title: Human cytomegalovirus kinetics following institution of artesunate after hematopoietic stem cell transplantation.
abstract: The anti-malaria drug artesunate has been shown to be an effective inhibitor of cytomegalovirus (CMV) in vitro, in an experimental animal model, and in a recent single-case clinical use. In this first case-series of 6 stem cell transplant recipients who received preemptive artesunate treatment for CMV infection, we have examined the viral kinetics following institution of artesunate, and employed first-phase viral kinetics studies to calculate its antiviral effectiveness. Two patients demonstrated a rapid 0.8-2.1 log viral load decline by 7 days, with a viral decay half-live of 0.9-1.9 days. Four patients demonstrated a continued yet stalled viral growth slope during treatment. No adverse events were noted in treatment courses of up to 28 days. Overall, a divergent antiviral efficacy was revealed, ranging from 43% to 90%, which appeared to be primarily dependent on the virus baseline growth dynamics. Further dose escalation studies are needed to examine the role of artesunate in the treatment of CMV infection in the transplantation setting.
authors: Clinical Virology Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel. dana.wolf@ekmd.huji.ac.il
authors: Dana G
authors: DG
authors: Wolf
authors: Avichai
authors: A
authors: Shimoni
authors: Igor B
authors: IB
authors: Resnick
authors: Thomas
authors: T
authors: Stamminger
authors: Avidan U
authors: AU
authors: Neumann
authors: Sunwen
authors: S
authors: Chou
authors: Thomas
authors: T
authors: Efferth
authors: Orit
authors: O
authors: Caplan
authors: Jessica
authors: J
authors: Rose
authors: Arnon
authors: A
authors: Nagler
authors: Manfred
authors: M
authors: Marschall
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D037621:Artemisinins / Q000009:adverse effects / Q000627:therapeutic use*; D000077332:Artesunate; D002648:Child; D003587:Cytomegalovirus / Q000737:chemistry / Q000187:drug effects* / Q000235:genetics / Q000502:physiology*; D003586:Cytomegalovirus Infections / Q000188:drug therapy* / Q000209:etiology / Q000821:virology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D019562:Viral Load / Q000187:drug effects
chemical_list: D000998:Antiviral Agents; D037621:Artemisinins; D000077332:Artesunate