Epidemiology of cytomegalovirus disease in solid organ and hematopoietic stem cell transplant recipients

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Abstract

Purpose. The novel and traditional risk factors for cytomegalovirus (CMV) infection and disease in solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients, the current strategies for the prevention of CMV disease, the emerging syndrome of late-onset CMV disease, and the risk factors for antiviral drug resistance are described. Summary. The evolution of transplantation practices, the changes in the characteristics of donors and recipients, the introduction of novel immunosuppressive drugs, and the widespread use of antiviral drugs for CMV prevention have collectively influenced the natural history of CMV infection and disease in SOT and HSCT recipients. Strategies for CMV prevention with the use of antiviral drugs, whether as prophylaxis or as preemptive therapy, are effective in reducing the incidence of CMV disease in transplant recipients. However, late-onset CMV disease is now emerging as a serious problem. Donor and recipient CMV serostatus and other traditional risk factors for early-onset CMV disease appear to contribute to the occurrence of late-onset CMV disease during the first year after transplantation. Conclusion. The epidemiology of CMV infection and disease has changed after transplantation. Strategies to prevent late-onset CMV disease include the prolonged use of antiviral prophylaxis, but this practice can lead to the emergence of antiviral drug resistance, which has been associated with high rates of morbidity and mortality.

Original languageEnglish (US)
JournalAmerican Journal of Health-System Pharmacy
Volume62
Issue numberSUPPL. 1
StatePublished - Apr 15 2005

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Hematopoietic Stem Cells
Cytomegalovirus
Epidemiology
Transplants
Cytomegalovirus Infections
Viral Drug Resistance
Antiviral Agents
Transplantation
Transplant Recipients
Tissue Donors
Immunosuppressive Agents
Morbidity
Mortality
Late Onset Disorders
Incidence

Keywords

  • Antivirals
  • Cytomegalovirus infections
  • Dosage schedules
  • Epidemiology
  • Immunosuppressive agents
  • Mortality
  • Resistance
  • Transplantation

ASJC Scopus subject areas

  • Leadership and Management
  • Pharmaceutical Science

Cite this

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title = "Epidemiology of cytomegalovirus disease in solid organ and hematopoietic stem cell transplant recipients",
abstract = "Purpose. The novel and traditional risk factors for cytomegalovirus (CMV) infection and disease in solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients, the current strategies for the prevention of CMV disease, the emerging syndrome of late-onset CMV disease, and the risk factors for antiviral drug resistance are described. Summary. The evolution of transplantation practices, the changes in the characteristics of donors and recipients, the introduction of novel immunosuppressive drugs, and the widespread use of antiviral drugs for CMV prevention have collectively influenced the natural history of CMV infection and disease in SOT and HSCT recipients. Strategies for CMV prevention with the use of antiviral drugs, whether as prophylaxis or as preemptive therapy, are effective in reducing the incidence of CMV disease in transplant recipients. However, late-onset CMV disease is now emerging as a serious problem. Donor and recipient CMV serostatus and other traditional risk factors for early-onset CMV disease appear to contribute to the occurrence of late-onset CMV disease during the first year after transplantation. Conclusion. The epidemiology of CMV infection and disease has changed after transplantation. Strategies to prevent late-onset CMV disease include the prolonged use of antiviral prophylaxis, but this practice can lead to the emergence of antiviral drug resistance, which has been associated with high rates of morbidity and mortality.",
keywords = "Antivirals, Cytomegalovirus infections, Dosage schedules, Epidemiology, Immunosuppressive agents, Mortality, Resistance, Transplantation",
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AU - Razonable, Raymund R

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N2 - Purpose. The novel and traditional risk factors for cytomegalovirus (CMV) infection and disease in solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients, the current strategies for the prevention of CMV disease, the emerging syndrome of late-onset CMV disease, and the risk factors for antiviral drug resistance are described. Summary. The evolution of transplantation practices, the changes in the characteristics of donors and recipients, the introduction of novel immunosuppressive drugs, and the widespread use of antiviral drugs for CMV prevention have collectively influenced the natural history of CMV infection and disease in SOT and HSCT recipients. Strategies for CMV prevention with the use of antiviral drugs, whether as prophylaxis or as preemptive therapy, are effective in reducing the incidence of CMV disease in transplant recipients. However, late-onset CMV disease is now emerging as a serious problem. Donor and recipient CMV serostatus and other traditional risk factors for early-onset CMV disease appear to contribute to the occurrence of late-onset CMV disease during the first year after transplantation. Conclusion. The epidemiology of CMV infection and disease has changed after transplantation. Strategies to prevent late-onset CMV disease include the prolonged use of antiviral prophylaxis, but this practice can lead to the emergence of antiviral drug resistance, which has been associated with high rates of morbidity and mortality.

AB - Purpose. The novel and traditional risk factors for cytomegalovirus (CMV) infection and disease in solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients, the current strategies for the prevention of CMV disease, the emerging syndrome of late-onset CMV disease, and the risk factors for antiviral drug resistance are described. Summary. The evolution of transplantation practices, the changes in the characteristics of donors and recipients, the introduction of novel immunosuppressive drugs, and the widespread use of antiviral drugs for CMV prevention have collectively influenced the natural history of CMV infection and disease in SOT and HSCT recipients. Strategies for CMV prevention with the use of antiviral drugs, whether as prophylaxis or as preemptive therapy, are effective in reducing the incidence of CMV disease in transplant recipients. However, late-onset CMV disease is now emerging as a serious problem. Donor and recipient CMV serostatus and other traditional risk factors for early-onset CMV disease appear to contribute to the occurrence of late-onset CMV disease during the first year after transplantation. Conclusion. The epidemiology of CMV infection and disease has changed after transplantation. Strategies to prevent late-onset CMV disease include the prolonged use of antiviral prophylaxis, but this practice can lead to the emergence of antiviral drug resistance, which has been associated with high rates of morbidity and mortality.

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KW - Transplantation

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