Kim Yae-Jean, Boeckh Michael, Englund Janet A
Division of Infectious Diseases, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Semin Respir Crit Care Med. 2007 Apr;28(2):222-42. doi: 10.1055/s-2007-976494.
Infection is the leading cause of morbidity and mortality in immunocompromised patients such as hematopoietic/solid organ transplant recipients and individuals with human immunodeficiency virus. Community respiratory virus infections are increasingly recognized as a significant threat to these patients. This article reviews current information in the clinical field of community respiratory viruses, including several newly discovered respiratory viruses. Respiratory syncytial virus, influenza viruses, parainfluenza viruses, and adenoviruses cause the most serious disease in immunocompromised hosts, but other respiratory viruses are becoming increasingly appreciated as a cause of both upper and lower respiratory tract disease. The clinical impact of these new viruses, including human metapneumovirus, non-SARS human coronaviruses, and human bocavirus, is not yet clear. Modern molecular technology has made the discovery of new viruses possible; the use of these new technologies in direct patient care is not yet standard but is becoming increasingly utilized. Clinicians should appreciate the potential for the development of antiviral resistance to influenza antivirals in immunocompromised patients.
感染是免疫功能低下患者发病和死亡的主要原因，如造血/实体器官移植受者以及感染人类免疫缺陷病毒的个体。社区呼吸道病毒感染日益被视为对这些患者的重大威胁。本文综述了社区呼吸道病毒临床领域的当前信息，包括几种新发现的呼吸道病毒。呼吸道合胞病毒、流感病毒、副流感病毒和腺病毒在免疫功能低下宿主中引起最严重的疾病，但其他呼吸道病毒作为上呼吸道和下呼吸道疾病的病因也越来越受到重视。这些新病毒，包括人偏肺病毒、非SARS人类冠状病毒和人博卡病毒的临床影响尚不清楚。现代分子技术使发现新病毒成为可能；这些新技术在直接患者护理中的应用尚未成为标准，但正越来越多地被使用。临床医生应认识到免疫功能低下患者对抗流感抗病毒药物产生耐药性的可能性。
