目前和新兴的抗病毒药物在儿科移植受者巨细胞病毒预防和治疗中的应用。
Current and Emerging Antiviral Agents in the Prevention and Treatment of Cytomegalovirus in Pediatric Transplant Recipients.
机构信息
Department of Pediatrics, Division of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA.
Division of Infectious Disease, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
出版信息
J Pediatric Infect Dis Soc. 2024 Feb 28;13(Supplement_1):S14-S21. doi: 10.1093/jpids/piad059.
Despite current prophylaxis regimens, cytomegalovirus (CMV) is common in hematopoietic cell transplantation (HCT) and solid organ transplantation (SOT) and remains a significant cause of morbidity and mortality. Newer antiviral medications are reshaping the landscape for prevention and treatment of CMV DNAemia, infection, and disease. Letermovir is approved for CMV prevention in adult HCT patients and is attractive due to the absence of marrow suppression seen with ganciclovir/valganciclovir. Letermovir should not be routinely used for CMV treatment due to its low threshold for resistance. Maribavir is approved for the treatment of refractory or resistant CMV disease in HCT and SOT recipients ≥12 years of age, though it has no current role in CMV prevention. More research is needed to fully elucidate the roles, efficacy, and safety of these newer agents in prevention and treatment of CMV in pediatric transplant recipients.
尽管目前有预防方案，但巨细胞病毒（CMV）在造血细胞移植（HCT）和实体器官移植（SOT）中很常见，仍然是发病率和死亡率的重要原因。较新的抗病毒药物正在改变 CMV DNA 血症、感染和疾病的预防和治疗格局。来特莫韦已获准用于成人 HCT 患者的 CMV 预防，因其无骨髓抑制作用而引人注目，与更昔洛韦/缬更昔洛韦相比。由于其耐药性的阈值较低，来特莫韦不应常规用于 CMV 治疗。马拉维若用于治疗 HCT 和 SOT 受者≥12 岁的难治性或耐药性 CMV 疾病，尽管它在 CMV 预防中没有作用。需要更多的研究来充分阐明这些新型药物在儿科移植受者中预防和治疗 CMV 的作用、疗效和安全性。
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