TY - JOUR
T1 - Diagnosis and monitoring of human cytomegalovirus infection in transplant recipients
AU - Gerna, Giuseppe
AU - Baldanti, Fausto
AU - Grossi, Paolo
AU - Locatelli, Franco
AU - Colombo, Paolo
AU - Viganò, Mario
AU - Revello, M. Grazia
PY - 2001
Y1 - 2001
N2 - In the last decade, transplantology has become the treatment of choice for a large number of malignant diseases or organ dysfunctions. Transplants are classified into two main groups: solid organ transplants (SOT) and haematopoietic stem cell transplants (HSCT). Human cytomegalovirus (HCMV) infection is the most common viral complication in both SOT and HSCT recipients within 3 months of transplant. Major risk factors for HCMV infection are the mismatch between donor and recipient antibody status, and the immunosuppressive regimen. Clinical manifestations range from asymptomatic infections to severe HCMV disease involving lung, gastrointestinal tract, liver, retina, central and peripheral nervous systems. Diagnosis is based mainly upon detection and quantification of virus in blood by determination of viraemia, antigenaemia, DNAaemia, and RNAaemia. In addition, detection of the emergence of resistance to HCMV-specific antiviral drugs such as ganciclovir and foscarnet, may be achieved by performing phenotypic and genotypic assays. Monitoring of HCMV infections in both SOT and HSCT recipients allows timely adoption of pre-emptive (presymptomatic) therapy strategies, which have led to almost complete disappearance of HCMV disease in both transplantation settings. In parallel, sustained treatment with specific antiviral drugs must elicit monitoring of antiviral drug resistance to permit a timely shift to an alternative drug. In conclusion, diagnostic and therapeutic tools now available allow almost complete control of HCMV infections in different transplantation settings. © 2001 Lippincott Williams & Wilkins.
AB - In the last decade, transplantology has become the treatment of choice for a large number of malignant diseases or organ dysfunctions. Transplants are classified into two main groups: solid organ transplants (SOT) and haematopoietic stem cell transplants (HSCT). Human cytomegalovirus (HCMV) infection is the most common viral complication in both SOT and HSCT recipients within 3 months of transplant. Major risk factors for HCMV infection are the mismatch between donor and recipient antibody status, and the immunosuppressive regimen. Clinical manifestations range from asymptomatic infections to severe HCMV disease involving lung, gastrointestinal tract, liver, retina, central and peripheral nervous systems. Diagnosis is based mainly upon detection and quantification of virus in blood by determination of viraemia, antigenaemia, DNAaemia, and RNAaemia. In addition, detection of the emergence of resistance to HCMV-specific antiviral drugs such as ganciclovir and foscarnet, may be achieved by performing phenotypic and genotypic assays. Monitoring of HCMV infections in both SOT and HSCT recipients allows timely adoption of pre-emptive (presymptomatic) therapy strategies, which have led to almost complete disappearance of HCMV disease in both transplantation settings. In parallel, sustained treatment with specific antiviral drugs must elicit monitoring of antiviral drug resistance to permit a timely shift to an alternative drug. In conclusion, diagnostic and therapeutic tools now available allow almost complete control of HCMV infections in different transplantation settings. © 2001 Lippincott Williams & Wilkins.
KW - Antiviral drug resistance
KW - Bone marrow transplant
KW - Diagnosis
KW - Human cytomegalovirus
KW - Pre-emptive therapy
KW - Solid-organ transplant
KW - Antiviral drug resistance
KW - Bone marrow transplant
KW - Diagnosis
KW - Human cytomegalovirus
KW - Pre-emptive therapy
KW - Solid-organ transplant
UR - http://hdl.handle.net/10807/262875
U2 - 10.1097/00013542-200107000-00004
DO - 10.1097/00013542-200107000-00004
M3 - Article
SN - 0954-139X
VL - 12
SP - 155
EP - 175
JO - Reviews in Medical Microbiology
JF - Reviews in Medical Microbiology
ER -