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肾移植后的病毒感染

Viral infections after kidney transplantation.

作者信息

Rostaing L, Wéclawiak H, Mengelle C, Kamar N

机构信息

Unit of Nephrology, Dialysis and Organ Translplantation, CHU Rangueil, Toulouse, France.

出版信息

Minerva Urol Nefrol. 2011 Mar;63(1):59-71.

Abstract

Chronic immunosuppression, required to maintain allograft function postorgan transplant, predisposes transplant patients to a variety of viral infections. These can occur at every stage of post-transplantation. Some infections, however, such as cytomegalovirus (CMV), Epstein Barr virus (EBV), or BK virus (BKV), tend to occur within months after transplantation. CMV infections can be easily prevented by prophylaxis therapy whereas EVB or BKV infections can be prevented by lowering (when possible) immunosuppression. Some viral infections can result in posttransplant lymphoproliferative disorders (EBV), Kaposi sarcoma (human herpes simplex virus type 8), or skin and/or cervical cancers (papillomavirus). Other viral infections, such as those due to influenza or para influenzae viruses, respiratory syncytial virus, or West nile fever virus, are mostly acquired through environmental spread. Thanks to modern laboratory technique, and a formidable antiviral armamentarium, viral infections in organ transplant patients i) can be easily detected at early stages, and ii) can be efficiently treated.

摘要

器官移植后为维持移植物功能而需要的慢性免疫抑制,使移植患者易患多种病毒感染。这些感染可发生在移植后的各个阶段。然而,一些感染,如巨细胞病毒(CMV)、爱泼斯坦-巴尔病毒(EBV)或BK病毒(BKV),往往在移植后数月内发生。CMV感染可通过预防性治疗轻松预防,而EBV或BKV感染可通过(尽可能)降低免疫抑制来预防。一些病毒感染可导致移植后淋巴细胞增生性疾病(EBV)、卡波西肉瘤(人疱疹病毒8型)或皮肤和/或宫颈癌(乳头瘤病毒)。其他病毒感染,如由流感或副流感病毒、呼吸道合胞病毒或西尼罗河热病毒引起的感染,大多通过环境传播获得。得益于现代实验室技术和强大的抗病毒药物库,器官移植患者的病毒感染:i)可以在早期轻松检测到,ii)可以得到有效治疗。

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