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Oral brincidofovir decreases the incidence of HHV-6B viremia after allogeneic HCT
- Source :
- Blood. 135(17)
- Publication Year :
- 2019
-
Abstract
- Human herpesvirus 6B (HHV-6B) frequently reactivates after allogeneic hematopoietic cell transplantation (HCT). There are no randomized studies of antiviral treatments to prevent HHV-6B reactivation. Brincidofovir has high in vitro activity against HHV-6B and other DNA viruses, but its in vivo activity for HHV-6B has not been demonstrated. We performed a post hoc analysis of a randomized controlled trial of twice-weekly oral brincidofovir for cytomegalovirus prophylaxis after allogeneic HCT to study the effect of brincidofovir on HHV-6B reactivation. We included patients randomized within 2 weeks of HCT and who received at least 6 consecutive doses of study drug after randomization. We tested plasma for HHV-6B through week 6 post-HCT. The cohort consisted of 92 patients receiving brincidofovir and 61 receiving placebo. The cumulative incidence of HHV-6B plasma detection through day 42 post-HCT was significantly lower among patients receiving brincidofovir (14.2%) compared with placebo (32.4%; log-rank, 0.019). In an adjusted Cox model, brincidofovir exposure remained associated with a lower hazard for HHV-6B plasma detection (hazard ratio, 0.40; 95% confidence interval, 0.20-0.80). In conclusion, brincidofovir prophylaxis reduced HHV-6B reactivation after allogeneic HCT in a post hoc analysis of a randomized controlled trial. These data support the study of intravenous brincidofovir for HHV-6B prophylaxis.
- Subjects :
- Male
viruses
medicine.medical_treatment
Herpesvirus 6, Human
Administration, Oral
Graft vs Host Disease
Hematopoietic stem cell transplantation
Biochemistry
Gastroenterology
law.invention
Cohort Studies
Randomized controlled trial
law
Medicine
Cumulative incidence
Randomized Controlled Trials as Topic
Incidence
Hazard ratio
Hematopoietic Stem Cell Transplantation
virus diseases
Hematology
Middle Aged
Viral Load
Prognosis
Hematologic Neoplasms
Female
medicine.drug
Adult
medicine.medical_specialty
Randomization
Adolescent
Immunology
Organophosphonates
Roseolovirus Infections
Brincidofovir
Placebo
Antiviral Agents
Cytosine
Young Adult
Internal medicine
Humans
Viremia
Aged
business.industry
Cell Biology
United States
Transplantation
DNA, Viral
Virus Activation
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 15280020
- Volume :
- 135
- Issue :
- 17
- Database :
- OpenAIRE
- Journal :
- Blood
- Accession number :
- edsair.doi.dedup.....2e94a23892a96863ef5499db5c4268b6