Recent advances in cytomegalovirus infection management in solid organ transplant recipients.

IF 1.8 4区医学 Q3 TRANSPLANTATION

Current Opinion in Organ Transplantation Pub Date : 2024-04-01 Epub Date: 2024-01-30 DOI:10.1097/MOT.0000000000001139

Paolo Antonio Grossi, Maddalena Peghin

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引用次数: 0

Abstract

Purpose of review: Human cytomegalovirus (CMV) continues to be the most important infectious complication following solid organ transplantation (SOT).

Recent findings: Universal prophylaxis and preemptive therapy are the most adopted strategies for prevention of CMV disease globally. Prophylaxis with valganciclovir is the most widely used approach to CMV prevention, however leukopenia and late onset CMV disease after discontinuation of prophylaxis requires new strategies to prevent this complication. The use of assays detecting CMV-specific T cell-mediated immunity may individualize the duration of antiviral prophylaxis after transplantation. Letermovir has been recently approved for prophylaxis in kidney transplant recipients. CMV-RNAemia used together with CMV-DNAemia in the viral surveillance of CMV infection provides accurate information on viral load kinetics, mostly in patients receiving letermovir prophylaxis/therapy. The development of refractory and resistant CMV infection remains a major challenge and a new treatment with maribavir is currently available. In the present paper we will review the most recent advances in prevention and treatment of CMV diseases in SOT recipients.

Summary: Recent findings, summarized in the present paper, may be useful to optimize prevention and treatment of CMV infection in SOT.

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实体器官移植受者巨细胞病毒感染管理的最新进展。

综述目的：人类巨细胞病毒（CMV）仍然是实体器官移植（SOT）后最重要的感染性并发症：在全球范围内，普遍预防和先期治疗是预防CMV疾病最常用的策略。使用缬更昔洛韦进行预防是预防 CMV 最广泛使用的方法，但在停止预防后出现的白细胞减少和晚发 CMV 病需要新的策略来预防这种并发症。使用检测 CMV 特异性 T 细胞介导免疫的化验方法可以个性化地确定移植后抗病毒预防的持续时间。Letermovir 最近已被批准用于肾移植受者的预防。在 CMV 感染的病毒监测中，CMV-RNAemia 与 CMV-DNAemia 可提供病毒载量动力学的准确信息，主要是在接受来特莫韦预防/治疗的患者中。难治性和耐药性 CMV 感染的发展仍然是一项重大挑战，目前已有一种使用马立巴韦的新疗法。本文将回顾在预防和治疗 SOT 受者 CMV 疾病方面取得的最新进展：本文总结的最新研究结果可能有助于优化 SOT 中 CMV 感染的预防和治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Organ Transplantation 医学-移植

CiteScore

4.10

自引率

4.50%

发文量

124

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Organ Transplantation is an indispensable resource featuring key, up-to-date and important advances in the field from around the world. Led by renowned guest editors for each section, every bimonthly issue of Current Opinion in Organ Transplantation delivers a fresh insight into topics such as stem cell transplantation, immunosuppression, tolerance induction and organ preservation and procurement. With 18 sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, surgeons and other healthcare professionals alike.