Division of Infectious Diseases.
Division of Infection Control and Hospital Epidemiology, Geneva University Hospitals, Geneva, Switzerland.
Curr Opin Infect Dis. 2023 Aug 1;36(4):243-249. doi: 10.1097/QCO.0000000000000928. Epub 2023 May 31.
Allogeneic hematopoietic cell transplantation (allogeneic HCT) is a highly effective therapy for a broad range of hematological diseases and its use is increasing worldwide. Despite advances in antiviral prophylaxis and treatment, viral infections are still one of the leading causes of post-HCT morbidity and mortality. In this patient population, metagenomic next-generation sequencing (mNGS) revealed a much larger diversity of viruses than previously suspected via the targeted screening approach. In the context of profound immunosuppression, these viral infections may cause transient viremia or protracted replication and potentially be associated with yet unrecognized or unspecific clinical manifestations. On the contrary, by constantly interacting with the immune system, viral infections may have a significant impact on posttransplant outcomes. Here, we review the latest advances in research assessing the role of the blood virome in the development of post-HCT complications.
Research efforts are under way to uncover the potential role of several previously undetected viruses in the development of allogeneic HCT complications and their impact on transplant outcomes.
The identification of viral actors impacting post-HCT morbidity and survival is key to optimize monitoring and infection prevention/treatment strategies.
异基因造血细胞移植（allogeneic HCT）是治疗多种血液系统疾病的有效方法，其应用正在全球范围内不断增加。尽管抗病毒预防和治疗取得了进展，但病毒感染仍然是移植后发病率和死亡率的主要原因之一。在这一患者群体中，宏基因组下一代测序（mNGS）比以前通过靶向筛查方法所怀疑的要揭示出更多种类的病毒。在严重免疫抑制的情况下，这些病毒感染可能会导致短暂的病毒血症或持续复制，并可能与尚未认识到或非特异性的临床表现相关。相反，病毒感染通过与免疫系统不断相互作用，可能对移植后结局产生重大影响。在这里，我们回顾了评估血液病毒组在移植后并发症发展中的作用的最新研究进展。
目前正在努力揭示几种以前未检测到的病毒在异基因 HCT 并发症发展及其对移植结局的影响中的潜在作用。
确定影响移植后发病率和生存率的病毒因子是优化监测和感染预防/治疗策略的关键。
