No abstract available.
Antiviral Agents/*therapeutic use ; Colitis, Ulcerative/*drug therapy ; *Cytomegalovirus ; Cytomegalovirus Infections/*drug therapy ; Ganciclovir/*therapeutic use ; Humans ; *Virus Activation

No abstract available.
Antiviral Agents/*therapeutic use ; Colitis, Ulcerative/*drug therapy ; *Cytomegalovirus ; Cytomegalovirus Infections/*drug therapy ; Ganciclovir/*therapeutic use ; Humans ; *Virus Activation

OBJECTIVETo study the value of antiviral therapy for infectious monocytosis (IM) in children by comparing the near-term therapeutic efficacies and long-term follow-up results in children with this disorder between receiving antiviral therapy or not.

METHODSThe medical data of IM children between 1999 and 2009 were retrospectively reviewed. A total of 172 cases with a follow-up visit period of 1 year and more were eligible. The children were classified into three groups according to the treatment protocol: ganciclovir treatment (n=49), acyclovir treatment (n=72) and symptomatic treatment (control; n=51). The children in the ganciclovir group received an intravenous drip of 10 mg/kg per day of ganciclovir, administered in twice-daily doses; Seven days later the drip volume was changed to 5 mg/kg, administered once each day; the total course lasting 10-14 days. The children in the acyclovir group received acyclovir orally at 20 mg/kg per day, administered in three times daily doses; the total course lasting 10-14 days. The children in the control group received symptomatic treatment only. In the three groups, indicators including fever course, improvement of isthmitis symptoms, lymph node retraction, hepatic and splenic lymph node retraction time, atypical lymphocyte fallback time and alteration of granulocyte amount after drug use were observed. The long-term follow-up visits covered such indicators as blood routine reexamination, hepatic function, liver and spleen B-ultrasonography, recovery rate, recurrence rate and mortality rate.

RESULTSIn the acute phase, there were no differences in terms of fever course, isthmitis improvement, hepatic and splenic lymph node retraction time and the time of atypical lymphocyte falling back to below 10% among the three groups (P>0.05). During the period of follow-up visits between 1 year and 8 years and 10 months, no significant differences were observed in the recovery rate, the recurrence rate and the mortality rate among the three groups (P>0.05).

CONCLUSIONSThe efficacies of antiviral therapy for IM children appear to be similar to non-antiviral therapy, suggesting that antiviral therapy fails to be beneficial for IM children.

Acyclovir ; therapeutic use ; Adolescent ; Antiviral Agents ; therapeutic use ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Ganciclovir ; therapeutic use ; Humans ; Infant ; Infectious Mononucleosis ; drug therapy ; Male ; Retrospective Studies

OBJECTIVETo analyze a Duchenne muscular dystrophy(DMD) patient's muscular regeneration, dystrophin expression and locomotive variation before and after he underwent umbilical cord blood stem cell transplantation in order to assess the therapeutic effect.

METHODSA 12-year-old DMD boy who could not walk for 3 years was confirmed by gene analysis and dystrophin protein immune test on his muscle. He had no other chronic disease. By HLA matching, a piece of umbilical cord blood stem cell with 6 HLA sites matching to the boy was found in Guangdong Umbilical Cord Blood Bank. The number of the nucleated cells of the umbilical cord blood stem cell was 24.08x 10(8). After pretreatment for the DMD boy with busulfan, cyclophosphamide and rabbit anti-human thymocyte globulin, the allergenic cord blood stem cells were transplanted into him by intravenous injection. Cyclosporin A, methylprednisolone, MMF, prostaglandin E1 and ganciclovir were given after the transplantation. At the same time, Gran, the granulocytic cell stimulating factor, and gamma globulin were administered. The biochemistry profile including serum creatine kinase (CK), the reconstruction of blood making, the deletion exon of DMD gene, the regenerating muscles, the dystrophin protein expression, and the locomotive function of the DMD boy were tested regularly.

RESULTS(1) The white blood cells (WBC) of peripheral blood decreased gradually to zero after pretreatment. In a period of 15 days after transplantation, the neutrophil increased to 0.5x 10(9)/L; at 25 days, WBC increased to normal level. Blood platelet was more than 20x 10(9)/L at 22 days. The hemoglobin rose to 85-100 g/L. At 140 days, sternal puncture revealed the rapid growth of neutrophil, blood platelet and hemoglobin. (2)At 140 days, the blood type of the DMD boy transformed from type O to type AB (the donor's blood type being AB). There was no grafe versus host reaction. (3) At 18, 30, 43, 55, 74 and 233 days after transplantation, the PCR-short tandem repeat test of the boy's peripheral blood DNA showed that his genotype was completely the same as the donor's. The results of PCR-short tandem repeat tests of the bone marrow cells DNA by sternal puncture at 140, 183 and 235 days were the same as those of the blood DNA. (4) At 60 days, DMD gene analysis by PCR showed that the defected DMD gene (exon 19 deletion) had been corrected by the umbilical cord stem cells transplantation. (5) At 75 days, the biopsy of calf muscle showed there were myoblast cells and muscular tubes growing. The dystrophin expressions were weak, but a few of them were strong. DNA analysis showed that the donor's gene DNA accounted for 1%-13%. At 126 days, obviously increased dystrophin positive muscular fibers of the boy were found. The donor's fibers rose to 2.5%-25%. (6) The serum CK of the boy declined from 5735 U/L to 274 U/L. (7) At 100 days, physical examination revealed improvement in his arms and legs.

CONCLUSIONThe therapy of Duchenne muscular dystrophy with allogeneic umbilical cord blood hematopoietic stem cell transplantation may reset up the blood-making function, decrease the serum CK level, restore the dystrophin in muscles, and improve the locomotive function of the DMD boy. These data suggest that the allogeneic umbilical cord blood hematopoietic stem cell transplantation may benefit the DMD boys.

Alprostadil ; therapeutic use ; Busulfan ; therapeutic use ; Child ; Combined Modality Therapy ; Cord Blood Stem Cell Transplantation ; methods ; Cyclosporine ; therapeutic use ; Dystrophin ; genetics ; Ganciclovir ; therapeutic use ; Humans ; Male ; Methylprednisolone ; therapeutic use ; Muscular Dystrophy, Duchenne ; genetics ; therapy ; Polymerase Chain Reaction ; Treatment Outcome

BACKGROUNDHerpes simplex keratitis (HSK) caused by herpes simplex virus 1 (HSV-1), which has high recurrent rate and incidence of severe vision loss, is the leading cause of infectious blindness in the world. The aim was to explore the clinical efficacy of oral ganciclovir (GCV) in the prevention of recurrent HSK.

METHODSA multicenter, prospective, randomized, single-blind, and controlled clinical trial was conducted from April 2010 to June 2013. One hundred seventy-three patients (173 eyes involved) who were diagnosed as recurrent HSK definitely, including stromal keratitis and corneal endotheliitis, were divided into three groups randomly: negative control (placebo) group was topically administered with 0.15% GCV ophthalmic gel, 4 times per day and 0.1% fluorometholone eye drops, 3 times per day until resolution of HSK; positive control acyclovir (ACV) group was topically adopted the same ophthalmic gel and eye drops and additionally received oral ACV 400 mg 5 times a day for 10 weeks and followed by 400 mg 2 times per day for 6 months; test GCV group was topically adopted the same treatment as negative control group and additionally received oral GCV 1000 mg 3 times per day for 8 weeks. The symptoms and signs were evaluated before and after the therapy 1 st week, 2 nd week and then followed up every 2 weeks until recovery. Furthermore, we followed up recurrence of HSK for every 3 months after recovery and then assessed the cure time, recurrent rate and adverse reactions.

RESULTSOne hundred and seventy-three patients were followed up 7-48 months (mean 32.1 ± 12.3 months), but 34 patients were failed to follow-up. The cure time was 12.1 ± 4.3, 11.9 ± 4.0 weeks in negative control (placebo) group and positive control ACV group respectively (P = 0.991), which was longer than that in test GCV group (8.6 ± 2.8 weeks) and there was a significant difference between test GCV group and negative control (placebo) group or positive control ACV group (P = 0.000). Furthermore, the recurrent rate was higher in negative control (placebo) group (47.3%) than that in positive control group ACV (26.7%) and test GCV group (17.2%), and there was a great significant difference among the three groups (P = 0.007), but there was no significant difference between positive control ACV group and test GCV group (P = 0.358). In addition, there was no obvious adverse reaction expect neutropenia (only one patient in test GCV group).

CONCLUSIONShort-term oral GCV could cure recurrent HSK and endotheliitis, shorten the course, reduce recurrent rate of HSK and have confirmed safety.

Adult ; Aged ; Antiviral Agents ; administration & dosage ; therapeutic use ; Female ; Ganciclovir ; administration & dosage ; therapeutic use ; Humans ; Keratitis, Herpetic ; drug therapy ; Male ; Middle Aged ; Single-Blind Method ; Treatment Outcome

OBJECTIVETo observe the clinical effects of Linda Mixture (LM) on cholestatic liver diseases caused by cytomegalovirus (CMV) infection.

METHODSTotally 240 CMV infected cholestatic liver diseases infants, who were hospitalized at the Department of Integrated Traditional Chinese and Western Medicine, Wuhan Children's Hospital from January 2008 to June 2011, were randomly assigned to the treatment group (120 cases) and the control group (120 cases). Patients in the treatment group were treated by LM combined ganciclovir, while those in the control group were treated by ganciclovir alone. The therapeutic course was 2 months. The patients were assigned to 3 sub-groups according to the quantification standards of symptoms and signs, i. e., the No. 1 treatment group (mild, 30 cases), the No. 1 control group (mild, 30 cases), the No. 2 treatment group (moderate, 30 cases), the No. 2 control group (moderate, 30 cases), the No. 3 treatment group (severe, 30 cases), the No. 1 control group (severe, 30 cases). The clinically cured rate and the total effective rate, the jaundice subside time, the retraction time for Gan and Pi, the body weight growth, the indices of the liver function, and lab indices of CMV infection were observed before and after treatment.

RESULTSAfter treatment the cured rate was 77.50% and the total effective rate was 88.33% in the treatment group, while they were 60.83% and 76.67% in the control group. There was statistical difference between the two group (P<0.05, P<0.01). There was some improvement in the jaundice subside time, the retraction time for Gan and Pi, the body weight growth, the indices of the liver function in the two groups. Better results were obtained in the treatment group than in the control group, showing statistical difference (P<0.05, P<0.01). The lab indices of CMV infection showed negative to some degrees. The negative rates of serum IgM (83.54% in the treatment group and 63. 64% in the control group) and the serum CMVDNA (84.52% in the treatment group and 67.47% in the control group) were better in the treatment group than in the control group, showing statistical difference (P<0.01). There was no obvious difference in the negative rate of CMV antigen in urine between the two groups (P>0.05).

CONCLUSIONSLM combined ganciclovir therapy showed definite effects in treating cholestatic liver diseases caused by CMV infection. Early treatment for severe infants might change their prognosis. LM also could alleviate adverse reactions during the therapeutic course.

Cholestasis ; complications ; drug therapy ; virology ; Cytomegalovirus Infections ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Ganciclovir ; therapeutic use ; Humans ; Infant ; Liver Diseases ; drug therapy ; etiology ; virology ; Male ; Phytotherapy

OBJECTIVETo evaluate the efficacy and safety of ganciclovir therapy for congenital cytomegalovirus (CMV) infection in newborn infants.

METHODSThe randomized controlled trials (RCTs) and quasi-RCTs on ganciclovir therapy for congenital CMV were reviewed in the following electronic databases: PubMed (January 1988 to January 2009), EMbase (January 1988 to January 2009), the Cochrane library (Issue 3, 2003 and Issue 1, 2009), the Chinese Journals Full-text Database (January 1994 to January 2009), the Chinese Biological Medical Disc (January 1994 to January 2009) and the Chinese Medical Current Contents (January 1994 to January 2009). Quality assessment, data extraction, and meta analysis were performed.

RESULTSTen papers were included. Meta analysis showed that the ganciclovir therapy increased the improvement rate (91.4% vs 34.0%; p<0.01) and led CMV infection indexes to become negative in more patients (87.6% vs 15.3%; p<0.01) and decreased incidence of hearing disturbance (4.7% vs 37.2%; p<0.01) as compared with the non-ganciclovir therapy control group. The incidence of the ganciclovir-therapy-related side effects was low.

CONCLUSIONSGanciclovir treatment may increase the improvement rate and the rate of CMV infection indexes becoming negative, and decrease incidence of hearing disturbance, with few side effects, in newborn infants with CMV infection. However the supporting evidence is not strong due to few trials and more high-quality research is needed.

Antiviral Agents ; therapeutic use ; Cytomegalovirus Infections ; complications ; congenital ; drug therapy ; Follow-Up Studies ; Ganciclovir ; therapeutic use ; Hearing Disorders ; etiology ; Humans ; Infant, Newborn

Hemophagocytic syndrome (HPS) is an uncommon hematological disorder that manifests as fever, splenomegaly, and jaundice, with hemophagocytosis in the bone marrow and other tissues pathologically. Secondary HPS is associated with malignancy and infection, especially viral infection. The prevalence of cytomegalovirus (CMV) infection in ulcerative colitis (UC) patients is approximately 16%. Nevertheless, HPS in UC superinfected by CMV is very rare. A 52-year-old female visited the hospital complaining of abdominal pain and hematochezia for 6 days. She was diagnosed with UC 3 years earlier and had been treated with sulfasalazine, but had stopped her medication 4 months earlier. On admission, her spleen was enlarged. The peripheral blood count revealed pancytopenia and bone marrow aspiration smears showed hemophagocytosis. Viral studies revealed CMV infection. She was treated successfully with ganciclovir. We report this case with a review of the related literature.
Antiviral Agents/therapeutic use ; Colitis, Ulcerative/*complications/drug therapy ; Cytomegalovirus Infections/*complications/drug therapy ; Female ; Ganciclovir/therapeutic use ; Gastrointestinal Agents/therapeutic use ; Gastrointestinal Hemorrhage/etiology ; Humans ; Lymphohistiocytosis, Hemophagocytic/drug therapy/*virology ; Middle Aged ; Sulfasalazine/therapeutic use ; Superinfection/*complications

OBJECTIVETo investigate the effective therapeutic method of human cytomegalovirus (HCMV) hepatitis in children.

METHODSTwenty-five children with HCMV hepatitis were randomly assigned to a treated group (n=13) or a control group (n=12). Both groups were treated with prednisone, glucurone, luminal and Xiaoyanlidanpian. But the treated group was given ganciclovir (GCV) + intravenous immunoglobulin (IVIG) in addition. Each infant of the two groups was checked for blood routine, liver function and HCMV copy numbers on admission and before discharge. They were seen at the third, sixth and ninth month after discharge. On each visit blood specimens were collected for HCMV copy numbers (fluorescence quantitative PCR, FQ-PCR).

RESULTSThe viral load of the treated group decreased significantly. A significant difference in viral copy numbers was found between the two groups on admission, discharge, and third, sixth and ninth month after discharge (P less than 0.001). The number of HCMV DNA copy fell to 10(3) copies/ml on discharge while that of the control group fell to the same level after the third month. The differences between the two groups in the length of hospitalization, time of initial jaundice disappearance and complete disappearance were statistically significant (P less than 0.05). The need for transfusion in the treated group was significantly less than that in the control group (chi-square=4.012, P less than 0.05).

CONCLUSIONCombination of GCV with a high dosage of IVIG to treat HCMV active infection could decrease viral load remarkably; The duration of disease, severity of symptoms, degree of anemia and the need for blood transfusion were reduced. No adverse effects related to the combination of GCV with IVIG therapy were observed.

Antiviral Agents ; therapeutic use ; Cytomegalovirus ; genetics ; Cytomegalovirus Infections ; drug therapy ; DNA, Viral ; analysis ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Ganciclovir ; therapeutic use ; Hepatitis, Viral, Human ; drug therapy ; virology ; Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Infant ; Male ; Treatment Outcome

OBJECTIVETo evaluate the therapeutic effects of bicyclol combined with ganciclocir on infantile cytomegalovirus hepatitis.

METHODSSeventy infants with cytomegalovirus hepatitis were randomized into treatment group (n=35) and control group (n=35) for a 2-week-long treatment with ganciclocir (5 mg/kg) with and without oral bicyclol (3 mg/kg, twice daily), respectively.

RESULTSIn both groups, significant changes occurred in the levels of alanine aminotransferase, alkaline phosphatase, serum total bilirubin, serum total bile acid, and glutamyl transpeptidase after the 2-week treatment (P<0.01); these parameters differed significantly between the two groups after the treatment (P<0.01). Compared with those in the control group, the infants in the treatment group showed significantly better responses to the treatment (P<0.05) with a significantly higher rate of serum anti CMV IgM negativity (P<0.05).

CONCLUSIONSBicyclol combined with ganciclocir can reduce glutamic pyruvic transaminase, alkaline phosphatase and serum total bilirubin, and decrease bile acid levels to lessen liver cell damage and promote the recovery of liver cells.

Alanine Transaminase ; metabolism ; Alkaline Phosphatase ; metabolism ; Antiviral Agents ; therapeutic use ; Bilirubin ; blood ; Biphenyl Compounds ; therapeutic use ; Cytomegalovirus ; Cytomegalovirus Infections ; drug therapy ; Drug Therapy, Combination ; Ganciclovir ; therapeutic use ; Hepatitis ; drug therapy ; virology ; Humans ; Infant ; Liver Function Tests