Gondo H
First Department of Internal Medicine, Faculty of Medicine, Kyushu University.
Nihon Rinsho. 1998 Jan;56(1):173-8.
Cytomegalovirus (CMV) is the most important infectious agent in transplant recipients. The critical step in the pathogenesis of CMV infection is the reactivation of latent virus, which is affected by the immunosuppressive therapy and/or alloantigenic stimulation. The clinical effects of CMV infection include CMV disease (syndrome), an immunosuppressed state, and allograft injury. Recently, the incidence of serious CMV diseases after transplant has been decreased, probably due to the advance in the method for rapid diagnosis, the ganciclovir administration, and the effective prevention of CMV diseases. Seronegative or filtered blood products, CMV immune globulin, and prophylactic or preemptive therapy with ganciclovir appear contribute to the improvement in the prophylaxis for CMV diseases after transplant. Antigenemia-guided early treatment may be promising for the effective prevention of CMV diseases after transplant.
巨细胞病毒（CMV）是移植受者最重要的感染源。CMV感染发病机制的关键步骤是潜伏病毒的重新激活，这受到免疫抑制治疗和/或同种异体抗原刺激的影响。CMV感染的临床影响包括CMV疾病（综合征）、免疫抑制状态和同种异体移植损伤。最近，移植后严重CMV疾病的发生率有所下降，这可能归因于快速诊断方法的进步、更昔洛韦的应用以及CMV疾病的有效预防。血清学阴性或经过滤的血液制品、CMV免疫球蛋白以及更昔洛韦的预防性或抢先性治疗似乎有助于改善移植后CMV疾病的预防。抗原血症引导的早期治疗对于有效预防移植后CMV疾病可能很有前景。
