Adenovirus, herpes simplex virus and cytomegalovirus infection in a lung transplant recipient

Nagarakanti, Sandhya; Bishburg, Eliahu; Bapat, Anita

doi:10.1016/j.idcr.2018.01.011

Cited by 5 publications

(3 citation statements)

References 6 publications

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“…Additionally, there are a few reports on coinfection of CMV and HSV in the lung. Among them, two patients received lung transplantation and one patient was an immunocompromised host [11,12,13]. To our knowledge, this is the first report on coinfection of CMV and HSV in an MPA patient.…”

Section: Discussionmentioning

confidence: 90%

Various patterns of acute alveolar haemorrhage in patients with microscopic polyangiitis: a clinicopathological study of four cases

Yorita¹,

Sakamoto²,

Tsuji³

2018

pjp

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It is well known that acute alveolar haemorrhage (AAH) is attributed to capillaritis in most cases with microscopic polyangiitis (MPA). In this article, we explore the cause of alveolar haemorrhage in MPA patients. In the present study, we extracted four autopsy cases of MPA with AAH. Patient's sex and age, cause of alveolar haemorrhage, therapy, follow-up duration, and cause of death were investigated. As a result, alveolar haemorrhage was caused by diffuse alveolar damage (DAD) due to candidiasis or influenza virus infection, haemorrhagic infarct due to aspergillosis, capillaritis due to MPA, vasculitis due to cytomegalovirus (CMV), and herpes simplex virus (HSV) infection. All patients received corticosteroid therapy, and one patient additionally underwent administration of cyclophosphamide. The duration of follow-up ranged from one to 26 months with a mean of eight months. All patients died of respiratory failure. In summary, clinicians and pathologists should recognise some causes of alveolar haemorrhage in MPA patients, which include DAD, haemorrhagic infarct, virus-associated vasculitis, or MPA-associated capillaritis.

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Section: Discussionmentioning

confidence: 90%

Various patterns of acute alveolar haemorrhage in patients with microscopic polyangiitis: a clinicopathological study of four cases

Yorita¹,

Sakamoto²,

Tsuji³

2018

pjp

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“…Although severe infections are relatively uncommon, even asymptomatic viral shedding may be associated with increased mortality [106]. Nagarakanti and colleagues reported a case of adenovirus, HSV and CMV infection in a lung transplant recipient with fatal outcome despite some initial amelioration with antiviral administration [112]. A case of HSV-2 hepatitis has been reported four years after lung transplantation in a patient with cystic fibrosis; despite the delay in diagnosis, the patient fully recovered with acyclovir, reduction of immunosuppression and intravenous immunoglobulin [113], thus underlining that rapid treatment with high-dose acyclovir is critical as the disease may be fatal if untreated.…”

Section: Herpesviruses 1 and 2 41 Epidemiology And Clinical Manifesta...mentioning

confidence: 99%

Herpes Virus Infection in Lung Transplantation: Diagnosis, Treatment and Prevention Strategies

Patrucco,

Curtoni,

Sidoti

et al. 2023

Viruses

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Lung transplantation is an ultimate treatment option for some end-stage lung diseases; due to the intense immunosuppression needed to reduce the risk of developing acute and chronic allograft failure, infectious complications are highly incident. Viral infections represent nearly 30% of all infectious complications, with herpes viruses playing an important role in the development of acute and chronic diseases. Among them, cytomegalovirus (CMV) is a major cause of morbidity and mortality, being associated with an increased risk of chronic lung allograft failure. Epstein–Barr virus (EBV) is associated with transformation of infected B cells with the development of post-transplantation lymphoproliferative disorders (PTLDs). Similarly, herpes simplex virus (HSV), varicella zoster virus and human herpesviruses 6 and 7 can also be responsible for acute manifestations in lung transplant patients. During these last years, new, highly sensitive and specific diagnostic tests have been developed, and preventive and prophylactic strategies have been studied aiming to reduce and prevent the incidence of these viral infections. In this narrative review, we explore epidemiology, diagnosis and treatment options for more frequent herpes virus infections in lung transplant patients.

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“…The newly synthetized DNA is inserted into an immature B capsid after the precapsid assembly stage and becomes a fully mature C capsid. This DNA packed capsid, egresses through the nuclear membrane from the nucleus, through an envelope and de-envelopment cycle [102]. The mechanism of assembly of tegument proteins is still unclear.…”

Section: Virus Assemblymentioning

confidence: 99%

Human Herpetic Viruses and Immune Profiles

Jassim¹,

Mahmood²,

Hussein³

2021

Innate Immunity in Health and Disease

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Herpesviruses are large, spherical, enveloped viral particles with linear double-stranded DNA genome. Herpesvirus virion consists of an icosahedral capsid containing viral DNA, surrounded by a protein layer called tegument, and enclosed by an envelope consisting of a lipid bilayer with various glycoproteins. Herpesviruses persist lifelong in their hosts after primary infection by establishing a latent infection interrupted recurrently by reactivations. The Herpesviridae family is divided into three subfamilies; α-herpesviruses, β-herpesviruses, and γ-herpesviruses based on the genome organization, sequence homology, and biological properties. There are eight human herpes viruses: Herpes simplex virus type 1 and 2 (HSV-1, −2) andVaricella-zoster virus (VZV), which belong to the α-herpesvirus subfamily; Human cytomegalovirus (HCMV), and Human herpesvirus type 6 and 7 (HHV-6,HHV-7), which belong to the β-herpesvirus subfamily; and Epstein–Barr virus (EBV) and Kaposi’s sarcoma-associated herpesvirus (KSHV) or Human herpesvirus 8 (HHV-8), which belong to the γ-herpesvirus subfamily. Within this chapter, we summarize the current knowledge about EBV and CMV, regarding their genome organization, structural characteristics, mehanisms of latency, types of infections, mechanisms of immune escape and prevention. Epstein–Barr Virus (EBV) genome encodes over 100 proteins, of which only (30) proteins are well characterized, including the proteins expressed during latent infection and lytic cycle proteins. Based on major variation in the EBNA-2 gene sequence, two types of EBV are recognized, EBV type 1 and 2. Epstein–Barr virus types occur worldwide and differ in their geographic distribution depending on the type of virus. EBV spreads most commonly through bodily fluids, especially saliva. However, EBV can also spread through blood, blood transfusions, and organ transplantations. The EBV is associated with many malignant diseases such as lymphomas, carcinomas, and also more benign such as infectious mononucleosis, chronic active infection. The EBV has also been suggested as a trigger/cofactor for some autoimmune diseases. Overall, 1–1.5% of the cancer burden worldwide is estimated to be attributable to EBV The latently infected human cancer cells express the most powerful monogenic proteins, LMP-1 and LMP-2(Latent Membrane Protein-1,-2), as well as Epstein–Barr Nuclear Antigens (EBNA) and two small RNAs called Epstein–Barr Encoded Small RNAs (EBERs). The EBV can evade the immune system by its gene products that interfering with both innate and adaptive immunity, these include EBV-encoded proteins as well as small noncoding RNAs with immune-evasive properties. Currently no vaccine is available, although there are few candidates under evaluation. Human cytomegalovirus (HCMV) is a ubiquitous beta herpesvirus type 5 with seroprevalence ranges between 60 to 100% in developing countries. CMV is spread from one person to another, usually by direct and prolonged contact with bodily fluids, mainly saliva, but it can be transmitted by genital secretions, blood transfusion and organ transplantation. In addition, CMV can be transmitted vertically from mother to child. CMV infection can result in severe disease for babies, people who receive solid organ transplants or bone marrow/stem cell transplants and people with severe immune suppression such as advanced human immunodeficiency virus (HIV) infection. The HCMV has several mechanisms of immune system evasion. It interferes with the initiation of adaptive immune responses, as well as prevent CD8+ and CD4+ T cell recognition interfering with the normal cellular MHC Class I and MHC Class II processing and presentation pathways. Challenges in developing a vaccine include adeptness of CMV in evading the immune system. Though several vaccine candidates are under investigation.

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Adenovirus, herpes simplex virus and cytomegalovirus infection in a lung transplant recipient

Abstract: Allograft infections post lung transplantation have a significant impact on morbidity and mortality. We report a rare case of triple viral infection with adenovirus, Herpes Simplex virus (HSV) and Cytomegalovirus (CMV) in a lung transplant recipient.

Cited by 5 publications

References 6 publications

Various patterns of acute alveolar haemorrhage in patients with microscopic polyangiitis: a clinicopathological study of four cases

Various patterns of acute alveolar haemorrhage in patients with microscopic polyangiitis: a clinicopathological study of four cases

Herpes Virus Infection in Lung Transplantation: Diagnosis, Treatment and Prevention Strategies

Human Herpetic Viruses and Immune Profiles

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