University of New South Wales Research Laboratories, Randwick, Australia.
Clin Infect Dis. 2013 Apr;56(7):1018-29. doi: 10.1093/cid/cis1035. Epub 2012 Dec 12.
Despite advances in the prophylaxis and acute treatment of cytomegalovirus (CMV), it remains an important pathogen affecting the short- and long-term clinical outcome of solid organ transplant. The emergence of CMV resistance in a patient reduces the clinical efficacy of antiviral therapy, complicates therapeutic and clinical management decisions, and in some cases results in loss of the allograft and/or death of the patient. There is increasing use of antiviral prophylaxis after transplant with little expansion in the range of antiviral agents effective in treatment of CMV. Further understanding is needed of the risk factors for development of CMV antiviral resistance and of therapeutic strategies for treating patients infected with resistant viruses. We review the current status of CMV resistance in solid organ transplant recipients, and provide diagnostic and therapeutic suggestions for the clinician in managing antiviral resistance.
尽管在巨细胞病毒 (CMV) 的预防和急性治疗方面取得了进展，但它仍然是影响实体器官移植患者短期和长期临床结果的重要病原体。患者出现 CMV 耐药性会降低抗病毒治疗的临床疗效，使治疗和临床管理决策变得复杂，并在某些情况下导致移植物丢失和/或患者死亡。移植后抗病毒预防的使用越来越多，但在治疗 CMV 方面有效的抗病毒药物范围并没有扩大。需要进一步了解 CMV 抗病毒耐药性发展的危险因素，以及治疗感染耐药病毒患者的治疗策略。我们回顾了实体器官移植受者中 CMV 耐药性的现状，并为临床医生管理抗病毒耐药性提供了诊断和治疗建议。
