acyclovir and Adenovirus-Infections--Human

Topics: Acyclovir; Adenovirus Infections, Human; Adenoviruses, Human; Antiviral Agents; Brain; Diffusion Magnetic Resonance Imaging; Humans; Infant, Newborn; Male; Meningoencephalitis; Polymerase Chain Reaction

Infections with adenovirus (AdV) and herpesviruses can result in considerable morbidity and mortality in pediatric hematopoietic stem cell transplant (SCT) recipients. Herpes simplex virus (HSV) reactivations are usually prevented by acyclovir (ACV) prophylaxis, whereas cidofovir (CDV) has been used off indication to manage AdV infections. We report a child with myelodysplastic syndrome undergoing multiple SCT, who experienced HSV-1 disease including severe mucositis and herpetic whitlow, as well as high viral load AdV DNAemia. Both ACV and CDV were ineffective; however, viral loads were decreased with brincidofovir, resulting in viral clearance. A subsequent Epstein-Barr virus disease with relevant meningoencephalitis responded to rituximab.

Topics: Acyclovir; Adenoviridae; Adenovirus Infections, Human; Antibiotic Prophylaxis; Antiviral Agents; Child, Preschool; Cidofovir; Cytosine; DNA, Viral; Drug Resistance, Viral; Epstein-Barr Virus Infections; Female; Foscarnet; Hematopoietic Stem Cell Transplantation; Herpes Simplex; Herpes Zoster; Herpesvirus 1, Human; Herpesvirus 3, Human; Herpesvirus 4, Human; Humans; Immunocompromised Host; Meningoencephalitis; Mucositis; Myelodysplastic Syndromes; Organophosphonates; Rituximab; Viral Load

Viral infections are common complications following renal transplantation. However, there have been few reported cases of viral cystitis secondary to herpes simplex virus or adenovirus infection. Herein, we have reported four cases of hemorrhagic cystitis secondary to infections with herpes simplex virus and adenovirus following renal transplantation. The etiology was adenovirus in three cases and herpes simplex virus in the remaining case. In all four cases, the primary cause of the renal dysfunction was diabetic nephropathy. All four patients presented with a clinical profile characterized by dysuria, pollakiuria, macroscopic hematuria, and graft dysfunction. Three of the four patients developed these symptoms within the first 3 months after renal transplantation. In all four cases, there was an increase, albeit slight, in creatinine levels, which returned to normal or near-normal values upon resolution of the symptoms. Acute cellular rejection was observed in only one case. Although rare, hemorrhagic cystitis secondary to infection, which typically occurs early in the posttransplant period, causes pronounced symptoms. The infection appears to be self-limiting, resolving completely within 4 weeks.

Topics: Acyclovir; Adenovirus Infections, Human; Aged; Aged, 80 and over; Antiviral Agents; Cystitis; Diabetic Nephropathies; Herpes Simplex; Humans; Kidney Transplantation; Male; Middle Aged; Treatment Outcome; Valacyclovir; Valine

A 17-year-old youth presented with bilateral follicular conjunctivitis and nummular subepithelial corneal infiltrates. Failure of this to settle in an outpatient setting led to corneal scraping with microscopy and culturing for bacteria, fungi, Herpes simplex, adenovirus and Acanthamoeba as an inpatient. Polymerase chain reaction analysis of corneal cells was positive for adenovirus, and culture on live Escherichia coli-coated agar plates was positive for Acanthamoeba by phase contrast microscopy on day two. We conclude that Acanthomoeba infection can complicate adenoviral keratoconjunctivitis. This observation is in keeping with previously reported modes of infection by Acanthamoeba, whereby any epithelial breach seems to allow inoculation of the eye by this opportunistic organism.

Topics: Acanthamoeba; Acanthamoeba Keratitis; Acyclovir; Adenovirus Infections, Human; Adenoviruses, Human; Adolescent; Animals; Biguanides; Cyclopentolate; Drug Therapy, Combination; Eye Infections, Viral; Humans; Keratoconjunctivitis; Male; Prednisolone

Infection and expression of recombinant human adenovirus in mouse abdominal cavity was reported. After adenovirus vector Ad/RSV-beta-gal harboring the E. coli lacZ marker gene was injected into mice abdominal cavity, the peritoneal surface of jejunum, ileum, colon, uterus, liver, spleen, stomach, bladder, abdominal wall, diaphragm and testis was found large patches of lacZ-positive cells. But the adenovirus vector was not able to penetrate the peritoneum, as demonstrated by histochemical staining. Another adenovirus vector Ad/RSV-tk harboring the HSV-tk gene was injected into mouse abdominal cavity and the mouse was treated with ACV. No acute toxic reaction was observed. Based on these data, the feasibility of gene therapy of malignant tumor within abdominal cavity with adenovirus mediated TK/GCV system was discussed.

Topics: Abdomen; Acyclovir; Adenovirus Infections, Human; Adenoviruses, Human; Animals; Antiviral Agents; Escherichia coli; Gene Expression; Genetic Therapy; Genetic Vectors; Humans; Lac Operon; Mice; Rabbits; Recombination, Genetic; Thymidine Kinase

The most common causes of acute viral infections of the eye for which there are no effective antiviral drugs are the adenoviruses. Until recently, pathogenesis studies and antiviral drug testing for adenovirus-induced ocular disease were not practical because no animal model was available. However, new animal models for human adenovirus-induced ocular and respiratory infections have now made such studies possible. We assessed the in vitro and in vivo activity of ganciclovir against a genetically defined adenovirus (Ad5 wt 300) known to cause severe ocular disease. The 50% inhibitory dose (ID50) values were determined by plaque reduction assays in human cells. The ID50 values of 47 and 604 microM were determined for ganciclovir and acyclovir, respectively, against Ad5, and 26 and 152 microM, respectively against Ad8. Cotton rats were inoculated bilaterally with 10(5) plaque-forming units per eye and treated topically with ganciclovir (3%, 1%, or 0.3%) or placebo for 21 days. All inoculated eyes were culture positive on days 1-3 with increased infectivity titers, regardless of treatment. However, the incidence, duration, and titer of virus shed in eyes treated with 3% ganciclovir was reduced, and the antiadenovirus enzyme-linked immunosorbent assay titers in serum were lower in these animals. Although these differences were not statistically significant, the observed trend suggested that the highest ganciclovir dose had a suppressive effect on some disease parameters.

Topics: Acyclovir; Adenovirus Infections, Human; Adenoviruses, Human; Animals; Antibodies, Viral; Carcinoma; Enzyme-Linked Immunosorbent Assay; Eye Infections, Viral; Ganciclovir; Humans; Keratoconjunctivitis, Infectious; Lethal Dose 50; Lung Neoplasms; Ophthalmic Solutions; Sigmodontinae; Tumor Cells, Cultured; Virus Shedding

Topics: Acyclovir; Adenoviridae Infections; Adenovirus Infections, Human; Antiviral Agents; Child, Preschool; Female; Ganciclovir; Humans; Immunosuppression Therapy; Liver Transplantation