VZV meningoencephalitis treated with ganciclovir

Collet, A; Baes, D; Mambie, A.; Hembert, K; Boulle, Claire; Gana, Inès; Lemaire, Xavier

doi:10.1016/j.medmal.2020.03.001

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…Several clinical studies report the efficacy of GCV as a treatment for VZV infection in humans, despite the lack of in vitro and in vivo data linking suppression of VZV to GCV ( 34 , 35 ). The Infectious Diseases Society of America (IDSA) recommends GCV as a substitute therapy for VZV-associated encephalitis ( 36 ).…”

Section: Discussionmentioning

confidence: 99%

Analysis of antiviral drug properties of thymidine kinase of herpes B virus using recombinant herpes simplex virus 1

Nguyen,

Fukushi,

Yamada

et al. 2024

Microbiol Spectr

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Zoonotic infection by herpes B virus (BV) causes severe neurological disease, which in the absence of appropriate treatment can have a mortality rate of 80%. Long-term administration of acyclovir or ganciclovir is the recommended prophylactic treatment option for BV infections. However, the emergence of acyclovir- and/or ganciclovir-resistant BV may become a major problem. Here, we examined the ability of BV thymidine kinase (TK) from monkeys (mBVTK) and humans (hBVTK) to acquire resistance to acyclovir and ganciclovir. The sequences of mBVTK and hBVTK differ by two amino acids. We constructed and expressed four HSV-1-based recombinant viruses (HSV-1_mBVTK, HSV-1_hBVTK, HSV-1_VZVTK, and HSV_HSV-1TK) in which the HSV-1TK gene was deleted and the TK gene of monkey BV, human BV, varicella-zoster virus, and HSV-1 was inserted, respectively. We then tested the sensitivity of these recombinant viruses to acyclovir, ganciclovir, penciclovir, and brivudine. HSV-1_HSV-1TK and wild-type HSV-1 were more susceptible to ganciclovir, acyclovir, and penciclovir than HSV-1_VZVTK, HSV-1_hBVTK, and HSV-1_mBVTK. Both HSV-1_hBVTK and HSV-1_mBVTK exhibited similar sensitivity profiles against all tested drugs: both were susceptible to acyclovir, ganciclovir, and penciclovir but resistant to brivudine. In addition, we forced HSV-1_hBVTK to replicate under selective pressure from acyclovir or ganciclovir and then examined the ability of the BV TK gene to develop drug resistance. Investigation of the drug-resistant HSV-1_hBVTK gene revealed the absence of amino acid substitutions in BV TK, suggesting that the development of acyclovir- or ganciclovir-resistant BV through mutations in the TK gene is a rare occurrence in this experimental system. IMPORTANCE Zoonotic infection of humans with herpes B virus (BV) causes severe neurological diseases. Acyclovir (ACV) and ganciclovir (GCV), most frequently used as anti-herpes drugs, are recommended for prophylaxis and therapy in human BV infection. In this study, we examined the property of BV thymidine kinase (TK) against anti-herpes drugs using a recombinant herpes simplex virus type 1 (HSV-1) carrying BV TK gene. We found that HSV-1 carrying BV TK was similarly sensitive to GCV as HSV-1 carrying varicella zoster virus TK. In addition, we demonstrated that BV TK was not mutated in the GCV- and ACV-resistant HSV-1 carrying BV TK, suggesting that ACV- or GCV-resistant BV might be rare during treatment with these antiviral drugs. These data can provide a new insight into the properties of BV TK in terms of the development of drug resistance.

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Section: Discussionmentioning

confidence: 99%

Analysis of antiviral drug properties of thymidine kinase of herpes B virus using recombinant herpes simplex virus 1

Nguyen,

Fukushi,

Yamada

et al. 2024

Microbiol Spectr

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show abstract

“…Additionally, the observed increase in these enzymes could also be associated with muscle breakdown, further complicating the interpretation of these laboratory findings. Ganciclovir stands as the preferred treatment for CMV [ 13 ] and has demonstrated effectiveness against VZV [ 14 ]. espite the intravenous administration of 0.25 g of ganciclovir per day starting on the third day of hospitalization, the treatment’s efficacy remained suboptimal.…”

Section: Discussionmentioning

confidence: 99%

An adult with hemorrhagic varicella co-infects with cytomegalovirus: a case report

Shi,

Li,

et al. 2024

BMC Infect Dis

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Background Hemorrhagic varicella (HV) is a particular form of chicken pox.,with high mortality in adults. This form of the disease is rare, to date, approximately 4 cases have been reported. Occasional cases of HV have been documented in adults with hematologic disorders or other diseases. While there is one reported case of simultaneous reactivation of cytomegalovirus in an adult with chickenpox, there is a lack of information regarding changes in liver function indicators for such patients. This is unfortunate, as CMV reactivation can further exacerbate liver failure and increase mortality. In this report, we present a case of hemorrhagic varicella reactivation with cytomegalovirus and provide some relevant discussions. Case presentation We present the case of a 25-year-old male with HV, who had a history of nephrotic syndrome generally controlled with orally administered prednisone at a dosage of 50 mg per day for two months. The patient arrived at the emergency room with complaints of abdominal pain and the presence of hemorrhagic vesicles on his body for the past 3 days. Despite medical evaluation, a clear diagnosis was not immediately determined. Upon admission, the leukocyte count was recorded as 20.96 × 109/L on the first day, leading to the initiation of broad-spectrum antibiotic treatment. Despite the general interpretation that a positive IgG and a negative IgM indicate a previous infection, the patient’s extraordinarily elevated IgG levels, coupled with a markedly increased CMV DNA quantification, prompted us to suspect a reactivation of the CMV virus. In light of these findings, we opted for the intravenous administration of ganciclovir as part of the treatment strategy. Unfortunately,,the patient succumbed to rapidly worsening symptoms and passed away. Within one week of the patient’s demise, chickenpox gradually developed in the medical staff who had been in contact with him. In such instances, we speculate that the patient’s diagnosis should be classified as a rare case of hemorrhagic varicella. Conclusion Swift identification and timely administration of suitable treatment for adult HV are imperative to enhance prognosis.

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“…The reason for the poor prognosis of this patient was considered as follows:On the one hand,the patient was immunocompromised for long-term oral administration of hormones,50mg per day,to control nephrotic syndrome,at least two months;on the other hand,he combined with CMV infection which could cause severe hepatitis,coagulation function deterioratation and platelet decline [11].Ganciclovir is currently the preferred drug against CMV [12] and also proved effective against VZV [13]. Although ganciclovir was administered intravenously 0.25g,per day,on the third day of hospitalization, the e cacy was still poor.…”

mentioning

confidence: 99%

An adult with hemorrhagic varicella co-infects with cytomegalovirus:A case report

Shi,

Zheng,

Cai

et al. 2023

Preprint

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Background Hemorrhagic varicella(HV) is a rare disease with high mortality in adults. Thus far,approximately 4 cases have been reported. Occasional cases of HV have been reported in adults with hemopathy or other diseases. There only one case described simultaneous reactivation of cytomegalovirus in a chickenpox adult but we are not aware of any description of the changes in liver function indicators of the patient. This is very regrettable for that CMV infection can further exacerbate liver failure and increase mortality.Here we describe a patient with hemorrhagic varicella co-infection with cytomegalovirus and provide a specific description of the indicators of liver damage.Case Presentation: We report the case of a 25-year-old male with HV.He had a history of nephrotic syndrome generally controlled with orally administered prednisone,50mg per day for two months.The patient presented to the emergency room with a complaint of abdominal pain and hemorrhagic vesicles on his body for 3 days.And doctors were unable to make a clear diagnosis.On the first day of hospitalization, the leukocyte count was 20.96/L. So he was given broad-spectrum antibiotic treatment.At the same time, the quantitative analysis of cytomegalovirus DNA was IU/ml in his plasma,so he was treated with intravenous administered ganciclovir. However,he died due to rapidly worsening symptoms. Within one week of the patient's death, chickenpox gradually developed in the doctors and nurses who came into contact with him. In situations like this We speculated that the diagnosis of this patient should be rare hemorrhagic varicella.Conclusions Rapid recognition and appropriate treatment of adult HV are needed to improve the prognosis.

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VZV meningoencephalitis treated with ganciclovir

Cited by 4 publications

References 7 publications

Analysis of antiviral drug properties of thymidine kinase of herpes B virus using recombinant herpes simplex virus 1

Analysis of antiviral drug properties of thymidine kinase of herpes B virus using recombinant herpes simplex virus 1

An adult with hemorrhagic varicella co-infects with cytomegalovirus: a case report

An adult with hemorrhagic varicella co-infects with cytomegalovirus:A case report

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