BRIEF REPORT| APRIL 23, 2020
Oral brincidofovir decreases the incidence of HHV-6B viremia after allogeneic HCTJoshua A. Hill, W. Garrett Nichols, Francisco M. Marty, Genovefa A. Papanicolaou, Thomas M. Brundage, Randall Lanier, Danielle M. Zerr, Michael J. Boeckh
Blood (2020) 135 (17): 1447–1451.
https://doi.org/10.1182/blood.2019004315
Key PointsProphylactic brincidofovir reduced the incidence and magnitude of plasma HHV-6B detection after allogeneic HCT.
Prophylactic brincidofovir may reduce the morbidity associated with HHV-6B in HCT recipients.
AbstractHuman 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:
Brief Reports, Clinical Trials and Observations, Transplantation
Topics:
allogeneic hematopoietic stem cell transplant, brincidofovir, hematopoietic stem cell transplantation, viremia, cytomegalovirus, herpesviridae, simplexvirus
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