Presumed cytomegalovirus retinitis late after kidney transplant

Silva, Filipa; Ficher, Klaus Nunes; Viana, Laila Almeida; Coelho, Inês; Rezende, Juliana; Wagner, Daniel R.; Vaz, Maria Lúcia; Foresto, Renato Demarchi; Silva, Helio Tedesco; Medina-Pestana, José

doi:10.1590/2175-8239-jbn-2020-0254

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…Hematoxylin and eosin preparations as well as immunohistochemical stains are performed and the samples are evaluated for CMV viral inclusions ( 58 ). The exception to this is CMV retinitis, which is diagnosed primarily through classic ophthalmologic examination findings, with PCR of vitreous fluid used only at times to confirm the diagnosis, particularly in atypical cases ( 9 , 59 , 60 ). It should be noted that obtaining samples for confirmative histopathology review may not always be feasible given the inherent invasive nature of this testing.…”

Section: Diagnosis Of CMV Infection and Diseasementioning

confidence: 99%

Prevention and management of human cytomegalovirus in pediatric HSCT recipients: A review

et al. 2022

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Cytomegalovirus (CMV), like other herpesviruses, has the unique ability to establish latent infection with subsequent reactivation during periods of stress and immunosuppression. Herpesviruses cause potentially devastating disease, particularly in hematopoietic stem cell transplant (HSCT) recipients. CMV is especially of concern in HSCT recipients given the high community seroprevalence, high risk of reactivation and high risk of transmission from HSCT donors to recipients causing primary infection after transplantation. The risk of CMV infection and severity of CMV disease varies depending on the underlying disease of the HSCT recipient, donor and recipient CMV status prior to HSCT, type of conditioning therapy in preparation for HSCT, allogeneic versus autologous HSCT, donor graft source, timing of infection in relation to HSCT, and other patient comorbidities. Different strategies exist for prevention (e.g., preemptive therapy vs. universal prophylaxis) as well as management of CMV disease (e.g., antiviral therapy, augmenting immune reconstitution, cytotoxic T-cell therapy). The purpose of this narrative review is to discuss diagnosis, prevention, and management of CMV infection and disease at different stages of HSCT, including key points illustrated through presentations of complex cases and difficult clinical scenarios. Traditional and novel strategies for CMV management will be discussed in the context of these unique clinical cases.

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Section: Diagnosis Of CMV Infection and Diseasementioning

confidence: 99%

Prevention and management of human cytomegalovirus in pediatric HSCT recipients: A review

et al. 2022

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“…C ytomegalovirus (CMV) infection is common in immunocompromised patients with human immunodeficiency virus (HIV) infection [1][2][3][4] . Cytomegalovirus retinitis (CMVR) is a common cause of blindness in immunocompromised population [5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

Risk factors for the long-term prognosis and recurrence of HIV-negative cytomegalovirus retinitis in North China

Shi¹,

Kang²,

Feng³

et al. 2022

Int J Ophthalmol

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AIM: To demonstrate the clinical features, the risk factors, the visual prognosis and the recurrence of cytomegalovirus (CMV) retinitis (CMVR) in HIV-negative patients. METHODS: HIV-negative patients with CMVR were involved in this study. Best corrected visual acuity (BCVA), intraocular pressure (IOP), CMV-DNA load in aqueous and/or serum samples, treatment, follow-up time, recurrence and complications were recorded. Ocular characteristics were evaluated by fundus photographs. Association between ocular factors and visual prognosis were analyzed by regression analysis. RESULTS: Twenty-five eyes of 16 patients were included. All 25 eyes underwent intravitreal injections of anti-viral agents. The mean logMAR BCVA improved from 0.94±0.98 (0.98-0.78) initially to 0.77±0.73 (0.82-0.68) at last visit, but not significantly. After antiviral treatment, the aqueous CMV DNA load significantly reduced to (3.42±1.47)×102 copies/mL (P=0.001), compared with (2.51±3.11)×105 copies/mL at baseline. Macular involvement (R2=0.475, P=0.049) and initial visual acuity (R2=0.475, P=0.017) were significantly associated with the poor visual prognosis (BCVA<20/400). The extent of retinal lesions (R2=0.064, P=0.04) was significant associated with the risk of recurrence of CMVR. CONCLUSION: Intravitreal injection of anti-viral agents offers a safe and effective treatment for CMVR. Macular involvement and initial visual acuity significantly associate with visual prognosis. The extent of retinal lesions is significantly associated with the recurrence of CMVR. These ocular factors can be used as predictive risk factors for long term visual prognosis in HIV-negative CMVR patients.

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Aciclovir/immunosuppressants

2023

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Presumed cytomegalovirus retinitis late after kidney transplant

Cited by 4 publications

References 19 publications

Prevention and management of human cytomegalovirus in pediatric HSCT recipients: A review

Prevention and management of human cytomegalovirus in pediatric HSCT recipients: A review

Risk factors for the long-term prognosis and recurrence of HIV-negative cytomegalovirus retinitis in North China

Aciclovir/immunosuppressants

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