Journal of Clinical Immunology

, Volume 39, Issue 1, pp 112–117 | Cite as

Outcomes for Nitazoxanide Treatment in a Case Series of Patients with Primary Immunodeficiencies and Rubella Virus-Associated Granuloma

  • Ludmila Perelygina
  • David Buchbinder
  • Morna J. Dorsey
  • Marc Eloit
  • Fabian Hauck
  • Timo Hautala
  • Despina Moshous
  • Ignacio Uriarte
  • Elena Deripapa
  • Joseph Icenogle
  • Kathleen E. SullivanEmail author
Original Article



Nitazoxanide was recently reported as having in vitro effectiveness against the rubella virus. Immunodeficiency-related vaccine-derived rubella occurs in some patients who have an inherited immunodeficiency and who received the MMR vaccine. This study investigated the in vivo effectiveness of nitazoxanide therapy.


This is a retrospective analysis of seven patients treated with nitazoxanide as salvage therapy for immunodeficiency-related vaccine-derived rubella infection. The patients were recruited from an ongoing rubella detection surveillance project.


Seven patients with persistent rubella were treated with nitazoxanide and one demonstrated significant clinical improvement. Two additional patients exhibited diminished viral capsid production with one patient having transient slowing of progression. The cohort overall generally had low T cell counts and had a high burden of comorbidities. There were three deaths. Two deaths were from PML and one was related to hematopoietic stem cell transplantation.


Nitazoxanide has limited in vivo anti-viral effects for immunodeficiency-related vaccine-derived rubella. Most patients did not exhibit clinical improvement.


Granulomas chronic inflammation vaccine nitazoxanide MMR 



This study was supported by the Wallace Chair of Pediatrics and the CDC.

Compliance with Ethical Standards


The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention, US Department of Health and Human Services.

Conflict of Interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Ludmila Perelygina
    • 1
  • David Buchbinder
    • 2
  • Morna J. Dorsey
    • 3
  • Marc Eloit
    • 4
  • Fabian Hauck
    • 5
  • Timo Hautala
    • 6
  • Despina Moshous
    • 7
    • 8
  • Ignacio Uriarte
    • 9
  • Elena Deripapa
    • 10
  • Joseph Icenogle
    • 1
  • Kathleen E. Sullivan
    • 11
    Email author
  1. 1.Division of Viral DiseasesCenters for Disease Control and PreventionAtlantaUSA
  2. 2.Division of HematologyCHOC Children’s HospitalOrangeUSA
  3. 3.Department of Pediatrics, Division of Allergy, Immunology, and Blood and Marrow Transplant, Benioff Children’s HospitalUniversity of CaliforniaSan FranciscoUSA
  4. 4.Institut Pasteur, Laboratory of Pathogen DiscoveryBiology of Infection UnitParisFrance
  5. 5.Department of Pediatrics, Dr. von Hauner Children’s HospitalUniversity HospitalMunichGermany
  6. 6.Research Unit of Internal MedicineUniversity of Oulu and Oulu University HospitalOuluFinland
  7. 7.Department of Pediatric Immunology, Hematology and Rheumatology, Assistance Publique-Hôpitaux de Paris (AP-HP)Necker Children’s HospitalParisFrance
  8. 8.Laboratory “Genome Dynamics in The Immune System,” INSERM UMR1163Université Paris Descartes Sorbonne Paris Cité, Institut ImagineParisFrance
  9. 9.Immunology Unit, The Child’s and Mother Hospital, Vitorio Tetamanti, High School of MedicineMar del Plata National UniversityBuenos AiresArgentina
  10. 10.Department of ImmunologyCenter for Pediatric Hematology, Oncology, ImmunologyMoscowRussia
  11. 11.Division of Allergy Immunology, The Children’s Hospital of PhiladelphiaUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaUSA

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