Management of human cytomegalovirus infection in transplant recipients by the pre-emptive therapy approach

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Human cytomegalovirus (HCMV) infections are still a major infectious complication in the post-transplant period of both solid organ transplant recipient (SOTRs) and hematopoietic stem cell transplant recipients (HSCTRs). For many years, the major diagnostic assay has been antigenemia, allowing semi-quantification of HCMV load in blood from transplanted patients with disseminated HCMV infection. More recently, the real-time PCR assay has replaced antigenemia for HCMV DNAemia quantification. Prevention of HCMV disease is based on either prophylaxis or pre-emptive therapy with antiviral drugs. The latter approach has been in use in our department for the last 15 years. A cut-off of 300,000 DNA copies/ml whole blood in SOTRs with either primary or reactivated infection, and a cut-off of 10,000 DNA copies/ml blood in HSCTRs proved to be safe and effective in prospective randomized, controlled trials. With this approach, HCMV disease is consistently prevented, except for a limited number of cases of organ localization in the absence of virus in blood. In these cases, HCMV infection/disease must be diagnosed by local biopsy samples.

Original languageEnglish
Pages (from-to)155-164
Number of pages10
JournalFuture Virology
Volume4
Issue number2
DOIs
Publication statusPublished - 2009

Fingerprint

Cytomegalovirus Infections
Cytomegalovirus
Transplants
Hematopoietic Stem Cells
Therapeutics
DNA
Transplant Recipients
Antiviral Agents
Real-Time Polymerase Chain Reaction
Randomized Controlled Trials
Viruses
Biopsy
Infection

Keywords

  • HCMV
  • Hematopoietic stem cell transplant recipients
  • Pre-emptive therapy
  • Prophylaxis
  • Solid organ transplant recipients

ASJC Scopus subject areas

  • Virology

Cite this

@article{1f3e31edb9224084bd71e8268c7b7f50,
title = "Management of human cytomegalovirus infection in transplant recipients by the pre-emptive therapy approach",
abstract = "Human cytomegalovirus (HCMV) infections are still a major infectious complication in the post-transplant period of both solid organ transplant recipient (SOTRs) and hematopoietic stem cell transplant recipients (HSCTRs). For many years, the major diagnostic assay has been antigenemia, allowing semi-quantification of HCMV load in blood from transplanted patients with disseminated HCMV infection. More recently, the real-time PCR assay has replaced antigenemia for HCMV DNAemia quantification. Prevention of HCMV disease is based on either prophylaxis or pre-emptive therapy with antiviral drugs. The latter approach has been in use in our department for the last 15 years. A cut-off of 300,000 DNA copies/ml whole blood in SOTRs with either primary or reactivated infection, and a cut-off of 10,000 DNA copies/ml blood in HSCTRs proved to be safe and effective in prospective randomized, controlled trials. With this approach, HCMV disease is consistently prevented, except for a limited number of cases of organ localization in the absence of virus in blood. In these cases, HCMV infection/disease must be diagnosed by local biopsy samples.",
keywords = "HCMV, Hematopoietic stem cell transplant recipients, Pre-emptive therapy, Prophylaxis, Solid organ transplant recipients",
author = "Giuseppe Gerna and Fausto Baldanti and Danielle Lilleri",
year = "2009",
doi = "10.2217/17460794.4.2.155",
language = "English",
volume = "4",
pages = "155--164",
journal = "Future Virology",
issn = "1746-0794",
publisher = "Future Medicine Ltd.",
number = "2",

}

TY - JOUR

T1 - Management of human cytomegalovirus infection in transplant recipients by the pre-emptive therapy approach

AU - Gerna, Giuseppe

AU - Baldanti, Fausto

AU - Lilleri, Danielle

PY - 2009

Y1 - 2009

N2 - Human cytomegalovirus (HCMV) infections are still a major infectious complication in the post-transplant period of both solid organ transplant recipient (SOTRs) and hematopoietic stem cell transplant recipients (HSCTRs). For many years, the major diagnostic assay has been antigenemia, allowing semi-quantification of HCMV load in blood from transplanted patients with disseminated HCMV infection. More recently, the real-time PCR assay has replaced antigenemia for HCMV DNAemia quantification. Prevention of HCMV disease is based on either prophylaxis or pre-emptive therapy with antiviral drugs. The latter approach has been in use in our department for the last 15 years. A cut-off of 300,000 DNA copies/ml whole blood in SOTRs with either primary or reactivated infection, and a cut-off of 10,000 DNA copies/ml blood in HSCTRs proved to be safe and effective in prospective randomized, controlled trials. With this approach, HCMV disease is consistently prevented, except for a limited number of cases of organ localization in the absence of virus in blood. In these cases, HCMV infection/disease must be diagnosed by local biopsy samples.

AB - Human cytomegalovirus (HCMV) infections are still a major infectious complication in the post-transplant period of both solid organ transplant recipient (SOTRs) and hematopoietic stem cell transplant recipients (HSCTRs). For many years, the major diagnostic assay has been antigenemia, allowing semi-quantification of HCMV load in blood from transplanted patients with disseminated HCMV infection. More recently, the real-time PCR assay has replaced antigenemia for HCMV DNAemia quantification. Prevention of HCMV disease is based on either prophylaxis or pre-emptive therapy with antiviral drugs. The latter approach has been in use in our department for the last 15 years. A cut-off of 300,000 DNA copies/ml whole blood in SOTRs with either primary or reactivated infection, and a cut-off of 10,000 DNA copies/ml blood in HSCTRs proved to be safe and effective in prospective randomized, controlled trials. With this approach, HCMV disease is consistently prevented, except for a limited number of cases of organ localization in the absence of virus in blood. In these cases, HCMV infection/disease must be diagnosed by local biopsy samples.

KW - HCMV

KW - Hematopoietic stem cell transplant recipients

KW - Pre-emptive therapy

KW - Prophylaxis

KW - Solid organ transplant recipients

UR - http://www.scopus.com/inward/record.url?scp=70349219922&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70349219922&partnerID=8YFLogxK

U2 - 10.2217/17460794.4.2.155

DO - 10.2217/17460794.4.2.155

M3 - Article

AN - SCOPUS:70349219922

VL - 4

SP - 155

EP - 164

JO - Future Virology

JF - Future Virology

SN - 1746-0794

IS - 2

ER -