Management of alpha-herpesvirus infection following kidney transplantation: Our experience (7 cases)
Management of alpha-herpesvirus infection following kidney transplantation: Our experience (7 cases)
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肾移植后甲型疱疹病毒感染的处理：我们的经验（7例）
DOI：
10.1016/j.tpr.2020.100051
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发表时间：
2020
影响因子：
--
通讯作者：
Haruhito Azuma
中科院分区：
文献类型：
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作者：
Hirofumi Uehara;Hajime Hirano;Tomohisa Matsunaga;Koichiro Minami;Kazumasa Komura;Naokazu Ibuki;Teruo Inamoto;Hayahito Nomi;Haruhito Azuma
肾移植是终末期肾病患者的最终治疗方法。移植后的生活质量和寿命几乎与健康个体相等。免疫抑制提高了移植物的存活率，但使患者易受病毒感染。α -疱疹病毒属于疱疹病毒亚科，在自然界广泛分布。人类α -疱疹病毒包括1型和2型单纯疱疹病毒（HSV-1和HSV-2）和水痘带状疱疹病毒（VZV）。HSV-1、HSV-2和VZV常在肾移植后免疫抑制的情况下重新激活。移植中感染性疾病的管理是器官移植预后改善的主要因素。目的报告肾移植术后甲型疱疹病毒感染病例。方法2014年7月至2018年12月，在大阪医科大学附属医院施行肾移植手术55例。对肾移植术后所有甲型疱疹病毒感染病例进行回顾性评价。结果我们治疗了7例甲型疱疹病毒感染患者。中位年龄为60岁；女性2例。所有患者均能接受阿昔洛韦和伐昔洛韦治疗。1例患者并发带状疱疹后神经节（慢性疼痛）。1例患者继发细菌感染，经抗生素治疗。结论人α -疱疹病毒包括HSV-1、HSV-2和VZV在肾移植后经常重新激活。本病例报告展示了肾移植后甲型疱疹病毒感染病例的成功医学治疗。
BackgroundKidney transplantation is the definitive treatment for patients with end-stage kidney diseases. Quality of life and longevity following transplantation are nearly equal to those of healthy individuals. Immunosuppression has improved graft survival but leaves the patient susceptible to viral infections. Alpha-herpesviruses belong to a subfamily of herpesviruses and are widely distributed in nature. The human alpha-herpesviruses include herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) and varicella zoster virus (VZV). HSV-1, HSV-2 and VZV often reactivate in the setting of immune suppression after kidney transplantation. The management of infectious disease in transplantation are major contributors to improved outcomes in organ transplantation.ObjectivesThe aim of this study was to report cases of alpha-herpesvirus infection following kidney transplantation.MethodsFrom July 2014 to December 2018, we performed 55 kidney transplantations at Osaka Medical College Hospital. All alpha-herpesvirus infection cases following kidney transplantation were retrospectively evaluated.ResultsWe treated 7 patients with alpha-herpesvirus infection. Median age was 60; 2 patients were female. All patients were able to be treated with acyclovir and valacyclovir. A patient was complicated by postherpetic neuraglia (chronic pain). A patient was complicated by secondary bacterial infection and treated with antibiotic.ConclusionThe human alpha-herpesviruses include HSV-1, HSV-2 and VZV often reactivate after kidney transplantation. This case report demonstrates the successful medical treatment of alpha-herpesvirus infection cases following kidney transplantation.