{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T19:14:21Z","timestamp":1790795661086,"version":"4.1.0"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2022,3,7]],"date-time":"2022-03-07T00:00:00Z","timestamp":1646611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003061","name":"Erasmus Medical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003061","id-type":"DOI","asserted-by":"publisher"}]},{"name":"European Union\u2019s Horizon 2020 Research and Innovation Program","award":["643476"],"award-info":[{"award-number":["643476"]}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["PO1 AI057788"],"award-info":[{"award-number":["PO1 AI057788"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Immunocompromised individuals can become chronically infected with norovirus, but effective antiviral therapies are not yet available.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>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\u2013infection antiserum. In agreement, after administration of immunoglobulins, the patient cleared the infection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiac085","type":"journal-article","created":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T20:10:30Z","timestamp":1646424630000},"page":"1781-1789","source":"Crossref","is-referenced-by-count":36,"title":["Clinical and In Vitro Evidence Favoring Immunoglobulin Treatment of a Chronic Norovirus Infection in a Patient With Common Variable Immunodeficiency"],"prefix":"10.1093","volume":"226","author":[{"given":"Jeroen J A","family":"van Kampen","sequence":"first","affiliation":[{"name":"Department of Viroscience, Erasmus University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virgil A S H","family":"Dalm","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Erasmus University Medical Center , Rotterdam , the Netherlands"},{"name":"Department of Immunology, Erasmus University Medical Center , Rotterdam , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter L A","family":"Fraaij","sequence":"additional","affiliation":[{"name":"Department of Viroscience, Erasmus University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bas B","family":"Oude Munnink","sequence":"additional","affiliation":[{"name":"Department of Viroscience, Erasmus University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia M E","family":"Schapendonk","sequence":"additional","affiliation":[{"name":"Department of Viroscience, Erasmus University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ray W","family":"Izquierdo-Lara","sequence":"additional","affiliation":[{"name":"Department of Viroscience, Erasmus University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nele","family":"Villabruna","sequence":"additional","affiliation":[{"name":"Department of Viroscience, Erasmus University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalil","family":"Ettayebi","sequence":"additional","affiliation":[{"name":"Department of Molecular Virology and Microbiology, Baylor College of Medicine , Houston, Texas , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary K","family":"Estes","sequence":"additional","affiliation":[{"name":"Department of Molecular Virology and Microbiology, Baylor College of Medicine , Houston, Texas , USA"},{"name":"Department of Medicine, Baylor College of Medicine , Houston, Texas , 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