1
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Vasylyev M, Buhiichyk V, Buhiichyck N, Groenendijk A, Ben I, Ostapiuk L, Sluzhynska M, Bierman WFW, van Kampen JJA, Wit FWNM, Reiss P, Rijnders BJA, Sluzhynska O, Rokx C. COVID-19 epidemiology and performance of the WHO clinical algorithm to diagnose COVID-19 in people with HIV from Ukraine. Int J STD AIDS 2024:9564624241231016. [PMID: 38318789 DOI: 10.1177/09564624241231016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
BACKGROUND The two main objectives were to evaluate the COVID-19 point prevalence and the test performance of the WHO case definition to diagnose COVID-19 clinically in people with HIV in West Ukraine. METHODS Multicenter cross-sectional study in Lviv, Ukraine, from October 2020-November 2021. COVID-19 unvaccinated people with HIV were included regardless of COVID-19 symptoms at routine clinical visits and had standardized medical, quality of life (EQ(5D)) and SARS-CoV-2 serology assessments. Reported symptoms indicating potential COVID-19 events at inclusion or between March 2020 and inclusion were classified by the WHO case definition as suspected, probable or confirmed. A clinical COVID-19 case was defined as being SARS-CoV-2 seropositive with at least a suspected COVID-19 according to the WHO case definition. The primary endpoints were the clinical COVID-19 prevalence and the test characteristics of the WHO case definition with SARS-CoV-2 serology as reference. (Clinicaltrials.gov:NCT04711954). RESULTS The 971 included people with HIV were median 40 years, 38.8% women, 44.8% had prior AIDS, and 55.6% had comorbidities. SARS-CoV-2 seroprevalence was 40.1% (95%CI:37.0-43.1) and 20.5% (95%CI:18.0-23.1) had clinical COVID-19 median 4 months (IQR:2-7) before inclusion. Clinical COVID-19 occurred less frequently in people with HIV with tuberculosis history, injecting drug use, CD4+ T-cells <200/mL and unemployment. The quality of life was not impacted after COVID-19. An at least probable COVID-19 classification by the WHO case definition had 44.1% sensitivity (95%CI:38.7-49.7), 85.2% specificity (95%CI:81.5-88.4), 66.6% positive predictive value (95%CI:59.8-73.0) and 69.5% negative predictive value (95%CI:65.5-73.3) to diagnose COVID-19. CONCLUSIONS COVID-19 unvaccinated people with HIV from Ukraine had a significant COVID-19 rate and using the WHO case definition had insufficient diagnostic accuracy to diagnose these cases. The lower burden in vulnerable people with HIV was unexpected but might reflect a shielding effect.
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Affiliation(s)
- Marta Vasylyev
- Department of Internal Medicine, Section Infectious Diseases, and Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
- Astar Medical Center, Lviv, Ukraine
| | | | | | - Albert Groenendijk
- Department of Internal Medicine, Section Infectious Diseases, and Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Iryna Ben
- Department of Infectious Diseases, Danylo Halytsky National Medical University, Lviv, Ukraine
| | | | | | - Wouter F W Bierman
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jeroen J A van Kampen
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Ferdinand W N M Wit
- Stichting HIV Monitoring, Amsterdam, The Netherlands
- Amsterdam UMC, Location University of Amsterdam, Global Health, Meibergdreef 9, Amsterdam, The Netherlands
| | - Peter Reiss
- Amsterdam UMC, Location University of Amsterdam, Global Health, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Institute for Global Health and Development, Paasheuvelweg 25, Amsterdam, The Netherlands
| | - Bart J A Rijnders
- Department of Internal Medicine, Section Infectious Diseases, and Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Casper Rokx
- Department of Internal Medicine, Section Infectious Diseases, and Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
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2
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Malahe SRK, van Kampen JJA, Manintveld OC, Hoek RAS, den Hoed CM, Baan CC, Kho MML, Verjans GMGM. Current Perspectives on the Management of Herpesvirus Infections in Solid Organ Transplant Recipients. Viruses 2023; 15:1595. [PMID: 37515280 PMCID: PMC10383436 DOI: 10.3390/v15071595] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/12/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Solid organ transplant recipients (SOTRs) are at high risk of human herpesvirus (HHV)-related morbidity and mortality due to the use of immunosuppressive therapy. We aim to increase awareness and understanding of HHV disease burden in SOTRs by providing an overview of current prevention and management strategies as described in the literature and guidelines. We discuss challenges in both prevention and treatment as well as future perspectives.
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Affiliation(s)
- S Reshwan K Malahe
- Department of Internal Medicine, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Erasmus MC Transplant Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Jeroen J A van Kampen
- Department of Viroscience, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Olivier C Manintveld
- Erasmus MC Transplant Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Cardiology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Rogier A S Hoek
- Erasmus MC Transplant Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Pulmonary Medicine, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Caroline M den Hoed
- Erasmus MC Transplant Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Gastroenterology and Hepatology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Carla C Baan
- Department of Internal Medicine, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Erasmus MC Transplant Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Marcia M L Kho
- Department of Internal Medicine, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Erasmus MC Transplant Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Georges M G M Verjans
- Department of Viroscience, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- HerpeslabNL, Department of Viroscience, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
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3
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Prins HAB, Crespo R, Lungu C, Rao S, Li L, Overmars RJ, Papageorgiou G, Mueller YM, Stoszko M, Hossain T, Kan TW, Rijnders BJA, Bax HI, van Gorp ECM, Nouwen JL, de Vries-Sluijs TEMS, Schurink CAM, de Mendonça Melo M, van Nood E, Colbers A, Burger D, Palstra RJ, van Kampen JJA, van de Vijver DAMC, Mesplède T, Katsikis PD, Gruters RA, Koch BCP, Verbon A, Mahmoudi T, Rokx C. The BAF complex inhibitor pyrimethamine reverses HIV-1 latency in people with HIV-1 on antiretroviral therapy. Sci Adv 2023; 9:eade6675. [PMID: 36921041 PMCID: PMC10017042 DOI: 10.1126/sciadv.ade6675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Reactivation of the latent HIV-1 reservoir is a first step toward triggering reservoir decay. Here, we investigated the impact of the BAF complex inhibitor pyrimethamine on the reservoir of people living with HIV-1 (PLWH). Twenty-eight PLWH on suppressive antiretroviral therapy were randomized (1:1:1:1 ratio) to receive pyrimethamine, valproic acid, both, or no intervention for 14 days. The primary end point was change in cell-associated unspliced (CA US) HIV-1 RNA at days 0 and 14. We observed a rapid, modest, and significant increase in (CA US) HIV-1 RNA in response to pyrimethamine exposure, which persisted throughout treatment and follow-up. Valproic acid treatment alone did not increase (CA US) HIV-1 RNA or augment the effect of pyrimethamine. Pyrimethamine treatment did not result in a reduction in the size of the inducible reservoir. These data demonstrate that the licensed drug pyrimethamine can be repurposed as a BAF complex inhibitor to reverse HIV-1 latency in vivo in PLWH, substantiating its potential advancement in clinical studies.
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Affiliation(s)
- Henrieke A. B. Prins
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Raquel Crespo
- Department of Biochemistry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Cynthia Lungu
- Department of Biochemistry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Shringar Rao
- Department of Biochemistry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Letao Li
- Department of Pharmacy, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Ronald J. Overmars
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Yvonne M. Mueller
- Department of Immunology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Mateusz Stoszko
- Department of Biochemistry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Tanvir Hossain
- Department of Biochemistry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Tsung Wai Kan
- Department of Biochemistry, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Pathology, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Urology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Bart J. A. Rijnders
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Hannelore I. Bax
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Eric C. M. van Gorp
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Jan L. Nouwen
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Theodora E. M. S. de Vries-Sluijs
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Carolina A. M. Schurink
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Mariana de Mendonça Melo
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Els van Nood
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Angela Colbers
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center Nijmegen, Nijmegen, Netherlands
| | - David Burger
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center Nijmegen, Nijmegen, Netherlands
| | - Robert-Jan Palstra
- Department of Biochemistry, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Pathology, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Urology, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | | | - Thibault Mesplède
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Peter D. Katsikis
- Department of Immunology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Rob A. Gruters
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Birgit C. P. Koch
- Department of Pharmacy, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Annelies Verbon
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Internal Medicine, University Medical Center, Utrecht, Netherlands
| | - Tokameh Mahmoudi
- Department of Biochemistry, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Pathology, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Urology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Casper Rokx
- Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
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4
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van Kampen JJA, Pham HT, Yoo S, Overmars RJ, Lungu C, Mahmud R, Schurink CAM, van Boheemen S, Gruters RA, Fraaij PLA, Burger DM, Voermans JJC, Rokx C, van de Vijver DAMC, Mesplède T. HIV-1 resistance against dolutegravir fluctuates rapidly alongside erratic treatment adherence: a case report. J Glob Antimicrob Resist 2022; 31:323-327. [PMID: 36347497 DOI: 10.1016/j.jgar.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/26/2022] [Accepted: 11/02/2022] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES We report a case of incomplete HIV-1 suppression on a dolutegravir, lamivudine, and abacavir single-tablet regimen with the emergence of the H51Y and G118R integrase resistance mutations. METHODS Integrase sequencing was performed retrospectively by Sanger and next-generation sequencing. Rates of emergence and decline of resistance mutations were calculated using next-generation sequencing data. Dolutegravir plasma concentrations were measured by ultra-performance liquid chromatography-tandem mass spectrometry. The effects of H51Y and G118R on infectivity, fitness, and susceptibility to dolutegravir were quantified using cell-based assays. RESULTS During periods of non-adherence to treatment, mutations were retrospectively documented only by next-generation sequencing. Misdiagnosis by Sanger sequencing was caused by the rapid decline of mutant strains within the retroviral population. This observation was also true for a M184V lamivudine-resistant reverse transcriptase mutation found in association with integrase mutations on single HIV genomes. Resistance rebound upon treatment re-initiation was swift (>8000 copies per day). Next-generation sequencing indicated cumulative adherence to treatment. Compared to WT HIV-1, relative infectivity was 73%, 38%, and 43%; relative fitness was 100%, 35%, and 10% for H51Y, G118R, and H51Y+G118R viruses, respectively. H51Y did not change the susceptibility to dolutegravir, but G188R and H51Y+G118R conferred 7- and 28-fold resistance, respectively. CONCLUSION This case illustrates how poorly-fit drug-resistant viruses wax and wane alongside erratic treatment adherence and are easily misdiagnosed by Sanger sequencing. We recommend next-generation sequencing to improve the clinical management of incomplete virological suppression with dolutegravir.
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Affiliation(s)
| | - Hanh Thi Pham
- Department of Microbiology and Immunology, McGill University, Canada
| | - Sunbin Yoo
- Department of Microbiology and Immunology, McGill University, Canada
| | - Ronald J Overmars
- Viroscience department, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Cynthia Lungu
- Viroscience department, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Rizwan Mahmud
- Viroscience department, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Carolina A M Schurink
- Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Rob A Gruters
- Viroscience department, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Pieter L A Fraaij
- Viroscience department, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Subdivision Infectious Diseases and Immunology, Sophia's Children Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - David M Burger
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Casper Rokx
- Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Thibault Mesplède
- Viroscience department, Erasmus Medical Center, Rotterdam, The Netherlands.
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5
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Hendriks B, van Uitert E, Schoenmakers S, Duvekot JJ, Gommers D, Cornette JMJ, van de Sande D, van Bommel J, van Kampen JJA, Cornette J. Gravid uterine torsion after prone positioning in SARS-CoV2 (COVID-19)-related acute respiratory distress syndrome. J Surg Case Rep 2022; 2022:rjac289. [PMID: 35769307 PMCID: PMC9230700 DOI: 10.1093/jscr/rjac289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 05/27/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
A multiparous pregnant patient was admitted to the intensive care unit in her third trimester of pregnancy for prone positioning mechanical ventilation after developing SARS-CoV2 (COVID-19)-related acute respiratory distress syndrome. Repositioning in left lateral tilt was followed by uterine contractions and cardiotocography alterations. Preterm caesarean section was performed based on persistent foetal tachycardia and suspected foetal distress, followed by a per-operative diagnosis of uterine levotorsion. This case report is the first to explore a potential causal link between prolonged prone positioning in late pregnancy and postural gravid uterine torsion and highlights the need for appropriate foetal monitoring during prone positioning mechanical ventilation support.
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Affiliation(s)
- Bavo Hendriks
- Department of Uro-Gynaecology, Ghent University Hospital (Universitair Ziekenhuis Gent) , Corneel Heymanslaan 10, B-9000 Ghent , Belgium
- Department of Obstetrics and Gynaecology, Erasmus MC University Medical Center , Wytemaweg 80, 3015 CN Rotterdam , The Netherlands
| | - Evelyne van Uitert
- Department of Obstetrics and Gynaecology, Erasmus MC University Medical Center , Wytemaweg 80, 3015 CN Rotterdam , The Netherlands
| | - Sam Schoenmakers
- Department of Obstetrics and Gynaecology, Erasmus MC University Medical Center , Wytemaweg 80, 3015 CN Rotterdam , The Netherlands
| | - Johannes J Duvekot
- Department of Obstetrics and Gynaecology, Erasmus MC University Medical Center , Wytemaweg 80, 3015 CN Rotterdam , The Netherlands
| | - Diederik Gommers
- Department of Adult Intensive Care, Erasmus MC University Medical Center , Room Ne-413, Doctor Molewaterplein 40, 3015 GD Rotterdam , The Netherlands
| | - Jérôme M J Cornette
- Department of Obstetrics and Gynaecology, Erasmus MC University Medical Center , Wytemaweg 80, 3015 CN Rotterdam , The Netherlands
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6
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van Kampen JJA, Dalm VASH, Fraaij PLA, Oude Munnink BB, Schapendonk CME, Izquierdo-Lara RW, Villabruna N, Ettayebi K, Estes MK, Koopmans MPG, de Graaf M. Clinical and In Vitro Evidence Favoring Immunoglobulin Treatment of a Chronic Norovirus Infection in a Patient With Common Variable Immunodeficiency. J Infect Dis 2022; 226:1781-1789. [PMID: 35255136 PMCID: PMC9650502 DOI: 10.1093/infdis/jiac085] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/04/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Immunocompromised individuals can become chronically infected with norovirus, but effective antiviral therapies are not yet available. METHODS Treatments with nitazoxanide, ribavirin, interferon alpha-2a, and nasoduodenally administered immunoglobulins were evaluated sequentially in an immunocompromised patient chronically infected with norovirus. In support, these components were also applied to measure norovirus inhibition in intestinal enteroid cultures in vitro. Viral RNA levels were determined in fecal and plasma samples during each treatment and viral genomes were sequenced. RESULTS None of the antivirals resulted in a reduction of viral RNA levels in feces or plasma. However, during ribavirin treatment, there was an increased accumulation of virus genome mutations. In vitro, an effect of interferon alpha-2a on virus replication was observed and a genetically related strain was neutralized effectively in vitro using immunoglobulins and post-norovirus-infection antiserum. In agreement, after administration of immunoglobulins, the patient cleared the infection. CONCLUSIONS Intestinal enteroid cultures provide a relevant system to evaluate antivirals and the neutralizing potential of immunoglobulins. We successfully treated a chronically infected patient with immunoglobulins, despite varying results reported by others. This case study provides in-depth, multifaceted exploration of norovirus treatment that can be used as a guidance for further research towards norovirus treatments.
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Affiliation(s)
| | | | - Pieter L A Fraaij
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Bas B Oude Munnink
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Ray W Izquierdo-Lara
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Nele Villabruna
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Khalil Ettayebi
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas, USA
| | - Mary K Estes
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas, USA,Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Marion P G Koopmans
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Miranda de Graaf
- Correspondence: Miranda de Graaf, PhD, Erasmus University Medical Center, PO Box 1738, 3000 DR Rotterdam, the Netherlands ()
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7
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Bezstarosti K, Lamers MM, Doff WAS, Wever PC, Thai KTD, van Kampen JJA, Haagmans BL, Demmers JAA. Targeted proteomics as a tool to detect SARS-CoV-2 proteins in clinical specimens. PLoS One 2021; 16:e0259165. [PMID: 34762662 PMCID: PMC8584957 DOI: 10.1371/journal.pone.0259165] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 10/13/2021] [Indexed: 01/22/2023] Open
Abstract
The rapid, sensitive and specific detection of SARS-CoV-2 is critical in responding to the current COVID-19 outbreak. In this proof-of-concept study, we explored the potential of targeted mass spectrometry (MS) based proteomics for the detection of SARS-CoV-2 proteins in both research samples and clinical specimens. First, we assessed the limit of detection for several SARS-CoV-2 proteins by parallel reaction monitoring (PRM) MS in infected Vero E6 cells. For tryptic peptides of Nucleocapsid protein, the limit of detection was estimated to be in the mid-attomole range (9E-13 g). Next, this PRM methodology was applied to the detection of viral proteins in various COVID-19 patient clinical specimens, such as sputum and nasopharyngeal swabs. SARS-CoV-2 proteins were detected in these samples with high sensitivity in all specimens with PCR Ct values <24 and in several samples with higher CT values. A clear relationship was observed between summed MS peak intensities for SARS-CoV-2 proteins and Ct values reflecting the abundance of viral RNA. Taken together, these results suggest that targeted MS based proteomics may have the potential to be used as an additional tool in COVID-19 diagnostics.
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Affiliation(s)
- Karel Bezstarosti
- Proteomics Center, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Mart M. Lamers
- Viroscience Department, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Wouter A. S. Doff
- Proteomics Center, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Peter C. Wever
- Jeroen Bosch Hospital, ‘s-Hertogenbosch, the Netherlands
| | - Khoa T. D. Thai
- Star-shl Medical Diagnostic Center, Rotterdam, the Netherlands
| | | | - Bart L. Haagmans
- Viroscience Department, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jeroen A. A. Demmers
- Proteomics Center, Erasmus University Medical Center, Rotterdam, the Netherlands
- * E-mail:
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8
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Gharbharan A, Jordans CCE, GeurtsvanKessel C, den Hollander JG, Karim F, Mollema FPN, Stalenhoef-Schukken JE, Dofferhoff A, Ludwig I, Koster A, Hassing RJ, Bos JC, van Pottelberge GR, Vlasveld IN, Ammerlaan HSM, van Leeuwen-Segarceanu EM, Miedema J, van der Eerden M, Schrama TJ, Papageorgiou G, Te Boekhorst P, Swaneveld FH, Mueller YM, Schreurs MWJ, van Kampen JJA, Rockx B, Okba NMA, Katsikis PD, Koopmans MPG, Haagmans BL, Rokx C, Rijnders BJA. Effects of potent neutralizing antibodies from convalescent plasma in patients hospitalized for severe SARS-CoV-2 infection. Nat Commun 2021; 12:3189. [PMID: 34045486 PMCID: PMC8160346 DOI: 10.1038/s41467-021-23469-2] [Citation(s) in RCA: 115] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/31/2021] [Indexed: 02/08/2023] Open
Abstract
In a randomized clinical trial of 86 hospitalized COVID-19 patients comparing standard care to treatment with 300mL convalescent plasma containing high titers of neutralizing SARS-CoV-2 antibodies, no overall clinical benefit was observed. Using a comprehensive translational approach, we unravel the virological and immunological responses following treatment to disentangle which COVID-19 patients may benefit and should be the focus of future studies. Convalescent plasma is safe, does not improve survival, has no effect on the disease course, nor does plasma enhance viral clearance in the respiratory tract, influence SARS-CoV-2 antibody development or serum proinflammatory cytokines levels. Here, we show that the vast majority of patients already had potent neutralizing SARS-CoV-2 antibodies at hospital admission and with comparable titers to carefully selected plasma donors. This resulted in the decision to terminate the trial prematurely. Treatment with convalescent plasma should be studied early in the disease course or at least preceding autologous humoral response development.
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Affiliation(s)
| | | | | | | | - Faiz Karim
- Groene Hart Hospital, Gouda, The Netherlands
| | | | | | | | | | | | | | | | | | | | | | | | - Jelle Miedema
- Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | - Thijs J Schrama
- Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | | | - Francis H Swaneveld
- Unit of Transfusion Medicine, Sanquin Blood Supply, Amsterdam, The Netherlands
| | - Yvonne M Mueller
- Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | | | - Barry Rockx
- Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Nisreen M A Okba
- Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Peter D Katsikis
- Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | - Bart L Haagmans
- Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Casper Rokx
- Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
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9
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Ouwendijk WJD, Raadsen MP, van Kampen JJA, Verdijk RM, von der Thusen JH, Guo L, Hoek RAS, van den Akker JPC, Endeman H, Langerak T, Molenkamp R, Gommers D, Koopmans MPG, van Gorp ECM, Verjans GMGM, Haagmans BL. High Levels of Neutrophil Extracellular Traps Persist in the Lower Respiratory Tract of Critically Ill Patients With Coronavirus Disease 2019. J Infect Dis 2021; 223:1512-1521. [PMID: 33507309 PMCID: PMC7928833 DOI: 10.1093/infdis/jiab050] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/25/2021] [Indexed: 01/08/2023] Open
Affiliation(s)
| | | | | | | | | | - Lihui Guo
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Department of Experimental Immunology, Amsterdam Infection and Immune Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Rogier A S Hoek
- Department Pulmonary Medicine, Erasmus MC, Rotterdam, the Netherlands
| | | | - Henrik Endeman
- Department of Adult Intensive Care, Erasmus MC, Rotterdam, the Netherlands
| | - Thomas Langerak
- Department of Viroscience, Erasmus MC, Rotterdam,the Netherlands
| | | | - Diederik Gommers
- Department of Adult Intensive Care, Erasmus MC, Rotterdam, the Netherlands
| | | | | | | | - Bart L Haagmans
- Department of Viroscience, Erasmus MC, Rotterdam,the Netherlands
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10
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Hensley KS, Jordans CCE, van Kampen JJA, Mollema FPN, Gisolf EH, El Moussaoui R, Hermanides G, van Beek JEA, Vriesde ME, Finkenflügel RNN, Rijnders BJA, van de Vijver DAMC, Boucher CAB, Verbon A, Rokx C. Significant impact of COVID-19 on HIV care in hospitals affecting the first pillar of the HIV care continuum. Clin Infect Dis 2021; 74:521-524. [PMID: 33993276 PMCID: PMC8244584 DOI: 10.1093/cid/ciab445] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Indexed: 11/17/2022] Open
Abstract
During COVID-19 lockdown, the in-hospital number of HIV indicator conditions
decreased disproportionally compared to other non-COVID-19 diseases which was
accompanied by reduced HIV testing rates, number and proportion of positive HIV
tests, and new HIV referrals with more late presentation after lockdown
cessation, indicating a significantly impacted HIV care continuum.
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Affiliation(s)
- Kathryn S Hensley
- Erasmus MC, University Medical Center, Doctor
Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
- Alternate Corresponding Author: Kathryn Hensley,
| | - Carlijn C E Jordans
- Erasmus MC, University Medical Center, Doctor
Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Jeroen J A van Kampen
- Erasmus MC, University Medical Center, Doctor
Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Femke P N Mollema
- Haaglanden Medical Center, Postbus 432 2501
CK, The Hague, the Netherlands
| | - Elisabeth H Gisolf
- Rijnstate Hospital, Wagnerlaan 55, 6815 AD,
Arnhem, the Netherlands
- Hiv Vereniging Nederland, Eerste Helmersstraat 17, 1054
CX, Amsterdam, the Netherlands
| | | | - Gonneke Hermanides
- Rode Kruis Ziekenhuis, Vondellaan 13, 1942
LE, Beverwijk, the Netherlands
| | - Jan E A van Beek
- Erasmus MC, University Medical Center, Doctor
Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Marion E Vriesde
- Erasmus MC, University Medical Center, Doctor
Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | | | - Bart J A Rijnders
- Erasmus MC, University Medical Center, Doctor
Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | | | - Charles A B Boucher
- Erasmus MC, University Medical Center, Doctor
Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Annelies Verbon
- Erasmus MC, University Medical Center, Doctor
Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Casper Rokx
- Erasmus MC, University Medical Center, Doctor
Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
- Corresponding author: Dr. C. Rokx,
P.O. Box 2040, 3000 CA Rotterdam, the
Netherlands, internal postal address Na901K
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11
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Roest S, Brugts JJ, van Kampen JJA, von der Thüsen JH, Constantinescu AA, Caliskan K, Hirsch A, Manintveld OC. COVID-19-related myocarditis post-heart transplantation. Int J Infect Dis 2021; 107:34-36. [PMID: 33862215 PMCID: PMC8056480 DOI: 10.1016/j.ijid.2021.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 01/23/2023] Open
Abstract
This report describes the first heart transplantation recipient with acute biventricular heart failure symptoms caused by a post-myocarditis state, late after a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. No other viral pathogens could be detected. Computed tomography angiography did not show cardiac allograft vasculopathy, and myocardial biopsy demonstrated no clinically relevant rejection. Subsequent cardiovascular magnetic resonance imaging revealed extensive epicardial delayed enhancement without myocardial edema. Heart failure medication was initiated and an implantable cardioverter defibrillator was implanted (due to non-sustained ventricular tachycardias), leading to a partial recovery of the ejection fraction. Further studies are needed to investigate the number of heart transplant recipients with myocardial damage after a SARS-CoV-2 infection.
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Affiliation(s)
- Stefan Roest
- Department of Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jasper J Brugts
- Department of Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jeroen J A van Kampen
- Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jan H von der Thüsen
- Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Pathology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Alina A Constantinescu
- Department of Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Kadir Caliskan
- Department of Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Alexander Hirsch
- Department of Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Olivier C Manintveld
- Department of Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
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12
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van Kampen JJA, van de Vijver DAMC, Fraaij PLA, Haagmans BL, Lamers MM, Okba N, van den Akker JPC, Endeman H, Gommers DAMPJ, Cornelissen JJ, Hoek RAS, van der Eerden MM, Hesselink DA, Metselaar HJ, Verbon A, de Steenwinkel JEM, Aron GI, van Gorp ECM, van Boheemen S, Voermans JC, Boucher CAB, Molenkamp R, Koopmans MPG, Geurtsvankessel C, van der Eijk AA. Duration and key determinants of infectious virus shedding in hospitalized patients with coronavirus disease-2019 (COVID-19). Nat Commun 2021. [PMID: 33431879 DOI: 10.1101/2020.06.08.20125310] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
Key questions in COVID-19 are the duration and determinants of infectious virus shedding. Here, we report that infectious virus shedding is detected by virus cultures in 23 of the 129 patients (17.8%) hospitalized with COVID-19. The median duration of shedding infectious virus is 8 days post onset of symptoms (IQR 5-11) and drops below 5% after 15.2 days post onset of symptoms (95% confidence interval (CI) 13.4-17.2). Multivariate analyses identify viral loads above 7 log10 RNA copies/mL (odds ratio [OR] of 14.7 (CI 3.57-58.1; p < 0.001) as independently associated with isolation of infectious SARS-CoV-2 from the respiratory tract. A serum neutralizing antibody titre of at least 1:20 (OR of 0.01 (CI 0.003-0.08; p < 0.001) is independently associated with non-infectious SARS-CoV-2. We conclude that quantitative viral RNA load assays and serological assays could be used in test-based strategies to discontinue or de-escalate infection prevention and control precautions.
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Affiliation(s)
| | | | - Pieter L A Fraaij
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
- Department of Pediatrics, Subdivision Infectious Diseases and Immunology, Erasmus MC - Sophia, Rotterdam, The Netherlands
| | - Bart L Haagmans
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Mart M Lamers
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Nisreen Okba
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | | | - Henrik Endeman
- Department of Intensive Care, Erasmus MC, Rotterdam, The Netherlands
| | | | | | - Rogier A S Hoek
- Department of Pulmonary Medicine, Erasmus MC, Rotterdam, The Netherlands
- Erasmus MC Transplant Institute, Rotterdam, The Netherlands
| | | | - Dennis A Hesselink
- Erasmus MC Transplant Institute, Rotterdam, The Netherlands
- Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus MC, Rotterdam, The Netherlands
| | - Herold J Metselaar
- Erasmus MC Transplant Institute, Rotterdam, The Netherlands
- Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, The Netherlands
| | - Annelies Verbon
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands
| | | | - Georgina I Aron
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
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13
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van Kampen JJA, van de Vijver DAMC, Fraaij PLA, Haagmans BL, Lamers MM, Okba N, van den Akker JPC, Endeman H, Gommers DAMPJ, Cornelissen JJ, Hoek RAS, van der Eerden MM, Hesselink DA, Metselaar HJ, Verbon A, de Steenwinkel JEM, Aron GI, van Gorp ECM, van Boheemen S, Voermans JC, Boucher CAB, Molenkamp R, Koopmans MPG, Geurtsvankessel C, van der Eijk AA. Duration and key determinants of infectious virus shedding in hospitalized patients with coronavirus disease-2019 (COVID-19). Nat Commun 2021; 12:267. [PMID: 33431879 PMCID: PMC7801729 DOI: 10.1038/s41467-020-20568-4] [Citation(s) in RCA: 477] [Impact Index Per Article: 159.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 12/01/2020] [Indexed: 12/12/2022] Open
Abstract
Key questions in COVID-19 are the duration and determinants of infectious virus shedding. Here, we report that infectious virus shedding is detected by virus cultures in 23 of the 129 patients (17.8%) hospitalized with COVID-19. The median duration of shedding infectious virus is 8 days post onset of symptoms (IQR 5-11) and drops below 5% after 15.2 days post onset of symptoms (95% confidence interval (CI) 13.4-17.2). Multivariate analyses identify viral loads above 7 log10 RNA copies/mL (odds ratio [OR] of 14.7 (CI 3.57-58.1; p < 0.001) as independently associated with isolation of infectious SARS-CoV-2 from the respiratory tract. A serum neutralizing antibody titre of at least 1:20 (OR of 0.01 (CI 0.003-0.08; p < 0.001) is independently associated with non-infectious SARS-CoV-2. We conclude that quantitative viral RNA load assays and serological assays could be used in test-based strategies to discontinue or de-escalate infection prevention and control precautions.
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Affiliation(s)
| | | | - Pieter L A Fraaij
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
- Department of Pediatrics, Subdivision Infectious Diseases and Immunology, Erasmus MC - Sophia, Rotterdam, The Netherlands
| | - Bart L Haagmans
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Mart M Lamers
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Nisreen Okba
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | | | - Henrik Endeman
- Department of Intensive Care, Erasmus MC, Rotterdam, The Netherlands
| | | | | | - Rogier A S Hoek
- Department of Pulmonary Medicine, Erasmus MC, Rotterdam, The Netherlands
- Erasmus MC Transplant Institute, Rotterdam, The Netherlands
| | | | - Dennis A Hesselink
- Erasmus MC Transplant Institute, Rotterdam, The Netherlands
- Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus MC, Rotterdam, The Netherlands
| | - Herold J Metselaar
- Erasmus MC Transplant Institute, Rotterdam, The Netherlands
- Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, The Netherlands
| | - Annelies Verbon
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands
| | | | - Georgina I Aron
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
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14
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Lungu C, Procopio FA, Overmars RJ, Beerkens RJJ, Voermans JJC, Rao S, Prins HAB, Rokx C, Pantaleo G, van de Vijver DAMC, Mahmoudi T, Boucher CAB, Gruters RA, van Kampen JJA. Inter-Laboratory Reproducibility of Inducible HIV-1 Reservoir Quantification by TILDA. Viruses 2020; 12:v12090973. [PMID: 32887284 PMCID: PMC7552071 DOI: 10.3390/v12090973] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 08/29/2020] [Accepted: 08/31/2020] [Indexed: 12/16/2022] Open
Abstract
Substantial efforts to eliminate or reduce latent HIV-1 reservoirs are underway in clinical trials and have created a critical demand for sensitive, accurate, and reproducible tools to evaluate the efficacy of these strategies. Alternative reservoir quantification assays have been developed to circumvent limitations of the quantitative viral outgrowth assay. One such assay is tat/rev induced limiting dilution assay (TILDA), which measures the frequency of CD4+ T cells harboring inducible latent HIV-1 provirus. We modified pre-amplification reagents and conditions (TILDA v2.0) to improve assay execution and first internally validated assay performance using CD4+ T cells obtained from cART-suppressed HIV-1-infected individuals. Detection of tat/rev multiply spliced RNA was not altered by modifying pre-amplification conditions, confirming the robustness of the assay, and supporting the technique’s amenability to limited modifications to ensure better implementation for routine use in clinical studies of latent HIV-1 reservoirs. Furthermore, we cross-validated results of TILDA v2.0 and the original assay performed in two separate laboratories using samples from 15 HIV-1-infected individuals. TILDA and TILDA v2.0 showed a strong correlation (Lin’s Concordance Correlation Coefficient = 0.86). The low inter-laboratory variability between TILDAs performed at different institutes further supports use of TILDA for reservoir quantitation in multi-center interventional HIV-1 Cure trials.
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Affiliation(s)
- Cynthia Lungu
- Department of Viroscience, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (R.J.O.); (R.J.J.B.); (J.J.C.V.); (D.A.M.C.v.d.V.); (C.A.B.B.); (R.A.G.); (J.J.A.v.K.)
- Correspondence:
| | - Francesco A. Procopio
- Service of Immunology and Allergy, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland; (F.A.P.); (G.P.)
| | - Ronald J. Overmars
- Department of Viroscience, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (R.J.O.); (R.J.J.B.); (J.J.C.V.); (D.A.M.C.v.d.V.); (C.A.B.B.); (R.A.G.); (J.J.A.v.K.)
| | - Rob J. J. Beerkens
- Department of Viroscience, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (R.J.O.); (R.J.J.B.); (J.J.C.V.); (D.A.M.C.v.d.V.); (C.A.B.B.); (R.A.G.); (J.J.A.v.K.)
| | - Jolanda J. C. Voermans
- Department of Viroscience, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (R.J.O.); (R.J.J.B.); (J.J.C.V.); (D.A.M.C.v.d.V.); (C.A.B.B.); (R.A.G.); (J.J.A.v.K.)
| | - Shringar Rao
- Department of Biochemistry, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (S.R.); (T.M.)
| | - Henrieke A. B. Prins
- Department of Internal Medicine, Section of Infectious Diseases, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (H.A.B.P.); (C.R.)
| | - Casper Rokx
- Department of Internal Medicine, Section of Infectious Diseases, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (H.A.B.P.); (C.R.)
| | - Giuseppe Pantaleo
- Service of Immunology and Allergy, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland; (F.A.P.); (G.P.)
| | - David A. M. C. van de Vijver
- Department of Viroscience, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (R.J.O.); (R.J.J.B.); (J.J.C.V.); (D.A.M.C.v.d.V.); (C.A.B.B.); (R.A.G.); (J.J.A.v.K.)
| | - Tokameh Mahmoudi
- Department of Biochemistry, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (S.R.); (T.M.)
| | - Charles A. B. Boucher
- Department of Viroscience, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (R.J.O.); (R.J.J.B.); (J.J.C.V.); (D.A.M.C.v.d.V.); (C.A.B.B.); (R.A.G.); (J.J.A.v.K.)
| | - Rob A. Gruters
- Department of Viroscience, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (R.J.O.); (R.J.J.B.); (J.J.C.V.); (D.A.M.C.v.d.V.); (C.A.B.B.); (R.A.G.); (J.J.A.v.K.)
| | - Jeroen J. A. van Kampen
- Department of Viroscience, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (R.J.O.); (R.J.J.B.); (J.J.C.V.); (D.A.M.C.v.d.V.); (C.A.B.B.); (R.A.G.); (J.J.A.v.K.)
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15
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Kirichenko A, Lapovok I, Baryshev P, van de Vijver DAMC, van Kampen JJA, Boucher CAB, Paraskevis D, Kireev D. Genetic Features of HIV-1 Integrase Sub-Subtype A6 Predominant in Russia and Predicted Susceptibility to INSTIs. Viruses 2020; 12:v12080838. [PMID: 32752001 PMCID: PMC7472261 DOI: 10.3390/v12080838] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/29/2020] [Accepted: 07/29/2020] [Indexed: 02/07/2023] Open
Abstract
The increasing use of the integrase strand transfer inhibitor (INSTI) class for the treatment of HIV-infection has pointed to the importance of analyzing the features of HIV-1 subtypes for an improved understanding of viral genetic variability in the occurrence of drug resistance (DR). In this study, we have described the prevalence of INSTI DR in a Russian cohort and the genetic features of HIV-1 integrase sub-subtype A6. We included 408 HIV infected patients who were not exposed to INSTI. Drug resistance mutations (DRMs) were detected among 1.3% of ART-naïve patients and among 2.7% of INSTI-naïve patients. The prevalence of 12 polymorphic mutations was significantly different between sub-subtypes A6 and A1. Analysis of the genetic barriers determined two positions in which subtype A (A1 and A6) showed a higher genetic barrier (G140C and V151I) compared with subtype B, and one position in which subtypes A1 and B displayed a higher genetic barrier (L74M and L74I) than sub-subtype A6. Additionally, we confirmed that the L74I mutation was selected at the early stage of the epidemic and subsequently spread as a founder effect in Russia. Our data have added to the overall understanding of the genetic features of sub-subtype A6 in the context of drug resistance.
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Affiliation(s)
- Alina Kirichenko
- Central Research Institute of Epidemiology, 111123 Moscow, Russia; (I.L.); (P.B.); (D.K.)
- Correspondence:
| | - Ilya Lapovok
- Central Research Institute of Epidemiology, 111123 Moscow, Russia; (I.L.); (P.B.); (D.K.)
| | - Pavel Baryshev
- Central Research Institute of Epidemiology, 111123 Moscow, Russia; (I.L.); (P.B.); (D.K.)
| | - David A. M. C. van de Vijver
- Viroscience Department, Erasmus Medical Centre, 3015 CE Rotterdam, The Netherlands; (D.A.M.C.v.d.V.); (J.J.A.v.K.); (C.A.B.B.)
| | - Jeroen J. A. van Kampen
- Viroscience Department, Erasmus Medical Centre, 3015 CE Rotterdam, The Netherlands; (D.A.M.C.v.d.V.); (J.J.A.v.K.); (C.A.B.B.)
| | - Charles A. B. Boucher
- Viroscience Department, Erasmus Medical Centre, 3015 CE Rotterdam, The Netherlands; (D.A.M.C.v.d.V.); (J.J.A.v.K.); (C.A.B.B.)
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Goudi, Athens, Greece;
| | - Dmitry Kireev
- Central Research Institute of Epidemiology, 111123 Moscow, Russia; (I.L.); (P.B.); (D.K.)
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16
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GeurtsvanKessel CH, Okba NMA, Igloi Z, Bogers S, Embregts CWE, Laksono BM, Leijten L, Rokx C, Rijnders B, Rahamat-Langendoen J, van den Akker JPC, van Kampen JJA, van der Eijk AA, van Binnendijk RS, Haagmans B, Koopmans M. An evaluation of COVID-19 serological assays informs future diagnostics and exposure assessment. Nat Commun 2020; 11:3436. [PMID: 32632160 PMCID: PMC7338506 DOI: 10.1038/s41467-020-17317-y] [Citation(s) in RCA: 259] [Impact Index Per Article: 64.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/25/2020] [Indexed: 11/09/2022] Open
Abstract
The world is entering a new era of the COVID-19 pandemic in which there is an increasing call for reliable antibody testing. To support decision making on the deployment of serology for either population screening or diagnostics, we present a detailed comparison of serological COVID-19 assays. We show that among the selected assays there is a wide diversity in assay performance in different scenarios and when correlated to virus neutralizing antibodies. The Wantai ELISA detecting total immunoglobulins against the receptor binding domain of SARS CoV-2, has the best overall characteristics to detect functional antibodies in different stages and severity of disease, including the potential to set a cut-off indicating the presence of protective antibodies. The large variety of available serological assays requires proper assay validation before deciding on deployment of assays for specific applications.
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Affiliation(s)
| | - Nisreen M A Okba
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Zsofia Igloi
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Susanne Bogers
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | | | | | - Lonneke Leijten
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Casper Rokx
- Department of Internal Medicine, Section of Infectious Diseaseas, Erasmus MC, Rotterdam, The Netherlands
| | - Bart Rijnders
- Department of Internal Medicine, Section of Infectious Diseaseas, Erasmus MC, Rotterdam, The Netherlands
| | | | | | | | | | | | - Bart Haagmans
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Marion Koopmans
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
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17
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Liu Y, Lam TTY, Lai FYL, Krajden M, Drews SJ, Hatchette TF, Fraaij PLA, van Kampen JJA, Badarch D, Nymadawa P, Tee KK, Lee HK, Koay ESC, Jennings L, Koopmans M, Tang JW. Comparative seasonalities of influenza A, B and 'common cold' coronaviruses - setting the scene for SARS-CoV-2 infections and possible unexpected host immune interactions. J Infect 2020; 81:e62-e64. [PMID: 32360499 PMCID: PMC7189195 DOI: 10.1016/j.jinf.2020.04.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 01/25/2023]
Affiliation(s)
- Yang Liu
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Tommy T Y Lam
- School of Public Health, University of Hong Kong, Hong Kong SAR, China
| | | | - Mel Krajden
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Steven J Drews
- Canadian Blood Services, Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada
| | - Todd F Hatchette
- Todd Hachette, Department of Pathology and Laboratory Medicine, Dalhousie University, Halifax, Canada
| | | | | | - Darmaa Badarch
- National Center of Communicable Diseases, Ministry of Health, Mongolia
| | | | - Kok Keng Tee
- Department of Medical Microbiology, University of Malaya, Kuala Lumpur, Malaysia
| | - Hong Kai Lee
- Singapore Immunology Network, Agency for Science, Technology and Research
| | - Evelyn S C Koay
- Molecular Diagnosis Diagnosis Unit, National University Hospital, Singapore
| | | | | | - Julian W Tang
- Respiratory Sciences, University of Leicester, Leicester, UK.
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18
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Cohen S, Roy J, Lachance S, Delisle JS, Marinier A, Busque L, Roy DC, Barabé F, Ahmad I, Bambace N, Bernard L, Kiss T, Bouchard P, Caudrelier P, Landais S, Larochelle F, Chagraoui J, Lehnertz B, Corneau S, Tomellini E, van Kampen JJA, Cornelissen JJ, Dumont-Lagacé M, Tanguay M, Li Q, Lemieux S, Zandstra PW, Sauvageau G. Hematopoietic stem cell transplantation using single UM171-expanded cord blood: a single-arm, phase 1-2 safety and feasibility study. Lancet Haematol 2019; 7:e134-e145. [PMID: 31704264 DOI: 10.1016/s2352-3026(19)30202-9] [Citation(s) in RCA: 124] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 08/27/2019] [Accepted: 08/30/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Benefits of cord blood transplantation include low rates of relapse and chronic graft-versus-host disease (GVHD). However, the use of cord blood is rapidly declining because of the high incidence of infections, severe acute GVHD, and transplant-related mortality. UM171, a haematopoietic stem cell self-renewal agonist, has been shown to expand cord blood stem cells and enhance multilineage blood cell reconstitution in mice. We aimed to investigate the safety and feasibility of single UM171-expanded cord blood transplantation in patients with haematological malignancies who do not have a suitable HLA-matched donor. METHODS This single-arm, open-label, phase 1-2 safety and feasibility study was done at two hospitals in Canada. The study had two parts. In part 1, patients received two cord blood units (one expanded with UM171 and one unmanipulated cord blood) until UM171-expanded cord blood demonstrated engraftment. Once engraftment was documented we initiated part 2, reported here, in which patients received a single UM171-expanded cord blood unit with a dose de-escalation design to determine the minimal cord blood unit cell dose that achieved prompt engraftment. Eligible patients were aged 3-64 years, weighed 12 kg or more, had a haematological malignancy with an indication for allogeneic hematopoietic stem cell transplant and did not have a suitable HLA-matched donor, and a had a Karnofsky performance status score of 70% or more. Five clinical sites were planned to participate in the study; however, only two study sites opened, both of which only treated adult patients, thus no paediatric patients (aged <18 years) were recruited. Patients aged younger than 50 years without comorbidities received a myeloablative conditioning regimen (cyclophosphamide 120 mg/kg, fludarabine 75 mg/m2, and 12 Gy total body irradiation) and patients aged older than 50 years and those with comorbidities received a less myeloablative conditioning regimen (cyclophosphamide 50 mg/kg, thiotepa 10 mg/kg, fludarabine 150 mg/m2, and 4 Gy total body irradiation). Patients were infused with the 7-day UM171-expanded CD34-positive cells and the lymphocyte-containing CD34-negative fraction. The primary endpoints were feasibility of UM171 expansion, safety of the transplant, kinetics of hematopoietic reconstitution (time to neutrophil and platelet engraftment) of UM171-expanded cord blood, and minimal pre-expansion cord blood unit cell dose that achieved prompt engraftment. We analysed feasibility in all enrolled patients and all other primary outcomes were analysed per protocol, in all patients who received single UM171-expanded cord blood transplantation. This trial has been completed and was registered with ClinicalTrials.gov, NCT02668315. FINDINGS Between Feb 17, 2016, and Nov 11, 2018, we enrolled 27 patients, four of whom received two cord blood units for safety purposes in part 1 of the study. 23 patients were subsequently enrolled in part 2 to receive a single UM171-expanded cord blood transplant and 22 patients received a single UM171-expanded cord blood transplantation. At data cutoff (Dec 31, 2018), median follow-up was 18 months (IQR 12-22). The minimal cord blood unit cell dose at thaw that achieved prompt engraftment as a single cord transplant after UM171 expansion was 0·52 × 105 CD34-positive cells. We successfully expanded 26 (96%) of 27 cord blood units with UM171. Among the 22 patients who received single UM171-expanded cord blood transplantation, median time to engraftment of 100 neutrophils per μL was 9·5 days (IQR 8-12), median time to engraftment of 500 neutrophils per μL was 18 days (12·5-20·0), and no graft failure occurred. Median time to platelet recovery was 42 days (IQR 35-47). The most common non-haematological adverse events were grade 3 febrile neutropenia (16 [73%] of 22 patients) and bacteraemia (nine [41%]). No unexpected adverse events were observed. One (5%) of 22 patients died due to treatment-related diffuse alveolar haemorrhage. INTERPRETATION Our preliminary findings suggest that UM171 cord blood stem cell expansion is feasible, safe, and allows for the use of small single cords without compromising engraftment. UM171-expanded cord blood might have the potential to overcome the disadvantages of other cord blood transplants while maintaining the benefits of low risk of chronic GVHD and relapse, and warrants further investigation in randomised trials. FUNDING Canadian Institutes of Health Research, Canadian Cancer Society and Stem Cell Network.
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Affiliation(s)
- Sandra Cohen
- Division of Hematology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada; Department of Medicine, Montreal, QC, Canada.
| | - Jean Roy
- Division of Hematology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada; Department of Medicine, Montreal, QC, Canada
| | - Silvy Lachance
- Division of Hematology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada; Department of Medicine, Montreal, QC, Canada
| | - Jean-Sébastien Delisle
- Division of Hematology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada; Department of Medicine, Montreal, QC, Canada
| | - Anne Marinier
- Drug Discovery Unit, Montreal, QC, Canada; ExCellThera, Montreal, QC, Canada
| | - Lambert Busque
- Division of Hematology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada; Department of Medicine, Montreal, QC, Canada
| | - Denis-Claude Roy
- Division of Hematology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada; Department of Medicine, Montreal, QC, Canada
| | - Frédéric Barabé
- Division of Hematology, CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus), Quebec, QC, Canada; Department of Medicine, Université Laval, Quebec, QC, Canada
| | - Imran Ahmad
- Division of Hematology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada; Department of Medicine, Montreal, QC, Canada
| | - Nadia Bambace
- Division of Hematology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada; Department of Medicine, Montreal, QC, Canada
| | - Léa Bernard
- Division of Hematology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada; Department of Medicine, Montreal, QC, Canada
| | - Thomas Kiss
- Division of Hematology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada; Department of Medicine, Montreal, QC, Canada
| | - Philippe Bouchard
- Department of Pharmacy, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada
| | | | - Sévérine Landais
- Division of Hematology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada
| | - Fannie Larochelle
- Center of Excellence for Cellular Therapy, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada
| | - Jalila Chagraoui
- Institute for Research in Immunology and Cancer, Université de Montréal, Montreal, QC, Canada
| | - Bernhard Lehnertz
- Institute for Research in Immunology and Cancer, Université de Montréal, Montreal, QC, Canada
| | - Sophie Corneau
- Institute for Research in Immunology and Cancer, Université de Montréal, Montreal, QC, Canada
| | - Elisa Tomellini
- Institute for Research in Immunology and Cancer, Université de Montréal, Montreal, QC, Canada
| | - Jeroen J A van Kampen
- Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Jan J Cornelissen
- Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | | | - Mégane Tanguay
- Department of Medicine, Montreal, QC, Canada; Institute for Research in Immunology and Cancer, Université de Montréal, Montreal, QC, Canada
| | - Qi Li
- Division of Hematology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada; Department of Medicine, Montreal, QC, Canada
| | - Sébastien Lemieux
- Molecular Genetics of Stem Cells Laboratory, and Department of Biochemistry and Molecular Medicine, Montreal, QC, Canada
| | - Peter W Zandstra
- ExCellThera, Montreal, QC, Canada; School of Biomedical Engineering and Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada
| | - Guy Sauvageau
- Division of Hematology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada; Department of Medicine, Montreal, QC, Canada; Institute for Research in Immunology and Cancer, Université de Montréal, Montreal, QC, Canada; ExCellThera, Montreal, QC, Canada
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19
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Pham HT, Labrie L, Wijting IEA, Hassounah S, Lok KY, Portna I, Goring ME, Han Y, Lungu C, van der Ende ME, Brenner BG, Boucher CA, Rijnders BJA, van Kampen JJA, Mesplède T, Wainberg MA. The S230R Integrase Substitution Associated With Virus Load Rebound During Dolutegravir Monotherapy Confers Low-Level Resistance to Integrase Strand-Transfer Inhibitors. J Infect Dis 2019; 218:698-706. [PMID: 29617824 DOI: 10.1093/infdis/jiy175] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 03/27/2018] [Indexed: 01/24/2023] Open
Abstract
Background Dolutegravir (DTG) is an integrase strand-transfer inhibitor (INSTI) used for treatment of human immunodeficiency virus (HIV)-infected individuals. Owing to its high genetic barrier to resistance, DTG has been clinically investigated as maintenance monotherapy to maintain viral suppression and to reduce complication and healthcare costs. Our study aims to explain the underlying mechanism related to the emergence of a S230R substitution in patients who experienced virologic failure while using DTG monotherapy. Methods We evaluated the effect of the S230R substitution in regard to integrase enzyme activity, viral infectivity, replicative capacity, and susceptibility to different INSTIs by biochemical and cell-based assays. Results The S230R substitution conferred a 63% reduction in enzyme efficiency. S230R virus was 1.29-fold less infectious than wild-type virus but could replicate in PM1 cells without significant delay. Resistance levels against DTG, cabotegravir, raltegravir, and elvitegravir in tissue culture were 3.85-, 3.72-, 1.52-, and 1.21-fold, respectively, in virus with the S230R substitution. Conclusions Our data indicate that the S230R substitution is comparable to the previously reported R263K substitution in some respects. Virologic failure during DTG monotherapy can occur through the development of the S230R or R263K mutation, without the need for high-level DTG resistance.
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Affiliation(s)
- Hanh T Pham
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Microbiology and Immunology, McGill University, Montreal, Canada
| | - Lydia Labrie
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Microbiology and Immunology, McGill University, Montreal, Canada
| | - Ingeborg E A Wijting
- Department of Microbiology and Infectious Diseases, Erasmus Medical Center, Rotterdam, Netherlands
| | - Said Hassounah
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, Canada
| | - Ka Yee Lok
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Inna Portna
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Microbiology and Immunology, McGill University, Montreal, Canada
| | - Mark E Goring
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, Canada
| | - Yingshan Han
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Cynthia Lungu
- Department of Viroscience, Erasmus University, Rotterdam, Netherlands
| | - Marchina E van der Ende
- Department of Microbiology and Infectious Diseases, Erasmus Medical Center, Rotterdam, Netherlands
| | - Bluma G Brenner
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Faculty of Surgery, McGill University, Montreal, Canada
| | - Charles A Boucher
- Department of Viroscience, Erasmus University, Rotterdam, Netherlands
| | - Bart J A Rijnders
- Department of Microbiology and Infectious Diseases, Erasmus Medical Center, Rotterdam, Netherlands
| | | | - Thibault Mesplède
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Microbiology and Immunology, McGill University, Montreal, Canada.,Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, Canada
| | - Mark A Wainberg
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Microbiology and Immunology, McGill University, Montreal, Canada.,Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, Canada
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20
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Wijting IEA, Lungu C, Rijnders BJA, van der Ende ME, Pham HT, Mesplede T, Pas SD, Voermans JJC, Schuurman R, van de Vijver DAMC, Boers PHM, Gruters RA, Boucher CAB, van Kampen JJA. HIV-1 Resistance Dynamics in Patients With Virologic Failure to Dolutegravir Maintenance Monotherapy. J Infect Dis 2019; 218:688-697. [PMID: 29617822 DOI: 10.1093/infdis/jiy176] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 03/18/2018] [Indexed: 11/14/2022] Open
Abstract
Background A high genetic barrier to resistance to the integrase strand transfer inhibitor (INSTI) dolutegravir has been reported in vitro and in vivo. We describe the dynamics of INSTI resistance-associated mutations (INSTI-RAMs) and mutations in the 3'-polypurine tract (3'-PPT) in relation to virologic failure (VF) observed in the randomized Dolutegravir as Maintenance Monotherapy for HIV-1 study (DOMONO, NCT02401828). Methods From 10 patients with VF, plasma samples were collected before the start of cART and during VF, and were used to generate Sanger sequences of integrase, the 5' terminal bases of the 3' long terminal repeat (LTR), and the 3'-PPT. Results Median human immunodeficiency virus RNA load at VF was 3490 copies/mL (interquartile range 1440-4990 copies/mL). INSTI-RAMs (S230R, R263K, N155H, and E92Q+N155H) were detected in 4 patients, no INSTI-RAMs were detected in 4 patients, and sequencing of the integrase gene was unsuccessful in 2 patients. The time to VF ranged from 4 weeks to 72 weeks. In 1 patient, mutations developed in the highly conserved 3'-PPT. No changes in the terminal bases of the 3'-LTR were observed. Conclusions The genetic barrier to resistance is too low to justify dolutegravir maintenance monotherapy because single INSTI-RAMs are sufficient to cause VF. The large variation in time to VF suggests that stochastic reactivation of a preexisting provirus containing a single INSTI-RAM is the mechanism for failure. Changes in the 3'-PPT point to a new dolutegravir resistance mechanism in vivo. Clinical Trials Registration NCT02401828.
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Affiliation(s)
- Ingeborg E A Wijting
- Department of Internal Medicine and Infectious Diseases, Erasmus MC, Rotterdam, the Netherlands
| | - Cynthia Lungu
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
| | - Bart J A Rijnders
- Department of Internal Medicine and Infectious Diseases, Erasmus MC, Rotterdam, the Netherlands
| | - Marchina E van der Ende
- Department of Internal Medicine and Infectious Diseases, Erasmus MC, Rotterdam, the Netherlands
| | - Hanh T Pham
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Microbiology and Immunology, Faculty of Medicine, McGill University, Montreal, Canada
| | - Thibault Mesplede
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Microbiology and Immunology, Faculty of Medicine, McGill University, Montreal, Canada
| | - Suzan D Pas
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
| | | | - Rob Schuurman
- Division of Virology, Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | | | - Rob A Gruters
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
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21
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Wijting IEA, Lungu C, Rijnders BJA, van der Ende ME, Pham HT, Mesplede T, Pas SD, Voermans JJC, Schuurman R, van de Vijver DAMC, Boers PHM, Gruters RA, Boucher CAB, van Kampen JJA. Reply to Darcis and Berkhout. J Infect Dis 2018; 218:2020-2021. [PMID: 30085047 DOI: 10.1093/infdis/jiy475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ingeborg E A Wijting
- Department of Internal Medicine-Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands
| | - Cynthia Lungu
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Bart J A Rijnders
- Department of Internal Medicine-Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands
| | | | - Hanh T Pham
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Québec, Canada
- Department of Microbiology and Immunology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Thibault Mesplede
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Québec, Canada
- Department of Microbiology and Immunology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Suzan D Pas
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | | | - Rob Schuurman
- Virology, Department of Medical Microbiology, University Medical Center Utrecht, The Netherlands
| | | | | | - Rob A Gruters
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
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22
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van Kampen JJA, Tintu A, Russcher H, Fraaij PLA, Reusken CBEM, Rijken M, van Hellemond JJ, van Genderen PJJ, Koelewijn R, de Jong MD, Haddock E, Fischer RJ, Munster VJ, Koopmans MPG. Ebola Virus Inactivation by Detergents Is Annulled in Serum. J Infect Dis 2017; 216:859-866. [PMID: 28961947 DOI: 10.1093/infdis/jix401] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 08/10/2017] [Indexed: 12/21/2022] Open
Abstract
Background Treatment of blood samples from hemorrhagic fever virus (HFV)-infected patients with 0.1% detergents has been recommended for virus inactivation and subsequent safe laboratory testing. However, data on virus inactivation by this procedure are lacking. Here we show the effect of this procedure on diagnostic test results and infectious Ebola virus (EBOV) titers. Methods Serum and whole-blood samples were treated with 0.1% or 1% sodium dodecyl sulfate (SDS) or 0.1% Triton X-100 and assayed for clinical chemistry and malaria antigen detection. Infectious EBOV titers were determined in SDS-treated plasma and whole blood from EBOV-infected nonhuman primates (NHPs). Infectious titers of EBOV or herpes simplex virus type 1 (HSV-1) in detergents-treated cell culture medium containing various serum concentrations were determined. Results Laboratory test results were not affected by 0.1% detergent treatment of blood samples, in contrast with 1% SDS treatment. However, 0.1% detergent treatment did not inactivate EBOV in blood samples from infected NHPs. Experiments with cell culture medium showed that virus inactivation by detergents is annulled at physiological serum concentrations. Conclusions Treatment of blood samples with 0.1% SDS or Triton X-100 does not inactivate EBOV. Inactivation protocols for HFV should be validated with serum and whole blood.
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Affiliation(s)
| | | | | | | | | | | | - Jaap J van Hellemond
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam
| | | | - Rob Koelewijn
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam
| | - Menno D de Jong
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Elaine Haddock
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
| | - Robert J Fischer
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
| | - Vincent J Munster
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
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23
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Mumtaz N, Jimmerson LC, Bushman LR, Kiser JJ, Aron G, Reusken CBEM, Koopmans MPG, van Kampen JJA. Cell-line dependent antiviral activity of sofosbuvir against Zika virus. Antiviral Res 2017; 146:161-163. [PMID: 28912011 DOI: 10.1016/j.antiviral.2017.09.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 07/17/2017] [Accepted: 09/07/2017] [Indexed: 10/18/2022]
Abstract
The recent epidemic of Zika virus (ZIKV) in the Americas and its association with fetal and neurological complications has shown the need to develop a treatment. Repurposing of drugs that are already FDA approved or in clinical development may shorten drug development timelines in case of emerging viral diseases like ZIKV. Initial studies have shown conflicting results when testing sofosbuvir developed for treatment of infections with another Flaviviridae virus, hepatitis C virus. We hypothesized that the conflicting results could be explained by differences in intracellular processing of the compound. We assessed the antiviral activity of sofosbuvir and mericitabine against ZIKV using Vero, A549, and Huh7 cells and measured the level of the active sofosbuvir metabolite by mass spectrometry. Mericitabine did not show activity, while sofosbuvir inhibited ZIKV with an IC50 of ∼4 μM, but only in Huh7 cells. This correlated with differences in intracellular concentration of the active triphosphate metabolite of sofosbuvir, GS-461203 or 007-TP, which was 11-342 times higher in Huh7 cells compared to Vero and A549 cells. These results show that a careful selection of cell system for repurposing trials of prodrugs is needed for evaluation of antiviral activity. Furthermore, the intracellular levels of 007-TP in tissues and cell types that support ZIKV replication in vivo should be determined to further investigate the potential of sofosbuvir as anti-ZIKV compound.
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Affiliation(s)
- Noreen Mumtaz
- Department of Viroscience, Unit Clinical Virology, Erasmus MC, Rotterdam, The Netherlands
| | - Leah C Jimmerson
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, USA
| | - Lane R Bushman
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, USA
| | - Jennifer J Kiser
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, USA
| | - Georgina Aron
- Department of Viroscience, Unit Clinical Virology, Erasmus MC, Rotterdam, The Netherlands
| | - Chantal B E M Reusken
- Department of Viroscience, Unit Clinical Virology, Erasmus MC, Rotterdam, The Netherlands
| | - Marion P G Koopmans
- Department of Viroscience, Unit Clinical Virology, Erasmus MC, Rotterdam, The Netherlands
| | - Jeroen J A van Kampen
- Department of Viroscience, Unit Clinical Virology, Erasmus MC, Rotterdam, The Netherlands.
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24
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van der Meijden E, Horváth B, Nijland M, de Vries K, Rácz EK, Diercks GF, de Weerd AE, Clahsen-van Groningen MC, van der Blij-de Brouwer CS, van der Zon AJ, Kroes ACM, Hedman K, van Kampen JJA, Riezebos-Brilman A, Feltkamp MCW. Primary Polyomavirus Infection, Not Reactivation, as the Cause of Trichodysplasia Spinulosa in Immunocompromised Patients. J Infect Dis 2017; 215:1080-1084. [PMID: 27578847 DOI: 10.1093/infdis/jiw403] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 08/19/2016] [Indexed: 11/13/2022] Open
Abstract
Classic human polyomaviruses (JC and BK viruses) become pathogenic when reactivating from latency. For the rare skin disease trichodysplasia spinulosa, we show that manifestations of the causative polyomavirus (TSPyV) occur during primary infection of the immunosuppressed host. High TSPyV loads in blood and cerebrospinal fluid, sometimes coinciding with cerebral lesions and neuroendocrine symptoms, marked the acute phase of trichodysplasia spinulosa, whereas initiation and maturation of TSPyV seroresponses occurred in the convalescent phase. TSPyV genomes lacked the rearrangements typical for reactivating polyomaviruses. These findings demonstrate the clinical importance of primary infection with this rapidly expanding group of human viruses and explain the rarity of some novel polyomavirus-associated diseases.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Aloys C M Kroes
- Department of Medical Microbiology, Leiden University Medical Center
| | - Klaus Hedman
- Department of Virology, University of Helsinki and Helsinki University Hospital, Finland
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25
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Fraaij PLA, Wildschut ED, Houmes RJ, Swaan CM, Hoebe CJ, de Jonge HCC, Tolsma P, de Kleer I, Pas SD, Oude Munnink BB, Phan MVT, Bestebroer TM, Roosenhoff RS, van Kampen JJA, Cotten M, Beerens N, Fouchier RAM, van den Kerkhof JH, Timen A, Koopmans MP. Severe acute respiratory infection caused by swine influenza virus in a child necessitating extracorporeal membrane oxygenation (ECMO), the Netherlands, October 2016. Euro Surveill 2016; 21:30416. [PMID: 27934581 PMCID: PMC5388114 DOI: 10.2807/1560-7917.es.2016.21.48.30416] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 11/30/2016] [Indexed: 11/20/2022] Open
Abstract
In October 2016, a severe infection with swine influenza A(H1N1) virus of the Eurasian avian lineage occurred in a child with a previous history of eczema in the Netherlands, following contact to pigs. The patient's condition deteriorated rapidly and required life support through extracorporeal membrane oxygenation. After start of oseltamivir treatment and removal of mucus plugs, the patient fully recovered. Monitoring of more than 80 close unprotected contacts revealed no secondary cases.
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Affiliation(s)
- Pieter L A Fraaij
- Department of Viroscience Erasmus MC, Rotterdam, The Netherlands
- Department of Pediatrics, Subdivision Infectious diseases and Immunology, Erasmus MC - Sophia, Rotterdam, The Netherlands
| | - Enno D Wildschut
- Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia, Rotterdam, The Netherlands
| | - Robert J Houmes
- Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia, Rotterdam, The Netherlands
| | - Corien M Swaan
- Centre for Infectious Disease Control-National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Christian J Hoebe
- Department of Sexual Health, Infectious Diseases and Environmental Health, Public Health Service South Limburg, Geleen, The Netherlands
- Faculty of Health, Medicine and Life Sciences Department of Medical Microbiology, Maastricht Infection Center (MINC),School of Public Health and Primary Care (CAPHRI),Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - H C C de Jonge
- Gemeentelijke Gezondheidsdienst Rotterdam-Rijnmond, Rotterdam, The Netherlands
| | - Paulien Tolsma
- Gemeentelijke Gezondheidsdienst Brabant zuidoost, Eindhoven, The Netherlands
| | - Isme de Kleer
- Department of Paediatrics, Subdivision of pulmonary medicine, Erasmus MC - Sophia, Rotterdam, The Netherlands
| | - Suzan D Pas
- Department of Viroscience Erasmus MC, Rotterdam, The Netherlands
| | | | - My V T Phan
- Department of Viroscience Erasmus MC, Rotterdam, The Netherlands
| | | | | | | | - Matthew Cotten
- Department of Viroscience Erasmus MC, Rotterdam, The Netherlands
| | - Nancy Beerens
- Wageningen Bioveterinary reseach- Wageningen University and Research, Lelystad, the Netherlands
| | - Ron A M Fouchier
- Department of Viroscience Erasmus MC, Rotterdam, The Netherlands
| | - Johannes H van den Kerkhof
- Centre for Infectious Disease Control-National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Aura Timen
- Centre for Infectious Disease Control-National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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van der Eijk AA, van Genderen PJ, Verdijk RM, Reusken CB, Mögling R, van Kampen JJA, Widagdo W, Aron GI, GeurtsvanKessel CH, Pas SD, Raj VS, Haagmans BL, Koopmans MPG. Miscarriage Associated with Zika Virus Infection. N Engl J Med 2016; 375:1002-4. [PMID: 27463941 DOI: 10.1056/nejmc1605898] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Suzan D Pas
- Erasmus Medical Center, Rotterdam, the Netherlands
| | - V Stalin Raj
- Erasmus Medical Center, Rotterdam, the Netherlands
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27
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Affiliation(s)
- Noreen Mumtaz
- Department of Viroscience, Unit Clinical Virology, Erasmus MC, Room Na-1018, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | - Jeroen J A van Kampen
- Department of Viroscience, Unit Clinical Virology, Erasmus MC, Room Na-1018, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | - Chantal B E M Reusken
- Department of Viroscience, Unit Clinical Virology, Erasmus MC, Room Na-1018, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | - Charles A B Boucher
- Department of Viroscience, Unit Clinical Virology, Erasmus MC, Room Na-1018, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | - Marion P G Koopmans
- Department of Viroscience, Unit Clinical Virology, Erasmus MC, Room Na-1018, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
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28
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Stittelaar KJ, de Waal L, van Amerongen G, Veldhuis Kroeze EJB, Fraaij PLA, van Baalen CA, van Kampen JJA, van der Vries E, Osterhaus ADME, de Swart RL. Ferrets as a Novel Animal Model for Studying Human Respiratory Syncytial Virus Infections in Immunocompetent and Immunocompromised Hosts. Viruses 2016; 8:v8060168. [PMID: 27314379 PMCID: PMC4926188 DOI: 10.3390/v8060168] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 06/03/2016] [Accepted: 06/05/2016] [Indexed: 12/21/2022] Open
Abstract
Human respiratory syncytial virus (HRSV) is an important cause of severe respiratory tract disease in immunocompromised patients. Animal models are indispensable for evaluating novel intervention strategies in this complex patient population. To complement existing models in rodents and non-human primates, we have evaluated the potential benefits of an HRSV infection model in ferrets (Mustela putorius furo). Nine- to 12-month-old HRSV-seronegative immunocompetent or immunocompromised ferrets were infected with a low-passage wild-type strain of HRSV subgroup A (105 TCID50) administered by intra-tracheal or intra-nasal inoculation. Immune suppression was achieved by bi-daily oral administration of tacrolimus, mycophenolate mofetil, and prednisolone. Throat and nose swabs were collected daily and animals were euthanized four, seven, or 21 days post-infection (DPI). Virus loads were determined by quantitative virus culture and qPCR. We observed efficient HRSV replication in both the upper and lower respiratory tract. In immunocompromised ferrets, virus loads reached higher levels and showed delayed clearance as compared to those in immunocompetent animals. Histopathological evaluation of animals euthanized 4 DPI demonstrated that the virus replicated in the respiratory epithelial cells of the trachea, bronchi, and bronchioles. These animal models can contribute to an assessment of the efficacy and safety of novel HRSV intervention strategies.
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Affiliation(s)
| | - Leon de Waal
- Viroclinics Biosciences, 3029 AK Rotterdam, The Netherlands.
| | | | - Edwin J B Veldhuis Kroeze
- Viroclinics Biosciences, 3029 AK Rotterdam, The Netherlands.
- Department of Viroscience, Erasmus MC, 3015 CN Rotterdam, The Netherlands.
| | - Pieter L A Fraaij
- Department of Viroscience, Erasmus MC, 3015 CN Rotterdam, The Netherlands.
| | | | | | - Erhard van der Vries
- Department of Viroscience, Erasmus MC, 3015 CN Rotterdam, The Netherlands.
- Research Centre for Emerging Infections and Zoonoses, University of Veterinary Medicine, 30559 Hannover, Germany.
| | - Albert D M E Osterhaus
- Viroclinics Biosciences, 3029 AK Rotterdam, The Netherlands.
- Department of Viroscience, Erasmus MC, 3015 CN Rotterdam, The Netherlands.
- Research Centre for Emerging Infections and Zoonoses, University of Veterinary Medicine, 30559 Hannover, Germany.
| | - Rik L de Swart
- Department of Viroscience, Erasmus MC, 3015 CN Rotterdam, The Netherlands.
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Mitterreiter JG, Titulaer MJ, van Nierop GP, van Kampen JJA, Aron GI, Osterhaus ADME, Verjans GMGM, Ouwendijk WJD. Prevalence of Intrathecal Acyclovir Resistant Virus in Herpes Simplex Encephalitis Patients. PLoS One 2016; 11:e0155531. [PMID: 27171421 PMCID: PMC4865163 DOI: 10.1371/journal.pone.0155531] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 04/29/2016] [Indexed: 11/18/2022] Open
Abstract
Herpes simplex encephalitis (HSE) is a life-threatening complication of herpes simplex virus (HSV) infection. Acyclovir (ACV) is the antiviral treatment of choice, but may lead to emergence of ACV-resistant (ACVR) HSV due to mutations in the viral UL23 gene encoding for the ACV-targeted thymidine kinase (TK) protein. Here, we determined the prevalence of intrathecal ACVR–associated HSV TK mutations in HSE patients and compared TK genotypes of sequential HSV isolates in paired cerebrospinal fluid (CSF) and blister fluid of mucosal HSV lesions. Clinical samples were obtained from 12 HSE patients, encompassing 4 HSV type 1 (HSV-1) and 8 HSV-2 encephalitis patients. HSV DNA load was determined by real-time PCR and complete HSV TK gene sequences were obtained by nested PCR followed by Sanger sequencing. All HSV-1 HSE patients contained viral TK mutations encompassing 30 unique nucleotide and 13 distinct amino acid mutations. By contrast, a total of 5 unique nucleotide and 4 distinct amino acid changes were detected in 7 of 8 HSV-2 patients. Detected mutations were identified as natural polymorphisms located in non-conserved HSV TK gene regions. ACV therapy did not induce the emergence of ACVR-associated HSV TK mutations in consecutive CSF and mucocutaneous samples of 5 individual patients. Phenotypic susceptibility analysis of these mucocutaneous HSV isolates demonstrated ACV-sensitive virus in 2 HSV-1 HSE patients, whereas in two HSV-2 HSE patients ACVR virus was detected in the absence of known ACVR-associated TK mutations. In conclusion, we did not detect intrathecal ACVR-associated TK mutations in HSV isolates obtained from 12 HSE patients.
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MESH Headings
- Acyclovir/pharmacology
- Adult
- Amino Acid Substitution/genetics
- Antiviral Agents/pharmacology
- Demography
- Drug Resistance, Viral/drug effects
- Encephalitis, Herpes Simplex/cerebrospinal fluid
- Encephalitis, Herpes Simplex/virology
- Female
- Herpesvirus 1, Human/drug effects
- Herpesvirus 1, Human/enzymology
- Herpesvirus 1, Human/isolation & purification
- Herpesvirus 1, Human/physiology
- Herpesvirus 2, Human/drug effects
- Herpesvirus 2, Human/enzymology
- Herpesvirus 2, Human/isolation & purification
- Herpesvirus 2, Human/physiology
- Humans
- Male
- Middle Aged
- Phenotype
- Polymorphism, Single Nucleotide/genetics
- Prevalence
- Spinal Cord/pathology
- Spinal Cord/virology
- Thymidine Kinase/genetics
- Young Adult
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Affiliation(s)
- Johanna G. Mitterreiter
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine Hannover, Hannover, Germany
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
| | | | - Gijsbert P. van Nierop
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
- Department of Neurology, Erasmus MC, Rotterdam, the Netherlands
| | | | - Georgina I. Aron
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
| | - Albert D. M. E. Osterhaus
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine Hannover, Hannover, Germany
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
| | - Georges M. G. M. Verjans
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine Hannover, Hannover, Germany
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
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30
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van Kampen JJA, Bielefeld-Buss AJ, Ott A, Maaskant J, Faber HJ, Lutisan JG, Boucher CAB. Case report: oseltamivir-induced resistant pandemic influenza A (H1N1) virus infection in a patient with AIDS and Pneumocystis jirovecii pneumonia. J Med Virol 2013; 85:941-3. [PMID: 23588718 DOI: 10.1002/jmv.23560] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2013] [Indexed: 11/11/2022]
Abstract
Pneumocystis jirovecii pneumonia is the main cause of severe respiratory failure in patients with advanced HIV disease who do not receive P. jirovecii prophylaxis. Other aetiological agents may contribute to the respiratory failure in these patients, which is highlighted by the case described below: A patient with advanced HIV disease was treated for a dual-infection with pandemic influenza A (H1N1) and P. jirovecii. Initially, his condition improved, but deteriorated after the emergence of oseltamivir-resistant influenza virus. This is the first documented case of emergence of drug-resistant influenza virus in a patient infected with HIV with a pandemic influenza A (H1N1) and P. jirovecii double infection.
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31
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Hooff GP, van Kampen JJA, Meesters RJW, van Belkum A, Goessens WHF, Luider TM. Characterization of β-lactamase enzyme activity in bacterial lysates using MALDI-mass spectrometry. J Proteome Res 2011; 11:79-84. [PMID: 22013912 DOI: 10.1021/pr200858r] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Plasmid-encoded β-lactamases are a major reason for antibiotic resistance in gram negative bacteria. These enzymes hydrolyze the β-lactam ring structure of certain β-lactam antibiotics, consequently leading to their inactivation. The clinical situation demands for specific first-line antibiotic therapy combined with a quick identification of bacterial strains and their antimicrobial susceptibility. Strategies for the identification of β-lactamase activity are often cumbersome and usually lack sensitivity and specificity. The current work demonstrates that matrix assisted laser desorption/ionization mass spectrometry (MALDI-MS) is an ideal tool for these analytical investigations. Herein, we describe a fast and specific assay to determine β-lactamase activity in bacterial lysates. The feasibility of the analytical read-out was demonstrated on a MALDI-triple quadrupole (QqQ) and a MALDI time-of-flight (TOF) instrument, and the results allow the comparison of both approaches. The assay specifically measures enzyme-mediated, time-dependent hydrolysis of the β-lactam ring structure of penicillin G and ampicillin and inhibition of hydrolysis by clavulanic acid for clavulanic acid susceptible β-lactamases. The assay is reproducible and builds the basis for future in-depth investigations of β-lactamase activity in various bacterial strains by mass spectrometry.
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Affiliation(s)
- Gero P Hooff
- Department of Neurology, Laboratory of Neuro-Oncology and Clinical and Cancer Proteomics, Erasmus University Medical Center (Erasmus MC), Rotterdam, The Netherlands.
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32
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Coulier L, Gerritsen H, van Kampen JJA, Reedijk ML, Luider TM, Osterhaus ADME, Gruters RA, Brüll L. Comprehensive analysis of the intracellular metabolism of antiretroviral nucleosides and nucleotides using liquid chromatography-tandem mass spectrometry and method improvement by using ultra performance liquid chromatography. J Chromatogr B Analyt Technol Biomed Life Sci 2011; 879:2772-82. [PMID: 21862423 DOI: 10.1016/j.jchromb.2011.07.045] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Revised: 07/26/2011] [Accepted: 07/27/2011] [Indexed: 11/27/2022]
Abstract
Nucleoside reverse transcriptase inhibitors (NRTIs) are a key class of drugs for the treatment of HIV infection. NRTIs are intracellularly phosphorylated to their active triphosphate metabolites and compete with endogenous deoxynucleotides (dNTP) for substrate binding. It is therefore important to analyze the intracellular concentrations of these compounds to understand drug efficacy and toxicity. To that purpose an analytical platform was developed that is capable of analyzing 8 NRTIs, 12 phosphorylated NRTIs and 4 dNTPs in small numbers of peripheral blood mononuclear cells, i.e. 1 × 10(6) cells. The platform consists of two liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods: a reversed-phase method for NRTIs using positive electrospray ionization (ESI) and an ion-pair LC-MS/MS method for the phosphorylated compounds using negative ESI. The methods use the same LC-MS system and column and changing from one method to the other only includes changing the mobile phase. The methods were partially validated, focussing on sensitivity, accuracy and precision. Successful transfer of the methods to ultra performance liquid chromatography (UPLC) led to a significant improvement of speed for the analysis of NRTIs and sensitivity for both NRTIs and phosphorylated NRTIs. The latter was demonstrated by the improved separation by UHPLC of dGTP vs. AZT-TP and ATP which made direct analysis of dGTP possible using the optimal MS/MS transition thereby significantly improving the detection limit of dGTP. Typically LLOQs observed for both the NRTIs and phosphorylated NRTIs were 1 nM, while the mean accuracy varied between 82 and 120% and inter- and intra-assay precision was generally <20%.
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Affiliation(s)
- Leon Coulier
- TNO, Utrechtseweg 48, 3700 AJ Zeist, The Netherlands.
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33
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Hooff GP, Meesters RJW, van Kampen JJA, van Huizen NA, Koch B, Al Hadithy AFY, van Gelder T, Osterhaus ADME, Gruters RA, Luider TM. Dried blood spot UHPLC-MS/MS analysis of oseltamivir and oseltamivircarboxylate--a validated assay for the clinic. Anal Bioanal Chem 2011; 400:3473-9. [PMID: 21537911 PMCID: PMC3119796 DOI: 10.1007/s00216-011-5050-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 04/18/2011] [Accepted: 04/20/2011] [Indexed: 12/01/2022]
Abstract
The neuraminidase inhibitor oseltamivir (Tamiflu®) is currently the first-line therapy for patients with influenza virus infection. Common analysis of the prodrug and its active metabolite oseltamivircarboxylate is determined via extraction from plasma. Compared with these assays, dried blood spot (DBS) analysis provides several advantages, including a minimum sample volume required for the measurement of drugs in whole blood. Samples can easily be obtained via a simple, non-invasive finger or heel prick. Mainly, these characteristics make DBS an ideal tool for pediatrics and to measure multiple time points such as those needed in therapeutic drug monitoring or pharmacokinetic studies. Additionally, DBS sample preparation, stability, and storage are usually most convenient. In the present work, we developed and fully validated a DBS assay for the simultaneous determination of oseltamivir and oseltamivircarboxylate concentrations in human whole blood. We demonstrate the simplicity of DBS sample preparation, and a fast, accurate and reproducible analysis using ultra high-performance liquid chromatography coupled to a triple quadrupole mass spectrometer. A thorough validation on the basis of the most recent FDA guidelines for bioanalytical method validation showed that the method is selective, precise, and accurate (≤15% RSD), and sensitive over the relevant clinical range of 5–1,500 ng/mL for oseltamivir and 20–1,500 ng/mL for the oseltamivircarboxylate metabolite. As a proof of concept, oseltamivir and oseltamivircarboxylate levels were determined in DBS obtained from healthy volunteers who received a single oral dose of Tamiflu®.
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Affiliation(s)
- Gero P Hooff
- Department of Neurology, Laboratory of Neuro-Oncology and Clinical and Cancer Proteomics, University Medical Center Rotterdam (Erasmus MC), Rotterdam, The Netherlands.
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Meesters RJW, van Kampen JJA, Scheuer RD, van der Ende ME, Gruters RA, Luider TM. Determination of the antiretroviral drug tenofovir in plasma from HIV-infected adults by ultrafast isotope dilution MALDI-triple quadrupole tandem mass spectrometry. J Mass Spectrom 2011; 46:282-289. [PMID: 21394844 DOI: 10.1002/jms.1897] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A new and reliable mass spectrometric method using an isotope dilution method in combination with matrix-assisted laser desorption/ionization-triple quadrupole tandem mass spectrometry (ID-MALDI-QqQ-MS/MS) has been developed and validated for the determination of concentrations of the antiretroviral drug tenofovir (TNV) in plasma from HIV-infected adults. The advantage of this new method is that (1) the method is ultrafast and (2) can be applied for high-throughput measurement of TNV in plasma. The method is based on a simple plasma deproteinization step in combination with the use of [adenine-(13) C(5) ]-TNV as the internal standard. TNV and [adenine-(13) C(5) ]-TNV were monitored by multiple reaction monitoring using the transition m/z 288.0 → 176.2 and m/z 293.2 → 181.2 for TNV and [adenine-(13) C(5) ]-TNV, respectively. The method was validated according to the most recent FDA guidelines for the development and validation of (new) bio-analytical assays. Validated method parameters were: linearity, accuracy, precision and stability of the method. The lowest limit of quantification was 0.10 µmol/l, whereas the limit of detection determined at a signal-to-noise ratio (S/N = 3:1) in pooled drug free human control plasma was 0.04 µmol/l. The validated method was successfully applied and tested for its clinical feasibility by the analysis of plasma samples from selected HIV-infected adults receiving the prodrug tenofovir disoproxil fumarate. Observed plasma TNV concentrations ranged between 0.11 and 0.76 µmol/l and measured plasma TNV concentrations were within the therapeutically relevant concentration range.
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Affiliation(s)
- Roland J W Meesters
- Laboratory of Neuro-Oncology and Clinical and Cancer Proteomics, Department of Neurology, University Medical Center Rotterdam, Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands.
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van Kampen JJA, Burgers PC, de Groot R, Gruters RA, Luider TM. Biomedical application of MALDI mass spectrometry for small-molecule analysis. Mass Spectrom Rev 2011; 30:101-120. [PMID: 20169623 DOI: 10.1002/mas.20268] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Matrix-assisted laser desorption/ionization (MALDI) mass spectrometry (MS) is an emerging analytical tool for the analysis of molecules with molar masses below 1,000 Da; that is, small molecules. This technique offers rapid analysis, high sensitivity, low sample consumption, a relative high tolerance towards salts and buffers, and the possibility to store sample on the target plate. The successful application of the technique is, however, hampered by low molecular weight (LMW) matrix-derived interference signals and by poor reproducibility of signal intensities during quantitative analyses. In this review, we focus on the biomedical application of MALDI-MS for the analysis of small molecules and discuss its favorable properties and its challenges as well as strategies to improve the performance of the technique. Furthermore, practical aspects and applications are presented.
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Affiliation(s)
- Jeroen J A van Kampen
- Laboratories of Neuro-Oncology/Clinical and Cancer Proteomics, Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
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36
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Meesters RJW, van Kampen JJA, Reedijk ML, Scheuer RD, Dekker LJM, Burger DM, Hartwig NG, Osterhaus ADME, Luider TM, Gruters RA. Ultrafast and high-throughput mass spectrometric assay for therapeutic drug monitoring of antiretroviral drugs in pediatric HIV-1 infection applying dried blood spots. Anal Bioanal Chem 2010; 398:319-28. [PMID: 20632164 PMCID: PMC2919689 DOI: 10.1007/s00216-010-3952-9] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Revised: 06/18/2010] [Accepted: 06/20/2010] [Indexed: 12/01/2022]
Abstract
Kaletra® (Abott Laboratories) is a co-formulated medication used in the treatment of HIV-1-infected children, and it contains the two antiretroviral protease inhibitor drugs lopinavir and ritonavir. We validated two new ultrafast and high-throughput mass spectrometric assays to be used for therapeutic drug monitoring of lopinavir and ritonavir concentrations in whole blood and in plasma from HIV-1-infected children. Whole blood was blotted onto dried blood spot (DBS) collecting cards, and plasma was collected simultaneously. DBS collecting cards were extracted by an acetonitrile/water mixture while plasma samples were deproteinized with acetone. Drug concentrations were determined by matrix-assisted laser desorption/ionization-triple quadrupole tandem mass spectrometry (MALDI-QqQ-MS/MS). The application of DBS made it possible to measure lopinavir and ritonavir in whole blood in therapeutically relevant concentrations. The MALDI-QqQ-MS/MS plasma assay was successfully cross-validated with a commonly used high-performance liquid chromatography (HPLC)–ultraviolet (UV) assay for the therapeutic drug monitoring (TDM) of HIV-1-infected patients, and it showed comparable performance characteristics. Observed DBS concentrations showed as well, a good correlation between plasma concentrations obtained by MALDI-QqQ-MS/MS and those obtained by the HPLC-UV assay. Application of DBS for TDM proved to be a good alternative to the normally used plasma screening. Moreover, collection of DBS requires small amounts of whole blood which can be easily performed especially in (very) young children where collection of large whole blood amounts is often not possible. DBS is perfectly suited for TDM of HIV-1-infected children; but nevertheless, DBS can also easily be applied for TDM of patients in areas with limited or no laboratory facilities.
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Affiliation(s)
- Roland J W Meesters
- Department of Neurology, Laboratory of Neuro-Oncology and Clinical and Cancer Proteomics, University Medical Center Rotterdam (Erasmus MC), Dr. Molewaterplein 50, Room Ee-1981, 3015 GE Rotterdam, The Netherlands.
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37
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van Kampen JJA, Reedijk ML, Burgers PC, Dekker LJM, Hartwig NG, van der Ende IE, de Groot R, Osterhaus ADME, Burger DM, Luider TM, Gruters RA. Ultra-fast analysis of plasma and intracellular levels of HIV protease inhibitors in children: a clinical application of MALDI mass spectrometry. PLoS One 2010; 5:e11409. [PMID: 20625386 PMCID: PMC2895665 DOI: 10.1371/journal.pone.0011409] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Accepted: 05/11/2010] [Indexed: 01/03/2023] Open
Abstract
HIV protease inhibitors must penetrate into cells to exert their action. Differences in the intracellular pharmacokinetics of these drugs may explain why some patients fail on therapy or suffer from drug toxicity. Yet, there is no information available on the intracellular levels of HIV protease inhibitors in HIV infected children, which is in part due to the large amount of sample that is normally required to measure the intracellular concentrations of these drugs. Therefore, we developed an ultra-fast and sensitive assay to measure the intracellular concentrations of HIV protease inhibitors in small amounts of peripheral blood mononuclear cells (PBMCs), and determined the intracellular concentrations of lopinavir and ritonavir in HIV infected children. An assay based on matrix-assisted laser desorption/ionization (MALDI) - triple quadrupole mass spectrometry was developed to determine the concentrations of HIV protease inhibitors in 10 µL plasma and 1×106 PBMCs. Precisions and accuracies were within the values set by the FDA for bioanalytical method validation. Lopinavir and ritonavir did not accumulate in PBMCs of HIV infected children. In addition, the intracellular concentrations of lopinavir and ritonavir correlated poorly to the plasma concentrations of these drugs. MALDI-triple quadrupole mass spectrometry is a new tool for ultra-fast and sensitive determination of drug concentrations which can be used, for example, to assess the intracellular pharmacokinetics of HIV protease inhibitors in HIV infected children.
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Affiliation(s)
- Jeroen J. A. van Kampen
- Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
- Department of Paediatrics, Erasmus MC – Sophia, Rotterdam, The Netherlands
- Department of Virology, Erasmus MC, Rotterdam, The Netherlands
| | | | | | | | - Nico G. Hartwig
- Department of Paediatrics, Erasmus MC – Sophia, Rotterdam, The Netherlands
| | | | - Ronald de Groot
- Department of Paediatrics, University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | | | - David M. Burger
- Department of Clinical Pharmacy, University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | - Theo M. Luider
- Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
- * E-mail:
| | - Rob A. Gruters
- Department of Virology, Erasmus MC, Rotterdam, The Netherlands
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van Kampen JJA, Luider TM, Ruttink PJA, Burgers PC. Metal ion attachment to the matrix meso-tetrakis(pentafluorophenyl)porphyrin, related matrices and analytes: an experimental and theoretical study. J Mass Spectrom 2009; 44:1556-1564. [PMID: 19499545 DOI: 10.1002/jms.1601] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In a previous study [van Kampen et al. Analytical Chemistry 2006; 78: 5403], we found that meso-tetrakis (pentafluorophenyl)porphyrin (F20TPP), in combination with lithium salts, provides an efficient matrix to cationize small molecules by Li+ attachment and that this combination can be successfully applied to the quantitative analysis of drugs, such as antiretroviral compounds using matrix-assisted laser desorption ionization in conjunction with a time-of-flight analyzer (MALDI-TOF). In the present study, we further explore the mechanism of metal ion attachment to F20TPP and analytes by MALDI-FTMS(/MS). To this end, we have studied the interaction of F20TPP and analytes with various mono-, di- and trivalent metal ions (Li+, Na+, K+, Rb+, Cs+, Co2+, Cu2+, Zn2+, Fe2+, Fe3+ and Ga3+). For the alkali cations, we find that F20TPP forms complexes only with Li+ and Na+; in addition, model analyte molecules such as poly(ethyleneglycol)s, mixed with F20TPP and the alkali cations, also only form Li+ and Na+ adducts. This contrasts sharply with the commonly used matrix 2,5-dihydroxybenzoic acid, where analytes are most efficiently cationized by Na+ or K+. Reasons for this difference are delineated. Ab initio calculations on porphyrin itself reveal that even the smallest alkali cation, Li+, does not fit in the porphyrin cavity, but lies on top of it, pushing the 21H and 23 H hydrogen atoms out of and below the plane with concomitant bending of the porphyrin skeleton in the opposite direction, i.e. toward the cation. Thus, the Li+ ion is not effectively sequestered and is in fact exposed and thus accessible for donation to analyte molecules. Interaction of F20TPP with di- and trivalent metal ions leads to protoporphyrin-metal ions, where the metal ion is captured within the protoporphyrin dianion cavity. The most intense signal is obtained when F20TPP is reacted with CuCl2 and then subjected to laser ablation. This method presents an easy general route to study the metal containing protoporphyrin molecules, which could all act as potential MALDI matrices.
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Affiliation(s)
- Jeroen J A van Kampen
- Laboratory of Neuro-Oncology and Clinical and Cancer Proteomics, Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
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Dekker LJM, van Kampen JJA, Reedijk ML, Burgers PC, Gruters RA, Osterhaus ADME, Luider TM. A mass spectrometry based imaging method developed for the intracellular detection of HIV protease inhibitors. Rapid Commun Mass Spectrom 2009; 23:1183-1188. [PMID: 19283784 DOI: 10.1002/rcm.3981] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Mass spectrometry imaging is a promising technique for measuring drugs and drug metabolites in cells and tissues. In this manuscript we describe a method for the imaging of HIV protease inhibitors. As a model system we used Mono Mac 6 cells cultured with the HIV protease inhibitors saquinavir and nelfinavir deposited on glass slides using a cytocentrifuge. A sublimation/deposition device for homogeneous matrix deposition was constructed which allows imaging of these HIV protease inhibitors at clinically relevant concentrations. Using this matrix sublimation/deposition method, glass slides containing the cytocentrifuged cells can be measured and analyzed by two types of mass spectrometry techniques, viz. matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) and MALDI Fourier transform ion cyclotron resonance (FTICR), and this makes it possible to perform imaging rapidly (MALDI-TOF) and with a very high selectivity (MALDI-FTICR).
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Coulier L, van Kampen JJA, de Groot R, Gerritsen HW, Bas RC, van Dongen WD, Brüll LP, Luider TM. Simultaneous determination of endogenous deoxynucleotides and phosphorylated nucleoside reverse transcriptase inhibitors in peripheral blood mononuclear cells using ion-pair liquid chromatography coupled to mass spectrometry. Proteomics Clin Appl 2008; 2:1557-62. [PMID: 21136803 DOI: 10.1002/prca.200800002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Indexed: 11/10/2022]
Abstract
Nucleoside reverse transcriptase inhibitors (NRTIs) are activated intracellularly to their triphosphate (TP) form, which compete with endogenous deoxynucleotide-triphosphates (dNTP) as substrate for HIV reverse transcriptase. The activity of NRTIs is thus described by the NRTI-TP-to-dNTP ratio in relevant cell types. Therefore, we developed an ion-pair (IP) LC-MS method for the simultaneous analysis of the mono-, di-, and TP forms of NRTIs and endogenous deoxynucleosides in peripheral blood mononuclear cells (PBMC). The IP-LC method was applied on an IT mass spectrometer using the MS-mode as well as on a triple quadrupole mass spectrometer using the MS/MS mode. The MS/MS approach on the triple quadrupole mass spectrometer demonstrated the best clinical applicability due to its higher sensitivity. The LOD (minimum amount on column) were 25 fmol for the TP forms of zidovudine, lamivudine, and stavudine, as well as for their endogenous dNTP counterparts. The linearity (R(2) ) of the calibration curves were>0.99. The obtained LOD readily allow for clinical applications using just one million PBMC obtained from HIV-infected patients under therapy.
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Affiliation(s)
- Leon Coulier
- Analytical Research Department, Business Unit Quality and Safety, TNO Quality of Life, Utrechtseweg Zeist, The Netherlands
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van Kampen JJA, Burgers PC, Gruters RA, Osterhaus ADME, de Groot R, Luider TM, Volmer DA. Quantitative analysis of antiretroviral drugs in lysates of peripheral blood mononuclear cells using MALDI-triple quadrupole mass spectrometry. Anal Chem 2008; 80:4969-75. [PMID: 18533679 DOI: 10.1021/ac800218a] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We report here on the use of a prototype matrix-assisted laser desorption/ionization (MALDI)-triple quadrupole mass spectrometer for quantitative analysis of six antiretroviral drugs in lysates of peripheral blood mononuclear cells (PBMC). Of the five investigated MALDI matrixes, 2,5-dihydroxybenzoic acid (DHB) and the novel 7-hydroxy-4-(trifluoromethyl)coumarin (HFMC) showed the broadest application ranges for the antiretroviral drugs. For DHB, the mean relative errors ranged from 8.3 (ritonavir) to 4.3% (saquinavir). The mean precisions (CV) ranged from 17.3 (nevirapine) to 10.8% (saquinavir). The obtained lower limits of quantitation (LLOQ) readily allow clinical applications using just 1 million PBMC from HIV-infected patients under therapy. The new matrix HFMC was used for quantitative analysis of the HIV protease inhibitor indinavir using a stainless steel target plate as well as a target plate with a novel, strongly hydrophobic fluoropolymer coating. Using the coated target plate, the mean relative error improved from 10.1 to 4.6%, the mean precision from 33.9 to 9.9% CV, and the LLOQ from 16 to 1 fmol. In addition, the measurement time for one spot went down from 6 to only 2.5 s.
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Affiliation(s)
- Jeroen J A van Kampen
- Department of Neurology, Laboratory of Neuro-Oncology and Clinical & Cancer Proteomics, Erasmus MC, Rotterdam, The Netherlands
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van Kampen JJA, Burgers PC, de Groot R, Osterhaus ADME, Reedijk ML, Verschuren EJ, Gruters RA, Luider TM. Quantitative Analysis of HIV-1 Protease Inhibitors in Cell Lysates Using MALDI-FTICR Mass Spectrometry. Anal Chem 2008; 80:3751-6. [DOI: 10.1021/ac702072c] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jeroen J. A. van Kampen
- Department of Neurology, Laboratory of Neuro-Oncology and Clinical and Cancer Proteomics and Department of Virology, Erasmus MC, Rotterdam, The Netherlands, Department of Pediatrics, Division of Pediatric Infectious Diseases & Immunology, Erasmus MC-Sophia, Rotterdam, The Netherlands, and Department of Pediatrics, UMC St. Radboud, Nijmegen, The Netherlands
| | - Peter C. Burgers
- Department of Neurology, Laboratory of Neuro-Oncology and Clinical and Cancer Proteomics and Department of Virology, Erasmus MC, Rotterdam, The Netherlands, Department of Pediatrics, Division of Pediatric Infectious Diseases & Immunology, Erasmus MC-Sophia, Rotterdam, The Netherlands, and Department of Pediatrics, UMC St. Radboud, Nijmegen, The Netherlands
| | - Ronald de Groot
- Department of Neurology, Laboratory of Neuro-Oncology and Clinical and Cancer Proteomics and Department of Virology, Erasmus MC, Rotterdam, The Netherlands, Department of Pediatrics, Division of Pediatric Infectious Diseases & Immunology, Erasmus MC-Sophia, Rotterdam, The Netherlands, and Department of Pediatrics, UMC St. Radboud, Nijmegen, The Netherlands
| | - Albert D. M. E. Osterhaus
- Department of Neurology, Laboratory of Neuro-Oncology and Clinical and Cancer Proteomics and Department of Virology, Erasmus MC, Rotterdam, The Netherlands, Department of Pediatrics, Division of Pediatric Infectious Diseases & Immunology, Erasmus MC-Sophia, Rotterdam, The Netherlands, and Department of Pediatrics, UMC St. Radboud, Nijmegen, The Netherlands
| | - Mariska L. Reedijk
- Department of Neurology, Laboratory of Neuro-Oncology and Clinical and Cancer Proteomics and Department of Virology, Erasmus MC, Rotterdam, The Netherlands, Department of Pediatrics, Division of Pediatric Infectious Diseases & Immunology, Erasmus MC-Sophia, Rotterdam, The Netherlands, and Department of Pediatrics, UMC St. Radboud, Nijmegen, The Netherlands
| | - Esther J. Verschuren
- Department of Neurology, Laboratory of Neuro-Oncology and Clinical and Cancer Proteomics and Department of Virology, Erasmus MC, Rotterdam, The Netherlands, Department of Pediatrics, Division of Pediatric Infectious Diseases & Immunology, Erasmus MC-Sophia, Rotterdam, The Netherlands, and Department of Pediatrics, UMC St. Radboud, Nijmegen, The Netherlands
| | - Rob A. Gruters
- Department of Neurology, Laboratory of Neuro-Oncology and Clinical and Cancer Proteomics and Department of Virology, Erasmus MC, Rotterdam, The Netherlands, Department of Pediatrics, Division of Pediatric Infectious Diseases & Immunology, Erasmus MC-Sophia, Rotterdam, The Netherlands, and Department of Pediatrics, UMC St. Radboud, Nijmegen, The Netherlands
| | - Theo M. Luider
- Department of Neurology, Laboratory of Neuro-Oncology and Clinical and Cancer Proteomics and Department of Virology, Erasmus MC, Rotterdam, The Netherlands, Department of Pediatrics, Division of Pediatric Infectious Diseases & Immunology, Erasmus MC-Sophia, Rotterdam, The Netherlands, and Department of Pediatrics, UMC St. Radboud, Nijmegen, The Netherlands
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van Kampen JJA, Verschuren EJ, Burgers PC, Luider TM, de Groot R, Osterhaus ADME, Gruters RA. Validation of an HIV-1 inactivation protocol that is compatible with intracellular drug analysis by mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2006; 847:38-44. [PMID: 17055786 DOI: 10.1016/j.jchromb.2006.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2006] [Revised: 09/27/2006] [Accepted: 10/01/2006] [Indexed: 11/28/2022]
Abstract
Mass spectrometry is a powerful tool for studying the intracellular pharmacokinetics of antiretroviral drugs. However, the biohazard of HIV-1 calls for a safety protocol for such analyses. To this end, we extracted HIV-1 producing cells with methanol or ethanol at 4 degrees C. After extraction, no viral infectivity was detected, as shown by a reduction in infectious titers of more than 6log. In addition, this protocol is compatible with the quantitative analysis of antiretroviral drugs in cell extracts using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) MS. Thus, using this protocol, infectious HIV-1 is inactivated and antiretroviral drugs are extracted from cells in a single step.
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Affiliation(s)
- Jeroen J A van Kampen
- Department of Neurology, Laboratory of Neuro-Oncology, Erasmus MC, Rotterdam, The Netherlands
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van Kampen JJA, Burgers PC, de Groot R, Luider TM. Qualitative and Quantitative Analysis of Pharmaceutical Compounds by MALDI-TOF Mass Spectrometry. Anal Chem 2006; 78:5403-11. [PMID: 16878875 DOI: 10.1021/ac060436i] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In this report, we discuss key issues for the successful application of MALDI-TOF mass spectrometry to quantify drugs. These include choice and preparation of matrix, nature of cationization agent, automation, and data analysis procedures. The high molecular weight matrix meso-tetrakis(pentafluorophenyl)porphyrin eliminates chemical noise in the low-mass range, a "brushing" spotting technique in combination with prestructured target plates enables fast preparation of homogeneous matrix crystals, and addition of Li+ leads to intense cationized drug species. Complex biological samples were cleaned up using a 96-well solid-phase extraction plate, and the purified samples were automatically spotted by a pipetting robot. To obtain a suitable data analysis procedure for the quantitative analysis of drugs by MALDI-TOF mass spectrometry, various data processing parameters were evaluated on our two model drugs lopinavir and ritonavir. Finally, and most importantly, it is shown that the above-described procedure can be successfully applied to quantify clinically relevant concentrations of lopinavir, an HIV protease inhibitor, in extracts of small numbers of peripheral blood mononuclear cells (1 x 10(6)).
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Affiliation(s)
- Jeroen J A van Kampen
- Department of Neurology, Laboratory of Neuro-Oncology, and Department of Pediatrics, Division of Pediatric Infectious Diseases & Immunology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
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Abstract
The initiation of antiretroviral therapy has resulted in an impressive reduction in the rate of disease progression in AIDS and HIV-1-related deaths in children; however, there are still several major challenges to be faced in order to improve therapy. A major topic that needs to be dealt with is the establishment of the optimal dosage of antiretroviral therapy for children. This review presents the currently available peer-reviewed data on the pharmacokinetics of nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs) and fusion inhibitors (FIs) in children. In addition, the data are discussed in relation to the currently available European and US guidelines and the US FDA-approved drug labels. High intra- and interpatient variability in pharmacokinetics are often observed for all antiretroviral drugs. The number of children included in the pharmacokinetic studies is often small and children are often divided into divergent groups using different dosage levels and/or drug formulations. For a substantial number of antiretroviral drugs, dosage recommendations, especially for young children, are still absent in the European and US guidelines. The recommended drug dosages in the guidelines are often different from that in the officially approved drug product label. In addition, the recommended drug dosages may deviate between the European and US guidelines. Thus, while practioners aim to meet the recommendations in the official guidelines, patients may receive highly divergent dosages of medication. The high intra- and interpatient variability in pharmacokinetics of antiretroviral drugs in children hampers the application of fixed dosages of antiretroviral drugs. For PIs and NNRTIs, plasma drug levels correlate with viral suppression and drug toxicity. NRTIs are prodrugs that are intracellularly converted to their active triphosphate form and, therefore, plasma NRTI levels correlate poorly with viral suppression. Therapeutic drug monitoring of PIs and NNRTIs should be considered to optimise HIV therapy in children.
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Affiliation(s)
- Pieter L A Fraaij
- Department of Pediatrics, Erasmus MC/Sophia Children's Hospital, Rotterdam, The Netherlands
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van Kampen JJA, Fraaij PLA, Hira V, van Rossum AMC, Hartwig NG, de Groot R, Luider TM. A new method for analysis of AZT-triphosphate and nucleotide-triphosphates. Biochem Biophys Res Commun 2004; 315:151-9. [PMID: 15013439 DOI: 10.1016/j.bbrc.2004.01.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2004] [Indexed: 11/21/2022]
Abstract
We have developed a new method based on matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry (MS) for analysis of zidovudine-triphosphate and (deoxy)nucleotide-triphosphates, which ultimately can be used for nucleoside reverse transcriptase inhibitor (NRTI) treatment monitoring in HIV-1 infected children and adults. Four different matrices were compared for sensitivity and reproducibility of zidovudine-triphosphate detection and anthranilic acid mixed with nicotinic acid (AA/NA) was selected as most suitable matrix. Solutions of zidovudine-triphosphate, ATP, and dGTP were detected up to 0.5fmol per sample. Furthermore, intracellular zidovudine-triphosphate, ATP, and dGTP were detected in peripheral blood mononuclear cells (PBMCs). Zidovudine-triphosphate, ATP, and dGTP yield identical mass spectra, however MALDI-TOF post-source decay analysis can be used for discrimination between these compounds. We conclude that this method based on MALDI-TOF MS can be used for analysis of intracellular zidovudine-triphosphate and (deoxy)nucleotide-triphosphates in PBMCs.
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Affiliation(s)
- Jeroen J A van Kampen
- Department of Paediatrics, Sophia Children's Hospital, Erasmus MC, Rotterdam, The Netherlands
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