title: Brincidofovir clearance of acyclovir-resistant herpes simplex virus-1 and adenovirus infection after stem cell transplantation.
abstract: 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.
authors.affiliation: Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany. sebastian.voigt@charite.de.|Department of Pediatric Oncology/Hematology/SCT, Charité-Universitätsmedizin Berlin, Berlin, Germany. sebastian.voigt@charite.de.
authors.forename: S
authors.initials: S
authors.lastname: Voigt
authors.affiliation: Institute of Medical Virology, Helmut-Ruska-Haus, Charité-Universitätsmedizin Berlin, and Labor Berlin Charité-Vivantes GmbH, Berlin, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Hofmann
authors.affiliation: Institute of Medical Virology, Helmut-Ruska-Haus, Charité-Universitätsmedizin Berlin, and Labor Berlin Charité-Vivantes GmbH, Berlin, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Edelmann
authors.affiliation: Institute of Virology and Antiviral Therapy, German Consulting Laboratory for HSV and VZV, Jena University Hospital, Jena, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Sauerbrei
authors.affiliation: Department of Pediatric Oncology/Hematology/SCT, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: J-S
authors.initials: JS
authors.lastname: Kühl
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage / Q000627:therapeutic use; D000256:Adenoviridae / Q000302:isolation & purification / Q000502:physiology*; D000258:Adenovirus Infections, Human / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D019072:Antibiotic Prophylaxis; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002675:Child, Preschool; D000077404:Cidofovir; D003596:Cytosine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004279:DNA, Viral / Q000097:blood; D024882:Drug Resistance, Viral; D020031:Epstein-Barr Virus Infections / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D005260:Female; D017245:Foscarnet / Q000008:administration & dosage / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006561:Herpes Simplex / Q000188:drug therapy* / Q000821:virology; D006562:Herpes Zoster / Q000188:drug therapy* / Q000821:virology; D018259:Herpesvirus 1, Human / Q000302:isolation & purification; D014645:Herpesvirus 3, Human / Q000302:isolation & purification; D004854:Herpesvirus 4, Human; D006801:Humans; D016867:Immunocompromised Host; D008590:Meningoencephalitis / Q000188:drug therapy* / Q000821:virology; D052016:Mucositis / Q000188:drug therapy* / Q000821:virology; D009190:Myelodysplastic Syndromes / Q000601:surgery*; D063065:Organophosphonates / Q000008:administration & dosage / Q000627:therapeutic use*; D000069283:Rituximab / Q000008:administration & dosage / Q000627:therapeutic use; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D063065:Organophosphonates; D017245:Foscarnet; D000069283:Rituximab; C525733:brincidofovir; D003596:Cytosine; D000077404:Cidofovir; D000212:Acyclovir
keywords: Epstein-Barr virus; adenovirus; brincidofovir; hematopoietic stem cell transplantation; herpes simplex virus