Overview: Cytomegalovirus and the Herpesviruses in Transplantation
Overview: Cytomegalovirus and the Herpesviruses in Transplantation
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DOI：
10.1111/ajt.12002
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发表时间：
2013-02-01
影响因子：
8.8
通讯作者：
Fishman, J. A.
中科院分区：
文献类型：
--
作者：
Fishman, J. A.
疱疹病毒感染大多数动物物种。在器官移植中，免疫抑制会加剧由八种人类疱疹病毒(HHV)引起的感染。疱疹病毒生命周期的特殊特征包括建立潜伏的、非生产性感染的能力，以及对生产性、裂解性感染重新激活的终生能力。潜伏病毒和免疫系统之间的相互作用决定了症状感染的频率和严重程度。疱疹病毒感染的免疫学和细胞效应增加了机会性感染和移植物排斥反应的风险。在移植方面最重要的进展是用于诊断和监测疱疹病毒感染的实验室分析，以及在预防和治疗中提高疗效的抗病毒药物。对于单纯疱疹病毒、水痘带状疱疹病毒和巨细胞病毒，这些进展显著降低了感染的发病率。移植后EB病毒相关性淋巴增生性疾病(PTLD)和卡波西肉瘤的症状仍然是免疫抑制的重要并发症。对人类疱疹病毒的流行病学和基本生物学进行了综述。
Herpesviruses infect most animal species. Infections due to the eight human herpesviruses (HHV) are exacerbated by immunosuppression in organ transplantation. The special features of the herpesvirus life cycle include the ability to establish latent, nonproductive infection and the life-long capacity for reactivation to productive, lytic infection. Interactions between latent virus and the immune system determine the frequency and severity of symptomatic infections. The immunologic and cellular effects of herpesvirus infections contribute to risk for opportunistic infections and graft rejection. Among the most important advances in transplantation are laboratory assays for the diagnosis and monitoring of herpesvirus infections and antiviral agents with improved efficacy in prophylaxis and therapy. For herpes simplex virus, varicella zoster virus and cytomegalovirus, these advances have significantly reduced the morbidity of infection. The syndromes of EBV-associated posttransplant lymphoproliferative disorders (PTLD) and Kaposi's sarcoma remain important complications of immunosuppression. The epidemiology and essential biology of human herpesvirus is reviewed.