Intravenous Cidofovir for Peripheral Cytomegalovirus Retinitis in Patients with AIDS

Lalezari, Jacob; Stagg, Robert; Kuppermann, Baruch D.; Holland, Gary N.; Kramer, Françoise; Ives, David V.; Youle, Michael; Robinson, Michael R.; Drew, W. Lawrence; Jaffe, Howard S.

doi:10.7326/0003-4819-126-4-199702150-00001

Cited by 332 publications

(180 citation statements)

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“…), hastalar yakından izlenmelidir. [58][59][60][61] Kinolonlar, DNA giraz inhibisyonu yaparak, T hücreler için BKV'ye karşı in vivo ve in vitro aktivite sağlarlar. [62][63][64] İki ay gatifloksasin kullanımı sonrası BKVN gözlenen nakilli hastalarda, viremide ve decoy hücrelerinde azalma olduğu izlenmiştir.…”

Section: Tarama Testleri̇unclassified

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BK Nephropathy in Renal Transplant Patients: Review

Ayar¹,

Muti²

2014

Turkiye Klinikleri J Nephrol

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38Böbrek Nakilli Hastalarda BK Nefropatisi Ö ÖZ ZE ET T Polyomavirüse bağlı nefropatinin en önemli nedeni insan BK polyomavirüsü (BKV)'dür. Virüs, üriner sistemde latent olarak yaşayabilir. Özellikle solid organ nakli sonrası ve immün sistemi bozulmuş kişilerde aktive olmaktadır. BK ilişkili nefropati (BKVN) böbrek nakli sonrası %1-10 sıklığında görülmekte ve %30-80 greft kaybına ilerlemektedir. BKVN'nin patogenezi tam bilinmemekle birlikte; viral replikasyon ve immünsupresyon suçlanmaktadır. İmmünsupresif protokollerdeki farklılıklar BKVN gelişimini etkileyebilmektedir. Özellikle kalsinörin inhibitörü, mikofenolat mofetil ve steroid içeren üçlü protokollerde risk daha fazladır. Hastalık, böbrek nakli sonrası erken dönemde greft kaybına yol açabilmektedir. Bu nedenle, naklin ilk yılında BKV'nin idrarda veya serumda replikasyonunun izlenmesi hastalığın seyri açısından önemlidir. İmmünsupre-sif tedavinin değiştirilmesi ve antiviral tedaviler, hastalarda virüse karşı hücresel yanıtı arttırmakta ve virüsün çoğalmasını azaltmaktadır. Geç tanı; geriye dönüşümsüz hasara, greft kaybına ve tedavi direncine yol açmaktadır. Sidofovir, leflunomid ve intravenöz immünglobulin gibi yardımcı tedavilerin etkinliği hâlâ tartışma konusudur. Tedaviye rağmen greft kaybı ve diyalize dönüş görüle-bilmektedir. Bu nedenle bu çalışmada, böbrek nakli hastalarında BKVN ile ilgili güncel yaklaşımlara odaklanılmıştır.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : BK virüsü; greft ömrü; böbrek transplantasyonu; immünsupresif ajanlar A AB BS S T TR RA AC CT T The human BK polyomavirus (BKV) is the major cause of polyomavirus-associated nephropathy. The virus can survive latently in urinary system. The virus activates in individuals with impaired immune functions, especially after solid organ transplantation. BK induced nephropathy (BKVN) is seen in 1-10% after kidney transplantation and 30-80% of them progress to graft loss. The pathogenesis of BKVN is unclear, but viral replication and immunosuppression are accused. Differences in immunosuppressive regimens may affect the development of BKVN. Especially, there is more risk in triple protocols including calcineurin inhibitor, mycophenolate mofetil and corticosteroid. The disease leads graft loss in the early period after kidney transplantation. Therefore, the monitoring of replication for BKV in urine or serum is important for disease progression within the first year of transplantation. Changing immunosuppressive and antiviral therapies increase cellular response against the virüs, and decrease viral replication in patients. Late diagnosis causes irreversible damage, treatment resistance and graft loss. The efficacy of adjuvant therapies such as cidofovir, leflunomide and intravenous immunoglobulin are still a matter of debate. Therefore, this review has been focused on the current approaches related with BKVN in kidney transplant patients. K Ke ey y W Wo or rd ds s: : BK virus; graft survival; kidney transplantation; immunosuppressive agents T Tu ur rk ki iy ye e K Kl li in ni ik k...

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“…[67][68][69][70][71] Profilaksi tedavisi Tablo 3'te görül-mektedir. [61][62][63][64][65][66][67][68][69][70][71] Yeterli BKV klerensinin sağlanamaması, greft fonksiyon bozukluğuna yol açar. İzlemde kan değeri PZR yöntemi ile bakılır.…”

Section: Tarama Testleri̇unclassified

BK Nephropathy in Renal Transplant Patients: Review

Ayar¹,

Muti²

2014

Turkiye Klinikleri J Nephrol

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“…In patients treated with cidofovir, proteinuria and elevations in creatinine have been reported for 39 O/O and 24 % , respectively [5,6]. In addition, renal impairment was observed in some patients after cidofovir administration despite hydration with intravenous normal saline and the administration of oral probenecid to inhibit anion transport [7,4].…”

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“…In addition, renal impairment was observed in some patients after cidofovir administration despite hydration with intravenous normal saline and the administration of oral probenecid to inhibit anion transport [7,4]. Other adverse effects of cidofovir are neutropenia, seen in 15 % of the individuals treated, and potentially irreversible dose-dependent nephrotoxicity [5,9] and iritis [8].…”

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Acute renal failure in a lung transplant patient after therapy with cidofovir

et al. 2001

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“…Cidofovir delays progression of CMV retinitis in patients with AIDS [21,221, and is approved for this indication in the USA and Europe. It has to be given intravenously at 5 mg/kg once weekly for 2 weeks and then once every other week, a regimen that is associated with manageable side effects.…”

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confidence: 99%

Acyclic Nucleoside Phosphonates: A New Dimension To The Chemotherapy Of Dna Virus And Retrovirus Infections

Clercq

1998

Journal of Medical Microbiology

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Most antiviral compounds that are currently used in the treatment of infection with herpes simplex virus (HSV), varicella-zoster virus (VZV) and cytomegalovirus (CMV) are acyclic nucleoside analogues: viz., acyclovir, penciclovir and ganciclovir [ 11. To increase their oral bioavailability, acyclovir and penciclovir have been converted to their oral prodrug forms, valaciclovir and famciclovir, respectively.

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Intravenous Cidofovir for Peripheral Cytomegalovirus Retinitis in Patients with AIDS

Cited by 332 publications

References 0 publications

BK Nephropathy in Renal Transplant Patients: Review

BK Nephropathy in Renal Transplant Patients: Review

Acute renal failure in a lung transplant patient after therapy with cidofovir

Acyclic Nucleoside Phosphonates: A New Dimension To The Chemotherapy Of Dna Virus And Retrovirus Infections

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