移植受者感染诺如病毒

IF 3.1 4区 医学 Q2 INFECTIOUS DISEASES
Matthew Ringer, Maricar Malinis
{"title":"移植受者感染诺如病毒","authors":"Matthew Ringer, Maricar Malinis","doi":"10.1007/s11908-024-00842-y","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose of Review</h3><p>Norovirus is a leading cause of diarrhea in transplant recipients. Norovirus can cause a severe acute syndrome in this patient population. Transplant recipients can also develop a chronic diarrheal syndrome with associated frailty, prolonged viral shedding, hospitalizations, and rejection, with associated mortality. Despite the significant burden of disease and improved diagnostics, there are no specific treatments to target norovirus. We aim to review the virology, epidemiology, diagnosis, clinical presentation, management, and prevention of norovirus.</p><h3 data-test=\"abstract-sub-heading\">Recent Findings</h3><p>A recent retrospective observational study included nine solid organ transplant recipients (5 kidneys, 2 kidney-pancreas, 1 heart, and 1 lung) with chronic norovirus (median duration of diarrhea 12 weeks). Six of these nine patients demonstrated resolution of diarrhea at hospital discharge after oral human immune globulin. A recent phase II randomized controlled trial including solid organ transplant and bone marrow transplant recipients with norovirus compared nitazoxanide with placebo. Nitazoxanide did not demonstrate improved time to resolution of symptoms or duration of viral shedding but may have resulted in transient symptom improvement.</p><h3 data-test=\"abstract-sub-heading\">Summary</h3><p>Norovirus causes significant morbidity and mortality in transplant recipients. Although there are no approved treatment options, there are multiple strategies available, including supportive care, reduction in immunosuppression, intravenous immunoglobulin (IVIG), oral human immune globulin (OHIG), vitamin A, ribavirin, nitazoxanide, and the use of mammalian target of rapamycin (mTOR) inhibitors. Randomized controlled trials are needed to better study these strategies and prevention through the development of a universally available vaccine.</p>","PeriodicalId":48839,"journal":{"name":"Current Infectious Disease Reports","volume":null,"pages":null},"PeriodicalIF":3.1000,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Norovirus Infection in Transplant Recipients\",\"authors\":\"Matthew Ringer, Maricar Malinis\",\"doi\":\"10.1007/s11908-024-00842-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Purpose of Review</h3><p>Norovirus is a leading cause of diarrhea in transplant recipients. Norovirus can cause a severe acute syndrome in this patient population. Transplant recipients can also develop a chronic diarrheal syndrome with associated frailty, prolonged viral shedding, hospitalizations, and rejection, with associated mortality. Despite the significant burden of disease and improved diagnostics, there are no specific treatments to target norovirus. We aim to review the virology, epidemiology, diagnosis, clinical presentation, management, and prevention of norovirus.</p><h3 data-test=\\\"abstract-sub-heading\\\">Recent Findings</h3><p>A recent retrospective observational study included nine solid organ transplant recipients (5 kidneys, 2 kidney-pancreas, 1 heart, and 1 lung) with chronic norovirus (median duration of diarrhea 12 weeks). Six of these nine patients demonstrated resolution of diarrhea at hospital discharge after oral human immune globulin. A recent phase II randomized controlled trial including solid organ transplant and bone marrow transplant recipients with norovirus compared nitazoxanide with placebo. Nitazoxanide did not demonstrate improved time to resolution of symptoms or duration of viral shedding but may have resulted in transient symptom improvement.</p><h3 data-test=\\\"abstract-sub-heading\\\">Summary</h3><p>Norovirus causes significant morbidity and mortality in transplant recipients. Although there are no approved treatment options, there are multiple strategies available, including supportive care, reduction in immunosuppression, intravenous immunoglobulin (IVIG), oral human immune globulin (OHIG), vitamin A, ribavirin, nitazoxanide, and the use of mammalian target of rapamycin (mTOR) inhibitors. Randomized controlled trials are needed to better study these strategies and prevention through the development of a universally available vaccine.</p>\",\"PeriodicalId\":48839,\"journal\":{\"name\":\"Current Infectious Disease Reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2024-05-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Infectious Disease Reports\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11908-024-00842-y\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Infectious Disease Reports","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11908-024-00842-y","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

摘要

综述目的 诺如病毒是导致移植受者腹泻的主要原因。诺罗病毒可在这一患者群体中引发严重的急性综合征。移植受者也可能患上慢性腹泻综合征,并伴有虚弱、病毒长期脱落、住院和排斥反应以及相关的死亡率。尽管疾病负担沉重,诊断方法也有所改进,但目前还没有针对诺如病毒的特殊治疗方法。我们旨在回顾诺如病毒的病毒学、流行病学、诊断、临床表现、管理和预防。最近的研究结果 最近的一项回顾性观察研究纳入了 9 名患有慢性诺如病毒的实体器官移植受者(5 名肾脏、2 名肾胰脏、1 名心脏和 1 名肺)(中位腹泻持续时间为 12 周)。这九名患者中有六名在口服人免疫球蛋白后,出院时腹泻症状得到缓解。最近进行的一项 II 期随机对照试验比较了硝唑沙尼和安慰剂的疗效,试验对象包括患有诺如病毒的实体器官移植和骨髓移植受者。尼他唑嗪类药物并没有改善症状缓解的时间或病毒脱落的持续时间,但可能会导致短暂的症状改善。虽然目前还没有获得批准的治疗方案,但有多种策略可供选择,包括支持性护理、减少免疫抑制、静脉注射免疫球蛋白 (IVIG)、口服人免疫球蛋白 (OHIG)、维生素 A、利巴韦林、硝氮杂酰胺以及使用哺乳动物雷帕霉素靶点 (mTOR) 抑制剂。需要进行随机对照试验,以更好地研究这些策略和通过开发普遍可用的疫苗进行预防。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Norovirus Infection in Transplant Recipients

Purpose of Review

Norovirus is a leading cause of diarrhea in transplant recipients. Norovirus can cause a severe acute syndrome in this patient population. Transplant recipients can also develop a chronic diarrheal syndrome with associated frailty, prolonged viral shedding, hospitalizations, and rejection, with associated mortality. Despite the significant burden of disease and improved diagnostics, there are no specific treatments to target norovirus. We aim to review the virology, epidemiology, diagnosis, clinical presentation, management, and prevention of norovirus.

Recent Findings

A recent retrospective observational study included nine solid organ transplant recipients (5 kidneys, 2 kidney-pancreas, 1 heart, and 1 lung) with chronic norovirus (median duration of diarrhea 12 weeks). Six of these nine patients demonstrated resolution of diarrhea at hospital discharge after oral human immune globulin. A recent phase II randomized controlled trial including solid organ transplant and bone marrow transplant recipients with norovirus compared nitazoxanide with placebo. Nitazoxanide did not demonstrate improved time to resolution of symptoms or duration of viral shedding but may have resulted in transient symptom improvement.

Summary

Norovirus causes significant morbidity and mortality in transplant recipients. Although there are no approved treatment options, there are multiple strategies available, including supportive care, reduction in immunosuppression, intravenous immunoglobulin (IVIG), oral human immune globulin (OHIG), vitamin A, ribavirin, nitazoxanide, and the use of mammalian target of rapamycin (mTOR) inhibitors. Randomized controlled trials are needed to better study these strategies and prevention through the development of a universally available vaccine.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Current Infectious Disease Reports
Current Infectious Disease Reports INFECTIOUS DISEASES-
CiteScore
6.70
自引率
0.00%
发文量
19
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of infectious disease. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as HIV/AIDS, sexually transmitted diseases, tropical and travel medicine, and urinary tract infections. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信