硝唑尼特治疗原发性免疫缺陷和风疹病毒相关性肉芽肿病例系列患者的结果。
Outcomes for Nitazoxanide Treatment in a Case Series of Patients with Primary Immunodeficiencies and Rubella Virus-Associated Granuloma.
机构信息
Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA.
Division of Hematology, CHOC Children's Hospital, Orange, CA, USA.
出版信息
J Clin Immunol. 2019 Jan;39(1):112-117. doi: 10.1007/s10875-019-0589-0. Epub 2019 Jan 24.
PURPOSE
Nitazoxanide was recently reported as having in vitro effectiveness against the rubella virus. Immunodeficiency-related vaccine-derived rubella occurs in some patients who have an inherited immunodeficiency and who received the MMR vaccine. This study investigated the in vivo effectiveness of nitazoxanide therapy.
METHODS
This is a retrospective analysis of seven patients treated with nitazoxanide as salvage therapy for immunodeficiency-related vaccine-derived rubella infection. The patients were recruited from an ongoing rubella detection surveillance project.
RESULTS
Seven patients with persistent rubella were treated with nitazoxanide and one demonstrated significant clinical improvement. Two additional patients exhibited diminished viral capsid production with one patient having transient slowing of progression. The cohort overall generally had low T cell counts and had a high burden of comorbidities. There were three deaths. Two deaths were from PML and one was related to hematopoietic stem cell transplantation.
CONCLUSIONS
Nitazoxanide has limited in vivo anti-viral effects for immunodeficiency-related vaccine-derived rubella. Most patients did not exhibit clinical improvement.
目的
硝唑尼特最近被报道具有体外抗风疹病毒的作用。一些患有遗传性免疫缺陷并接种了 MMR 疫苗的患者会发生与免疫缺陷相关的疫苗衍生性风疹。本研究调查了硝唑尼特治疗的体内疗效。
方法
这是对七名接受硝唑尼特作为免疫缺陷相关疫苗衍生性风疹感染挽救治疗的患者进行的回顾性分析。这些患者是从正在进行的风疹检测监测项目中招募的。
结果
七名持续性风疹患者接受了硝唑尼特治疗，其中一名患者的临床症状显著改善。另外两名患者的病毒衣壳产量减少，其中一名患者的病情进展暂时减缓。该队列的总体 T 细胞计数通常较低，且合并症负担较重。共有三人死亡。两例死亡与进行性多灶性白质脑病有关，一例与造血干细胞移植有关。
结论
硝唑尼特对免疫缺陷相关疫苗衍生性风疹的体内抗病毒作用有限。大多数患者的临床症状没有改善。
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