Management of Adenoviral Keratoconjunctivitis: Challenges and Solutions

Labib, Bisant A; Minhas, Bhawanjot K; Chigbu, DeGaulle I

The solution to these challenges led to the investigation of brincidofovir (BCV), a lipid-linked derivative of CDV, which allows for cells to uptake the drug more readily when administered orally. 13, 44, 55 Following cellular uptake, the lipid component is cleaved by phospholipases, leaving CDV. This allows for similar antiviral efficacy as seen with CDV, but without the subsequent nephrotoxicity. Averbuch et al. reported successful use of BCV in the treatment of adenoviral infection in a patient with primary immunodeficiency whereas Florescu et al demonstrated that it was clinically beneficial in treating adenoviral infection in immunocompromised individuals who were at risk of disseminated HAdV infection. 56 It was suggested that BCV could be a potential anti-adenoviral therapeutic agent. 57 Though this drug shows promise, there is still a need for more conclusive research regarding the effectivity and safety profile of BCV systemically, as well as its potential for the treatment of adenoviral ocular infections. Clinical development of this drug is ongoing, as there is yet to be an ophthalmic form. 13, 44 When antiviral comparison is made, ganciclovir appears to be the most favorable in terms of antiviral activity and limited systemic or local side effects. 46