Razonable Raymund R, Paya Carlos V
Division of Infectious Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Herpes. 2003 Dec;10(3):60-5.
Herpesvirus infections are common causes of morbidity and mortality in solid organ and haematopoietic stem cell transplant recipients. Significant scientific breakthroughs have reduced the incidence of herpesvirus infections during the early post-transplant period, but herpesvirus infections continue to impact significantly on the outcome of transplantation. Widespread and prolonged use of antiviral drugs has not eliminated the risk of cytomegalovirus (CMV) disease, but has changed its natural course by delaying its onset. Moreover, there is now increased recognition of ganciclovir (and other antiviral drug)-resistant CMV infections. By contrast, optimal preventive and treatment strategies for Epstein-Barr virus-related post-transplant lymphoproliferative disorders (PTLD) remain elusive. Recent experimental and clinical data, however, demonstrate a promising role for immunotherapy in preventing and treating PTLD. This review highlights the current challenges in managing CMV and Epstein-Barr virus infections in transplant patients.
疱疹病毒感染是实体器官和造血干细胞移植受者发病和死亡的常见原因。重大科学突破降低了移植后早期疱疹病毒感染的发生率，但疱疹病毒感染仍对移植结局有重大影响。抗病毒药物的广泛和长期使用并未消除巨细胞病毒（CMV）疾病的风险，但通过延迟其发病改变了其自然病程。此外，现在对更昔洛韦（及其他抗病毒药物）耐药的CMV感染的认识有所增加。相比之下，针对爱泼斯坦-巴尔病毒相关的移植后淋巴组织增生性疾病（PTLD）的最佳预防和治疗策略仍不明确。然而，最近的实验和临床数据表明免疫疗法在预防和治疗PTLD方面具有广阔前景。本综述重点介绍了移植患者中管理CMV和爱泼斯坦-巴尔病毒感染的当前挑战。
