A Scoping Review of Arthropod-Borne Flavivirus Infections in Solid Organ Transplant Recipients.

IF 2.6 4区医学 Q3 IMMUNOLOGY

Transplant Infectious Disease Pub Date : 2024-11-04 DOI:10.1111/tid.14400

Seohyeon Im, Fadie Altuame, Isabel H Gonzalez-Bocco, Cilomar Martins de Oliveira Filho, Andrea Goldstein Shipper, Maricar Malinis, Carlo Foppiano Palacios

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引用次数: 0

Abstract

Arthropod-borne flaviviruses (ABFs), transmitted by mosquitoes or ticks, are increasing due to climate change and globalization. This scoping review examines the epidemiology, clinical characteristics, diagnostics, treatment, and outcomes of ABF infection in solid organ transplant recipients (SOTRs). A database search up to January 25, 2024, focused on ABFs such as West Nile virus (WNV), dengue virus (DENV), Japanese encephalitis virus (JEV), Powassan virus (POWV), yellow fever virus (YFV), and Zika virus (ZIKV), limited to SOTRs. We identified 173 WNV cases from 84 studies, with 28 donor-derived infections (DDIs). Common clinical features included fever (78.5%), altered mental status (65.1%), and weakness or paralysis (45.6%). Treatment involved reducing immunosuppression (IS) in 93 cases, with intravenous immunoglobulin (IVIG), interferon alfa-2b, and ribavirin used in 75 cases. Seven cases involved graft loss or rejection post-infection. WNV infection had a 23.7% mortality rate, with severe neurological complications in 43.9% For DENV infection, 386 cases from 47 studies were identified, including 14 DDI cases. Symptoms included fever (85%), myalgias (56.4%), and headache or retro-orbital pain (34.6%). Severe dengue occurred in 50 cases (13.0%). IVIG was administered in six cases. Reduction in IS was reported in 116 patients. DENV mortality rate was 4.9%. Additionally, 26 cases of less common ABFs such as JEV, POWV, YFV, and ZIKV were described. In summary, ABF infections among SOTRs are associated with higher morbidity and mortality compared to the general population, emphasizing the need for improved preventive strategies, timely diagnosis, and optimized management protocols.

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关于实体器官移植受者中节肢动物传播的黄热病病毒感染的范围界定综述。

由于气候变化和全球化，由蚊子或蜱虫传播的节肢动物黄病毒（ABF）日益增多。本范围综述研究了实体器官移植受者（SOTRs）感染 ABF 的流行病学、临床特征、诊断、治疗和结果。截至 2024 年 1 月 25 日的数据库检索主要针对 ABF，如西尼罗河病毒 (WNV)、登革热病毒 (DENV)、日本脑炎病毒 (JEV)、波瓦桑病毒 (POWV)、黄热病病毒 (YFV) 和寨卡病毒 (ZIKV)，且仅限于 SOTR。我们从 84 项研究中发现了 173 例 WNV 病例，其中 28 例为供体源性感染 (DDI)。常见的临床特征包括发热（78.5%）、精神状态改变（65.1%）、虚弱或瘫痪（45.6%）。93例病例的治疗涉及减少免疫抑制（IS），75例病例使用了静脉注射免疫球蛋白（IVIG）、α-2b干扰素和利巴韦林。有 7 例患者在感染后出现移植物丢失或排斥反应。WNV感染的死亡率为23.7%，其中43.9%出现严重的神经系统并发症 DENV感染方面，47项研究共发现了386例病例，其中包括14例DDI病例。症状包括发热（85%）、肌痛（56.4%）、头痛或眶后疼痛（34.6%）。严重登革热病例有 50 例（13.0%）。6 例病例注射了 IVIG。据报告，116 名患者的 IS 有所减轻。DENV 死亡率为 4.9%。此外，还描述了 26 例较少见的 ABF，如 JEV、POWV、YFV 和 ZIKV。总之，与普通人群相比，SOTRs 中的 ABF 感染与更高的发病率和死亡率相关，这强调了改进预防策略、及时诊断和优化管理方案的必要性。

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

Transplant Infectious Disease 医学-传染病学

CiteScore

5.30

自引率

7.70%

发文量

210

审稿时长

4-8 weeks

期刊介绍： Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal. Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.