Mortality rates following HSE remain high.

PDF

http://www.journalofinfection.com/article/S0163-4453(16)30243-2/pdf

March 25, 2017 at 5:38 pm

Acyclovir reduces the duration of fever in patients with infectious mononucleosis-like illness.

Tohoku J Exp Med. 2013;229(2):137-42.

Usami O1, Saitoh H, Ashino Y, Hattori T.

Author information

1Department of Comprehensive Infection, Tohoku University Hospital, Miyagi, Japan.

Abstract

Acyclovir is known for its antiviral activity against some pathogenic viruses such as the Epstein-Barr virus (EBV) that causes infectious mononucleosis (IM) and IM-like illness. Therefore, we empirically administered acyclovir to patients with suspected EBV-IM and IM like-illness, upon their admission to our hospital. We admitted 25 patients, who were hospitalized for fever and lymphadenopathy, to the Tohoku University Hospital Infectious Disease Ward. As part of treatment, 8 of these patients were given acyclovir (750 mg/day) with their consent and were assigned to the acyclovir group; the remaining 17 patients were assigned to the control group. The mean age of acyclovir patients (all men) was 42±5.2 years, and that of control patients (13 men and 4 women) was 31±3.0 years. The cause of illness was confirmed as EBV-IM in 6 patients (1, acyclovir; 5, control), and remained unknown for the other 19 IM-like illness patients (7, acyclovir; 12, control). A shorter duration of hospitalization and fever was observed in the acyclovir compared to that in the control patients (hospitalization duration: 16±3.7 vs. 27±7.7 days, P=0.36; fever duration: 4.5±1.8 vs. 18±6.5 days, P=0.04). Additionally, serum amyloid A (SAA) levels were lower in acyclovir than that in control patients (98±37 vs. 505±204 µg/mL, P=0.02). Therefore, we propose that acyclovir is a potential therapeutic agent for both EBV-IM and IM like-illnesses. Future studies should further examine its mechanism of action.

PDF

https://www.jstage.jst.go.jp/article/tjem/229/2/229_137/_pdf

March 1, 2017 at 3:35 pm

Severe community-acquired adenovirus pneumonia treated with oral ribavirin: a case report.

BMC Res Notes. 2017 Jan 18;10(1):47.

Yoon BW1, Song YG1, Lee SH2,3.

Author information

1Department of Internal Medicine, Hanil General Hospital, Seoul, Republic of Korea.

2Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Republic of Korea. humanmd04@hanmail.net

3Department of Pulmonary and Critical Care Medicine, Kyung Hee University School of Medicine, Kyungheedae-ro 23, Dongdaemun-gu, Seoul, 02447, Republic of Korea. humanmd04@hanmail.net

Abstract

BACKGROUND:

Adenovirus is a common pathogen of acute upper respiratory infection in children and is generally self-limiting. Severe adenovirus infections have been reported in immunocompromised hosts especially bone marrow transplantation recipients due to hematologic malignancy. Severe adenovirus pneumonia in immunocompetent hosts has rarely been reported and optimal treatment has not been established. We report a case of community-acquired severe adenovirus pneumonia which was successfully treated with early administration of oral ribavirin.

CASE PRESENTATION:

A 39 year-old, previously healthy Korean male was admitted with symptoms of cough, myalgia, febrile sensation. Laboratory findings revealed that he had hypoxemia, thrombocytopenia and elevated transaminase. Chest imaging showed a consolidation with pleural effusion, which was rapidly progressed. All microbiological tests were negative except multiplex real-time reverse transcriptase polymerase chain reaction using respiratory specimen, which was positive for human adenovirus. Under the diagnosis of severe adenovirus pneumonia, we started oral ribavirin, which results in complete recovery without any complications.

CONCLUSIONS:

This case demonstrates that oral ribavirin, instead of other expensive antiviral treatment, could be a good therapeutic option for the severe adenovirus pneumonia at least occurred in immunocompetent hosts.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241922/pdf/13104_2016_Article_2370.pdf

February 25, 2017 at 1:19 pm

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