[Role of viral infections in immunosuppressed patients]

Med Intensiva. 2011 Mar;35(2):117-25. doi: 10.1016/j.medin.2010.12.003. Epub 2011 Feb 15.
[Article in Spanish]

Abstract

Being a solid organ and hematopoietic stem cell transplant recipient as well as receiving chemotherapy for a malignant hematological disease clearly predispose the subject to a variety of viral infections, both common and opportunistic diseases. The patient may have acquired these infections from the community as well as from the donor organ (donor-derived infections) and/or from reactivation of an endogenous latent virus. Herpes viruses and especially the cytomegalovirus and Epstein-Barr virus are among the most common of the opportunistic viral pathogens affecting these patients, in addition to respiratory viruses. Treatment consists in antiviral drug therapies combined with the reduction in the degree of the induced immunosuppression. A review of the literature has been performed in order to update the epidemiology, pathogenesis, clinical manifestations and therapeutic approach of the viral infections in these immunocompromised patients.

Ser receptor de un trasplante de órgano sólido, así como recibir tratamiento quimioterápico para una enfermedad hematólógica maligna, predispone claramente a padecer infecciones virales tanto comunes como oportunistas, de origen tanto comunitario como procedentes del donante de órganos y/o de una reactivación de un virus latente endógeno. Herpes virus y más especialmente citomegalovirus y virus de Epstein-Barr son los que con más frecuencia afectan a estos enfermos, así como los virus respiratorios. El tratamiento consiste en la combinación de reducir la inmunodepresión inducida junto con tratamiento antiviral. Se ha realizado una revisión de la literatura pormenorizada y actualizada de la epidemiología, la patogenia, las manifestaciones clínicas y la aproximación terapéutica de las infecciones virales en estos enfermos.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Antibodies, Monoclonal, Murine-Derived / therapeutic use
  • Antiviral Agents / therapeutic use
  • Comorbidity
  • Critical Care*
  • Critical Illness*
  • Cross Infection / drug therapy
  • Cross Infection / epidemiology
  • Cross Infection / immunology
  • Cross Infection / prevention & control
  • Cross Infection / virology
  • Disease Susceptibility
  • Herpesviridae Infections / drug therapy
  • Herpesviridae Infections / epidemiology
  • Herpesviridae Infections / immunology
  • Humans
  • Immunocompromised Host*
  • Immunosuppressive Agents / adverse effects
  • Lymphoproliferative Disorders / drug therapy
  • Lymphoproliferative Disorders / epidemiology
  • Lymphoproliferative Disorders / etiology
  • Lymphoproliferative Disorders / virology
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / epidemiology
  • Opportunistic Infections / immunology
  • Opportunistic Infections / virology
  • Postoperative Complications / drug therapy
  • Postoperative Complications / epidemiology
  • Postoperative Complications / immunology
  • Postoperative Complications / virology
  • Risk Factors
  • Rituximab
  • Transplantation
  • Tumor Virus Infections / drug therapy
  • Tumor Virus Infections / epidemiology
  • Tumor Virus Infections / immunology
  • Virus Diseases / drug therapy
  • Virus Diseases / epidemiology*
  • Virus Diseases / immunology
  • Virus Diseases / prevention & control
  • Virus Latency

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Antiviral Agents
  • Immunosuppressive Agents
  • Rituximab