Titre
Low-dose cidofovir for the treatment of polyomavirus-associated nephropathy: two case reports and review of the literature.
Type
synthèse (review)
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Lamoth, Frederic
Auteure/Auteur
Pascual, Manuel
Auteure/Auteur
Erard, Veronique
Auteure/Auteur
Venetz, Jean-Pierre
Auteure/Auteur
Nseir, Ghaleb
Auteure/Auteur
Meylan, Pascal
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1359-6535
Statut éditorial
Publié
Date de publication
2008
Volume
13
Numéro
8
Première page
1001
Dernière page/numéro d’article
1009
Peer-reviewed
Oui
Langue
anglais
Résumé
BACKGROUND: Polyomavirus-associated nephropathy (PVAN) is a serious complication and cause of graft loss in kidney transplant recipients. In the absence of specific antiviral drugs, early detection of the disease and reduction of immunosuppressive regimen is the cornerstone of therapy. Cidofovir, a nucleoside analogue, has been found to inhibit BK virus (BKV) replication in vitro and has been proposed as treatment of refractory PVAN at low doses; however, its efficacy has never been demonstrated in randomized controlled trials. METHODS: Cidofovir therapy (0.5 mg/kg at a 2-week interval for eight consecutive doses) was initiated in two patients with biopsy-proven PVAN and persistent BKV DNA viraemia (> or = 10,000 copies/ml despite sustained reduction of the immunosuppressive regimen). In addition to these two case reports, we performed a critical review of the literature on the use of cidofovir in PVAN. RESULTS: No significant decrease of BKV viral load in blood was observed during cidofovir therapy and in follow-up of the two patients treated with cidofovir. Our literature review identified 21 publications reporting the use of cidofovir for the treatment of PVAN. All were case reports or small series. The efficacy of cidofovir therapy could not be assessed in 17 of these publications because of lack of data or concomitant reduction of immunosuppressive regimen. The four remaining publications were case reports. CONCLUSIONS: In vitro and clinical data to support the efficacy of cidofovir in the treatment of PVAN are currently lacking. More promising compounds should be identified for further clinical studies.
PID Serval
serval:BIB_9B931842FA7E
PMID
Date de création
2009-05-29T08:14:12.024Z
Date de création dans IRIS
2025-05-20T21:13:22Z