Shahani Lokesh, Ariza-Heredia Ella J, Chemaly Roy F
a McGovern Medical School , The University of Texas Health Science Center at Houston , Houston , TX , USA.
b Department of Infectious Diseases, Infection Control and Employee Health , The University of Texas MD Anderson Cancer Center , Houston , TX , USA.
Expert Rev Anti Infect Ther. 2017 Apr;15(4):401-415. doi: 10.1080/14787210.2017.1279970. Epub 2017 Jan 16.
Respiratory viruses (influenza, parainfluenza, respiratory syncytial virus, coronavirus, human metapneumovirus, and rhinovirus) represent the most common causes of respiratory viral infections in immunocompromised patients. Also, these infections may be more severe in immunocompromised patients than in the general population. Early diagnosis and treatment of viral infections continue to be of paramount importance in immunocompromised patients; because once viral replication and invasive infections are evident, prognosis can be grave. Areas covered: The purpose of this review is to provide an overview of the main antiviral agents used for the treatment of respiratory viral infections in immunocompromised patients and review of the new agents in the pipeline. Expert commentary: Over the past decade, important diagnostic advances, specifically, the use of rapid molecular testing has helped close the gap between clinical scenarios and pathogen identification and enhanced early diagnosis of viral infections and understanding of the role of prolonged shedding and viral loads. Advancements in novel antiviral therapeutics with high resistance thresholds and effective immunization for preventable infections in immunocompromised patients are needed.
呼吸道病毒(流感病毒、副流感病毒、呼吸道合胞病毒、冠状病毒、人偏肺病毒和鼻病毒)是免疫功能低下患者呼吸道病毒感染最常见的病因。此外,这些感染在免疫功能低下患者中可能比在普通人群中更严重。病毒感染的早期诊断和治疗对免疫功能低下患者仍然至关重要;因为一旦病毒复制和侵袭性感染明显,预后可能很严重。涵盖领域:本综述的目的是概述用于治疗免疫功能低下患者呼吸道病毒感染的主要抗病毒药物,并综述正在研发的新药物。专家评论:在过去十年中,重要的诊断进展,特别是快速分子检测的应用,有助于缩小临床情况与病原体鉴定之间的差距,并加强病毒感染的早期诊断,以及对病毒长期脱落和病毒载量作用的理解。需要开发具有高耐药阈值的新型抗病毒疗法,并为免疫功能低下患者的可预防感染进行有效免疫接种。