Immune response to CMV in solid organ transplant recipients: current concepts and future directions

Watkins, Richard R.; Lemonovich, Tracy L.; Razonable, Raymund R.

doi:10.1586/eci.12.25

Cited by 25 publications

(21 citation statements)

References 94 publications

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“…The event most frequently associated with CMV was cardiovascular disease, which has been described following organ transplantation [71,72] and with HIV disease [73,74]. Given its ubiquity as a human pathogen and its ability to infect endothelial cells and smooth-muscle cells [75], CMV is an ideal candidate pathogen for atherosclerosis [76].…”

Section: CMV Hiv and Clinical Outcomesmentioning

confidence: 99%

Cytomegalovirus and HIV: A Dangerous Pas de Deux

2016

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Human immunodeficiency virus (HIV)-infected adults who take stable antiretroviral therapy (ART) are at risk for early onset of agerelated diseases. This is likely due to a complex interaction between traditional risk factors, HIV infection itself, and other factors, such as underlying immune dysfunction and persistent inflammation. HIV disrupts the balance between the host and coinfecting microbes, worsening control of these potential pathogens. For example, HIV-infected adults are more likely than the general population to have subclinical bursts of cytomegalovirus (CMV) replication at mucosal sites. Production of antigens can activate the immune system and stimulate HIV replication, and it could contribute to the pathogenesis of adverse outcomes of aging, like cardiovascular disease and neurocognitive impairment. Further investigation of the relationships between CMV, immune dysfunction, and unsuccessful aging during chronic HIV infection is warranted.

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Section: CMV Hiv and Clinical Outcomesmentioning

confidence: 99%

Cytomegalovirus and HIV: A Dangerous Pas de Deux

2016

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“…Primary CMV infection induces a robust cellular and humoral immune response (15). CMV immunoglobulin M (CMV-IgM) is initially secreted during early CMV infection, and the detection of CMV-IgM by serologic assays is indicative of active, acute, or recent infection (16).…”

Section: Viral Epidemiology and Mechanisms Of Infectionmentioning

confidence: 99%

“…The detection of CMV-IgG is indicative of previous or past infection (16). Durable control of CMV infection is the function of a robust cell-mediated immunity, with generation of CMVspecific CD4 ϩ and CD8 ϩ T cells (15,(17)(18)(19). Suppression of the number and function of CMV-specific CD4 ϩ and CD8 ϩ T cells allows for reactivation of the virus from latency, leading to uncontrolled viral replication and clinical disease in immunocompromised patients, including SOT recipients (15,17,18).…”

Section: Viral Epidemiology and Mechanisms Of Infectionmentioning

confidence: 99%

Clinical Utility of Viral Load in Management of Cytomegalovirus Infection after Solid Organ Transplantation

2013

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SUMMARY The negative impact of cytomegalovirus (CMV) infection on transplant outcomes warrants efforts toward improving its prevention, diagnosis, and treatment. During the last 2 decades, significant breakthroughs in diagnostic virology have facilitated remarkable improvements in CMV disease management. During this period, CMV nucleic acid amplification testing (NAT) evolved to become one of the most commonly performed tests in clinical virology laboratories. NAT provides a means for rapid and sensitive diagnosis of CMV infection in transplant recipients. Viral quantification also introduced several principles of CMV disease management. Specifically, viral load has been utilized (i) for prognostication of CMV disease, (ii) to guide preemptive therapy, (iii) to assess the efficacy of antiviral treatment, (iv) to guide the duration of treatment, and (v) to indicate the risk of clinical relapse or antiviral drug resistance. However, there remain important limitations that require further optimization, including the interassay variability in viral load reporting, which has limited the generation of standardized viral load thresholds for various clinical indications. The recent introduction of an international reference standard should advance the major goal of uniform viral load reporting and interpretation. However, it has also become apparent that other aspects of NAT should be standardized, including sample selection, nucleic acid extraction, amplification, detection, and calibration, among others. This review article synthesizes the vast amount of information on CMV NAT and provides a timely review of the clinical utility of viral load testing in the management of CMV in solid organ transplant recipients. Current limitations are highlighted, and avenues for further research are suggested to optimize the clinical application of NAT in the management of CMV after transplantation.

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“…12 Imunoglobulin M anti CMV disekresi saat awal infeksi CMV sehingga merupakan tanda infeksi baru/akut/aktif. Beberapa minggu kemudian, IgG CMV mulai diproduksi dan dapat ditemukan sepanjang hidup.…”

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“…Kontrol infeksi CMV memerlukan peran CD4 dan CD8 spesifik sehingga supresi jumlah dan fungsi kedua sel tersebut dapat mengakibatkan reaktivasi CMV. 12 Infeksi primer CMV menghasilkan infeksi laten CMV. Virus CMV dapat tersimpan dalam bentuk laten di berbagai sel tubuh, di antaranya makrofag, sel mononuklear, neutrofil, sel polimorfonuklear, epitel, endotel, fibroblast, sel neuron, dan sel parenkim.…”

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Tata laksana Infeksi Sitomegalovirus pada Pasien Transplantasi Organ Padat

Santoso

Karyanti

Putri

2018

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Pasien kandidat transplan organ padat merupakan populasi yang berisiko tinggi mengalami infeksi, terutama setelah transplantasi, karena pasien akan menerima terapi imunosupresan sehingga infeksi maupun reaktivasi patogen lebih mudah terjadi. Patogen penyebab morbiditas tersering adalah sitomegalovirus (CMV). Infeksi sitomegalovirus dapat bersifat simtomatik maupun asimtomatik. Penyakit CMV timbul apabila infeksi bersifat simtomatik dan dapat terjadi baik oleh infeksi primer, reaktivasi, maupun superinfeksi virus. Gejala penyakit CMV pada pasien imunokompromais dapat menjadi diseminata. Baku emas untuk mendiagnosis CMV adalah dengan polymerase chain reaction (PCR) CMV. Namun demikian, belum ada panduan tatalaksana profilaksis maupun batasan titer CMV yang memerlukan terapi. Makalah ini bertujuan untuk menelaah literatur sehingga dapat menghasilkan panduan profilaksis dan terapi penyakit CMV pada pasien transplantasi organ padat di Indonesia.

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Immune response to CMV in solid organ transplant recipients: current concepts and future directions

Cited by 25 publications

References 94 publications

Cytomegalovirus and HIV: A Dangerous Pas de Deux

Cytomegalovirus and HIV: A Dangerous Pas de Deux

Clinical Utility of Viral Load in Management of Cytomegalovirus Infection after Solid Organ Transplantation

Tata laksana Infeksi Sitomegalovirus pada Pasien Transplantasi Organ Padat

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