Machová Jana, Reischig Tomáš
Vnitr Lek. 2017 Fall;63(7-8):488-497.
Viral infections are among the most common infectious complications affecting transplant recipients. Due to immunosuppressive therapy predominantly affecting cellular immunity and thus successfully reducing the incidence of acute rejection, there is a higher incidence of viral infections. Herpesviruses and polyomaviruses are ubiquitous pathogens which have the ability to persist in a state of latent infection. In addition to post-transplant reactivation, donor-induced primoinfection can also occur, leading to increased morbidity and contributing to decreased survival of patients. Moreover, there are long-term indirect effects, resulting in an impaired function of the transplanted organs and their premature loss. This article provides a brief overview of infections which have the greatest impact on transplant recipients, i.e. cytomegalovirus and BK polyomavirus, their diagnosis, prevention and treatment.Key words: BK virus - cytomegalovirus - ganciclovir - immunosuppressive therapy - JC virus - kidney transplantation - polyomavirus - polyomavirus-associated nephropathy - preemptive therapy - prophylaxis - valaciclovir.
病毒感染是影响移植受者的最常见感染性并发症之一。由于免疫抑制疗法主要影响细胞免疫,从而成功降低了急性排斥反应的发生率,病毒感染的发生率更高。疱疹病毒和多瘤病毒是普遍存在的病原体,它们能够以潜伏感染的状态持续存在。除了移植后再激活外,还可能发生供体诱导的原发性感染,导致发病率增加并导致患者生存率降低。此外,还存在长期间接影响,导致移植器官功能受损及其过早丧失。本文简要概述了对移植受者影响最大的感染,即巨细胞病毒和BK多瘤病毒、它们的诊断、预防和治疗。关键词:BK病毒 - 巨细胞病毒 - 更昔洛韦 - 免疫抑制疗法 - JC病毒 - 肾移植 - 多瘤病毒 - 多瘤病毒相关性肾病 - 抢先治疗 - 预防 - 伐昔洛韦