Pharmacotherapy of post-transplant viral infections
Journal
Expert Opinion on Pharmacotherapy
Journal Volume
9
Journal Issue
14
Pages
2409-2421
Date Issued
2008
Author(s)
Singh N.
Abstract
Background: Management of a number of significant viral pathogens in transplant recipients remains challenging. Objectives: To define an optimal antiviral approach to the management of cytomegalovirus (CMV), human herpes virus-6 (HHV-6), Epstein-Barr (EBV)-associated post-transplant lymphoproliferative disorder (PTLD), and polyoma virus-associated nephropathy in transplant recipients. Methods: Clinical trials and existing data regarding use of antiviral agents for these viruses were reviewed to develop evidence-based recommendations for their management. Conclusions: Weighing the current evidence regarding the use of valganciclovir as pre-emptive therapy or prophylaxis, the former approach offers a greater benefit for the overall prevention of CMV disease. Limited data show that prophylaxis with antiviral agents is associated with a reduction in the risk of EBV-associated PTLD. Treatment options for HHV-6 and polyoma virus-associated nephropathy are still limited. ? 2008 Informa UK Ltd.
SDGs
Other Subjects
aciclovir; antivirus agent; benzimidavir; cidofovir; cyclophosphamide; Cytomegalovirus antibody; daunorubicin; doxorubicin; foscarnet; ganciclovir; gatifloxacin; immunoglobulin; leflunomide; lymphocyte antibody; mycophenolic acid 2 morpholinoethyl ester; placebo; prednisolone; quinoline derived antiinfective agent; rituximab; tacrolimus; valaciclovir; valganciclovir; vincristine; adjuvant therapy; antiviral activity; area under the curve; clinical trial; combination chemotherapy; cost effectiveness analysis; Cytomegalovirus; cytomegalovirus infection; drug dose increase; drug efficacy; drug fatality; drug half life; drug potency; drug selectivity; drug substitution; drug tolerability; drug treatment failure; drug withdrawal; Epstein Barr virus; graft infection; heart transplantation; Herpes virus infection; human; Human herpesvirus 6; immunosuppressive treatment; infection prevention; kidney disease; kidney transplantation; liver transplantation; low drug dose; lymphoproliferative disease; maximum plasma concentration; meningoencephalitis; monotherapy; multidrug resistance; nausea and vomiting; nephrotoxicity; neutropenia; nonhuman; pneumonia; Polyoma virus; postoperative infection; review; risk reduction; surgical patient; taste disorder; thrombocytopenia; time to maximum plasma concentration; unspecified side effect; uveitis; viremia; virus infection; Antiviral Agents; Herpesviridae Infections; Humans; Kidney Diseases; Lymphoproliferative Disorders; Postoperative Complications; Transplantation
Type
review