造血干细胞移植患者巨细胞病毒感染的十大常见问题。

Clinical Hematology International Pub Date : 2023-03-01 Epub Date: 2022-12-29 DOI:10.1007/s44228-022-00025-3
Johnny Zakhour, Fatima Allaw, Sara F Haddad, Souha S Kanj
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引用次数: 0

摘要

随着接受造血干细胞移植(HSCT)的患者人数不断增加,临床医生更有可能遇到免疫受损宿主的感染并发症,尤其是巨细胞病毒(CMV)感染。除了CMV终末器官疾病的高死亡率外,检测到CMV病毒血症的患者即使没有终末器官疾病,其预后也可能较差,存活率也可能下降。鉴于 CMV 对发病率和死亡率的影响,临床医生应保持高度怀疑,并在确诊 CMV 感染后及时启动抗病毒药物。应识别高危患者,以便提供最佳治疗方案。此外,目前已有安全性好、不良反应小的新型抗病毒药物可用于高危患者的预防以及耐药或难治性 CMV 感染的治疗。以下综述就该人群中 CMV 的负担和风险因素提供了简明而全面的指导,并更新了 CMV 感染管理的最新证据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Ten Most Common Questions on Cytomegalovirus Infection in Hematopoietic Stem Cell Transplant Patients.

With the rising number of patients undergoing hematopoietic stem cell transplantation (HSCT), clinicians are more likely to encounter infectious complications in immunocompromised hosts, particularly cytomegalovirus (CMV) infection. Besides the high mortality of CMV end-organ disease, patients with detectable CMV viremia may have worse outcomes and decreased survival even in the absence of end-organ disease. In view of the implications on morbidity and mortality, clinicians should maintain a high index of suspicion and initiate antiviral drugs promptly when CMV infection is confirmed. High-risk patients should be identified in order to provide optimal management. Additionally, novel antiviral agents with a good safety profile and minor adverse events are now available for prophylaxis in high-risk patients and for treatment of resistant or refractory CMV infection. The following review provides concise, yet comprehensive, guidance on the burden and risk factors of CMV in this population, as well as an update on the latest evidence for the management of CMV infection.

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