Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Curr Opin Infect Dis. 2018 Dec;31(6):542-552. doi: 10.1097/QCO.0000000000000503.
In hematopoietic cell transplant (HCT) recipients, paramyxovirus infections are major viral respiratory tract infections that, if they progress to lower respiratory tract infections, are associated with reduced survival rates in this population. There are important knowledge gaps regarding treatment decisions for HCT recipients with these infections and in the identification of risk factors that predict infection severity. Here, we review recent data on paramyxovirus infections in HCT recipients focusing on risk factors, new diagnostic and prognostic tools, and management including new drugs and vaccines under development.
Multiplexed molecular assays associated with immunodeficiency scoring index for respiratory syncytial virus (RSV) have improved our understanding of the epidemiology of RSV and other paramyxovirus infections and the risk factors for worse outcomes. Novel antiviral drugs, monoclonal antibodies, and vaccines are under evaluation with mixed preliminary results.
Advances in our knowledge of paramyxovirus infections in HCT recipients in the last two decades contributed to better strategies for management and prevention of these infections. A widespread understanding of how to stratify HCT recipients with paramyxovirus infections who would benefit most from antiviral therapy remains to be ascertained. Vaccines and new drugs under development may mitigate the burden of paramyxovirus infections.
在造血细胞移植（HCT）受者中，副黏病毒感染是主要的病毒性呼吸道感染，如果发展为下呼吸道感染，与该人群的生存率降低有关。关于这些感染的 HCT 受者的治疗决策以及预测感染严重程度的危险因素，存在重要的知识空白。在此，我们复习了有关 HCT 受者副黏病毒感染的最新数据，重点关注危险因素、新的诊断和预后工具以及包括正在开发的新药和疫苗在内的治疗管理。
与免疫缺陷评分指数相关的呼吸道合胞病毒（RSV）多重分子检测提高了我们对 RSV 和其他副黏病毒感染的流行病学以及不良结局危险因素的认识。新型抗病毒药物、单克隆抗体和疫苗正在评估中，初步结果喜忧参半。
在过去二十年中，我们对 HCT 受者副黏病毒感染的认识不断提高，有助于制定更好的管理和预防这些感染的策略。如何确定最受益于抗病毒治疗的 HCT 受者分层，这方面仍有待广泛了解。正在开发的疫苗和新药可能会减轻副黏病毒感染的负担。
