EPIDEMIOLOGY OF CYTOMEGALOVIRUS-INFECTION AFTER TRANSPLANTATION AND IMMUNOSUPPRESSION
EPIDEMIOLOGY OF CYTOMEGALOVIRUS-INFECTION AFTER TRANSPLANTATION AND IMMUNOSUPPRESSION
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DOI：
10.1093/infdis/132.4.421
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发表时间：
1975-01-01
影响因子：
6.4
通讯作者：
GUZE, LB
中科院分区：
文献类型：
--
作者：
FIALA, M;PAYNE, JE;GUZE, LB
研究血液透析和肾移植术后病毒感染及临床并发症。肾移植术后96%的患者出现活动性巨细胞病毒感染；单纯疱疹病毒、水痘带状疱疹病毒和爱泼斯坦-巴尔病毒的再激活分别在35%、24%和0%的患者中发现。42%的患者在肾移植后平均2个月内出现巨细胞病毒血症，持续时间为1.75（±1.5）个月（1例慢性病毒血症患者除外），随后出现慢性病毒血症。传染性巨细胞病毒的滴度在多形核中高于单核白细胞部分。肾移植后巨细胞病毒感染最可能的机制是潜伏性感染的再激活，呼吸道感染的可能性较小。移植后1 ~ 3个月，巨细胞病毒感染可能与发热、关节痛、肺炎和白细胞减少有关；移植后3 ~ 4个月，病毒可能与肝炎有关；移植后12-30个月，可能与慢性病毒血症患者视网膜炎有关。虽然可能有其他原因引起这些并发症，但在这方面，单纯性疱疹病毒、eb病毒、水痘带状疱疹病毒、麻疹病毒、腺病毒、乙型肝炎病毒和刚地弓形虫的重要性似乎不如巨细胞病毒。
Viral infections and clinical complications were studied during hemodialysis and after renal transplantation. Active cytomegalovirus infection developed in 96% of patients after renal transplantation; reactivation of herpes simplex, varicella-zoster, and Epstein-Barr viruses was found in 35%,24%, and 0% of patients, respectively. Cytomegalovirus viremia developed in 42% of patients an average of two months after renal transplantation, lasted 1.75 (±1.5) months (except in one patient with chronic viremia), and was followed by chronic viruria. Higher titers of infectious cytomegalovirus were found in the polymorphonuclear than in the mononuclear leukocyte fraction. Reactivation of a latent infection and, less likely, respiratory infection appear to be the most probable mechanisms of cytomegalovirus infection after renal transplantation. One to three months after transplant, cytomegalovirus infection may be related to fever, arthralgia, pneumonitis, and leukopenia; three to four months after transplant, the virus may be related to hepatitis; and 12–30 months after transplant, it may be related to retinitis in patients with chronic viremia. Although other causes of these complications are possible, herpes simplex virus, Epstein-Barr virus, varicella-zoster virus, measles virus, adenovirus, hepatitis B virus, andToxoplasma gondiiappear to be of lesser importance than cytomegalovirus in this respect.