SAGE
Antiviral Therapy
,  volume 17 ,  issue 3 ,  pages 459-466

Pleconaril Revisited: Clinical Course of Chronic Enteroviral Meningoencephalitis after Treatment Correlates with In Vitro Susceptibility

Joanne G. Wildenbeest 1
, 
Peterhans J. van den Broek 2
, 
Kimberley S. M. Benschop 3
, 
Gerrit Koen 3
, 
Peter C Wierenga 4
, 
Ann Vossen 5
, 
Taco W. Kuijpers 1
, 
Katja C Wolthers 3
1
 
2
 
3
 
Laboratory of Clinical Virology, Department of Medical Microbiology, AMC, Amsterdam, the Netherlands | 
4
 
Department of Clinical Pharmacy, AMC, Amsterdam, the Netherlands | 
5
 
Publication type: Journal Article
Publication date: 2011-04-01
SAGE
scimago Q2
wos Q3
SJR: 0.627
CiteScore: 3.8
Impact factor: 2.3
ISSN: 13596535, 20402058
DOI:  10.3851/imp1936
PubMed ID:  22293148
Pharmacology
Infectious Diseases
Pharmacology (medical)
Abstract
Background

Human enteroviruses (HEVs) can cause severe infections, especially in patients with a deficient humoral immune response, such as X-linked agammaglobulinemia. In this patient group, chronic enteroviral meningitis (CEMA) is feared because of extensive morbidity and high fatality rate. Treatment options consist of intravenous immunoglobulin (IVIG), with various outcomes. Pleconaril is an antiviral agent with in vitro activity against HEVs that has been used in the treatment of HEV infections.

Methods

The efficacy of pleconaril and IVIG against HEV isolated from the patients was assessed in vitro in two patients with CEMA.

Results

Echovirus 11 was found in the cerebrospinal fluid (CSF) of case 1. Treatment with high-dose IVIG and pleconaril did not provide any clinical improvement and HEV PCR in CSF remained positive. Case 2 (echovirus 13 positive in CSF) was also treated with IVIG and pleconaril. The patient recovered completely and HEV PCR in CSF became negative. Recent IVIG batches contained low titres of neutralizing antibodies against the patient strains. Echovirus 11 (case 1) was resistant to pleconaril in vitro, whereas echovirus 13 (case 2) was susceptible, in accordance with virological response after treatment and subsequent clinical results.

Conclusions

This is the first report that evaluates efficacy of antiviral treatment in CEMA patients in relation to in vitro susceptibility of clinical virus isolates. Since pleconaril is no longer available for compassionate use we strongly propagate that new drugs should be developed against these potential life threatening HEV infections.

Found 
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Wildenbeest J. G. et al. Pleconaril Revisited: Clinical Course of Chronic Enteroviral Meningoencephalitis after Treatment Correlates with In Vitro Susceptibility // Antiviral Therapy. 2011. Vol. 17. No. 3. pp. 459-466.
GOST all authors (up to 50) Copy
Wildenbeest J. G., van den Broek P. J., Benschop K. S. M., Koen G., Wierenga P. C., Vossen A., Kuijpers T. W., Wolthers K. C. Pleconaril Revisited: Clinical Course of Chronic Enteroviral Meningoencephalitis after Treatment Correlates with In Vitro Susceptibility // Antiviral Therapy. 2011. Vol. 17. No. 3. pp. 459-466.
RIS |
Cite this
RIS Copy
TY - JOUR
DO - 10.3851/imp1936
UR - https://doi.org/10.3851/imp1936
TI - Pleconaril Revisited: Clinical Course of Chronic Enteroviral Meningoencephalitis after Treatment Correlates with In Vitro Susceptibility
T2 - Antiviral Therapy
AU - Wildenbeest, Joanne G.
AU - van den Broek, Peterhans J.
AU - Benschop, Kimberley S. M.
AU - Koen, Gerrit
AU - Wierenga, Peter C
AU - Vossen, Ann
AU - Kuijpers, Taco W.
AU - Wolthers, Katja C
PY - 2011
DA - 2011/04/01
PB - SAGE
SP - 459-466
IS - 3
VL - 17
PMID - 22293148
SN - 1359-6535
SN - 2040-2058
ER -
BibTex |
Cite this
BibTex (up to 50 authors) Copy
@article{2011_Wildenbeest,
author = {Joanne G. Wildenbeest and Peterhans J. van den Broek and Kimberley S. M. Benschop and Gerrit Koen and Peter C Wierenga and Ann Vossen and Taco W. Kuijpers and Katja C Wolthers},
title = {Pleconaril Revisited: Clinical Course of Chronic Enteroviral Meningoencephalitis after Treatment Correlates with In Vitro Susceptibility},
journal = {Antiviral Therapy},
year = {2011},
volume = {17},
publisher = {SAGE},
month = {apr},
url = {https://doi.org/10.3851/imp1936},
number = {3},
pages = {459--466},
doi = {10.3851/imp1936}
}
MLA
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MLA Copy
Wildenbeest, Joanne G., et al. “Pleconaril Revisited: Clinical Course of Chronic Enteroviral Meningoencephalitis after Treatment Correlates with In Vitro Susceptibility.” Antiviral Therapy, vol. 17, no. 3, Apr. 2011, pp. 459-466. https://doi.org/10.3851/imp1936.