Infectious Diseases Division, Massachusetts General Hospital, Boston, MA 02114, USA.
Nat Rev Nephrol. 2010 Dec;6(12):711-21. doi: 10.1038/nrneph.2010.141. Epub 2010 Oct 26.
Cytomegalovirus (CMV) infections are among the most common infections that occur following solid organ transplantation. CMV disease ranges from asymptomatic viremia, to CMV syndrome, to tissue-invasive disease. As CMV prophylaxis, treatment, diagnostics, and overall awareness have improved, the general trend has been towards earlier diagnosis of CMV disease and more mild clinical presentations in solid organ transplant recipients. Major stumbling blocks remain in the areas of duration of prophylaxis for the individual recipient, in the identification of which patients might need secondary prophylaxis, in the treatment of resistant virus, and in the possible use of the adoptive transfer of CMV-specific T cells. Several guidelines have been published during the past few years regarding the management of CMV in solid organ transplant recipients. This Review covers CMV diagnostics, methods for the prevention of CMV infection, treatment of both regular and drug-resistant CMV, as well as future directions for CMV management and research.
巨细胞病毒 (CMV) 感染是实体器官移植后最常见的感染之一。CMV 病从无症状病毒血症到 CMV 综合征再到组织侵袭性疾病不等。随着 CMV 预防、治疗、诊断和整体意识的提高，CMV 疾病的总体趋势是更早诊断和实体器官移植受者更轻微的临床表现。在个体受者的预防持续时间、确定哪些患者可能需要二级预防、治疗耐药病毒以及可能使用 CMV 特异性 T 细胞的过继转移等方面仍然存在重大障碍。在过去几年中，已经发布了几份关于实体器官移植受者中 CMV 管理的指南。这篇综述涵盖了 CMV 的诊断、预防 CMV 感染的方法、常规和耐药 CMV 的治疗，以及 CMV 管理和研究的未来方向。
