New strategies for prevention and therapy of cytomegalovirus infection and disease in solid-organ transplant recipients

被引:191
作者
Sia, IG
Patel, R
机构
[1] Mayo Clin & Mayo Fdn, Div Infect Dis, Rochester, MN 55905 USA
[2] Mayo Clin & Mayo Fdn, Dept Internal Med, Rochester, MN 55905 USA
关键词
D O I
10.1128/CMR.13.1.83-121.2000
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
In the past three decades since the inception of human organ transplantation, cytomegalovirus (CMV) has gained increasing clinical import because it is a common pathogen in the immunocompromised transplant recipient. Patients may suffer from severe manifestations of this infection along with the threat of potential fatality. Additionally, the dynamic evolution of immunosuppressive and antiviral agents has brought forth changes in the natural history of CMV infection and disease. Transplant Physicians now face the daunting task of recognizing and managing the changing spectrum of CMV infection and its consequences in the organ recipient. For the microbiology laboratory, the emphasis has been geared toward the development of more sophisticated detection assays, including methods to detect emerging antiviral resistance. The discovery of novel antiviral chemotherapy is an important theme of clinical research. Investigations have also focused on preventative measures for CMV disease in the solid-organ transplant population. In all, while much has been achieved in the overall management of CMV infection, the current understanding of CMV pathogenesis and therapy still leaves much to be learned before success can be claimed.
引用
收藏
页码:83 / +
页数:41
相关论文
共 516 条
[41]   Cytomegalovirus infections following renal transplantation - effects of antiviral prophylaxis: a report of the North American Pediatric Renal Transplant Cooperative Study [J].
Bock, GH ;
Sullivan, EK ;
Miller, D ;
Gimon, D ;
Alexander, S ;
Ellis, E ;
Elshihabi, I .
PEDIATRIC NEPHROLOGY, 1997, 11 (06) :665-671
[42]   FACTORS INFLUENCING DETECTION OF QUANTITATIVE CYTOMEGALOVIRUS ANTIGENEMIA [J].
BOECKH, M ;
WOOGERD, PM ;
STEVENSAYERS, T ;
RAY, CG ;
BOWDEN, RA .
JOURNAL OF CLINICAL MICROBIOLOGY, 1994, 32 (03) :832-834
[43]   Quantitation of cytomegalovirus: Methodologic aspects and clinical applications [J].
Boeckh, M ;
Boivin, G .
CLINICAL MICROBIOLOGY REVIEWS, 1998, 11 (03) :533-+
[44]   GANCICLOVIR SUSCEPTIBILITIES OF CYTOMEGALOVIRUS (CMV) ISOLATES FROM SOLID-ORGAN TRANSPLANT RECIPIENTS WITH CMV VIREMIA AFTER ANTIVIRAL PROPHYLAXIS [J].
BOIVIN, G ;
ERICE, A ;
CRANE, DD ;
DUNN, DL ;
BALFOUR, HH .
JOURNAL OF INFECTIOUS DISEASES, 1993, 168 (02) :332-335
[45]   Early effects of ganciclovir therapy on the quantity of cytomegalovirus DNA in leukocytes of immunocompromised patients [J].
Boivin, G ;
Quirk, MR ;
Kringstad, BA ;
Germain, M ;
Jordan, MC .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1997, 41 (04) :860-862
[46]   Detection of ganciclovir resistance mutations and quantitation of cytomegalovirus (CMV) DNA in leukocytes of patients with fatal disseminated CMV disease [J].
Boivin, G ;
Chou, SW ;
Quirk, MR ;
Erice, A ;
Jordan, MC .
JOURNAL OF INFECTIOUS DISEASES, 1996, 173 (03) :523-528
[47]  
BOLAND GJ, 1993, CLIN EXP IMMUNOL, V94, P306
[48]  
Boriskin YS, 1996, J MED VIROL, V50, P59, DOI 10.1002/(SICI)1096-9071(199609)50:1<59::AID-JMV11>3.3.CO
[49]  
2-K
[50]   HUMAN CYTOMEGALOVIRUS-SPECIFIC CYTO-TOXIC T-CELLS - THEIR PRECURSOR FREQUENCY AND STAGE SPECIFICITY [J].
BORYSIEWICZ, LK ;
GRAHAM, S ;
HICKLING, JK ;
MASON, PD ;
SISSONS, JGP .
EUROPEAN JOURNAL OF IMMUNOLOGY, 1988, 18 (02) :269-275