Pulmonary cytomegalovirus (CMV) DNA shedding in allogeneic hematopoietic stem cell transplant recipients: Implications for the diagnosis of CMV pneumonia

Piñana, José Luís; Giménez, Estela; Gómez, María Dolores; Pérez, Ariadna; González, Eva; Vinuesa, Víctor; Hernández‐Boluda, Juan Carlos; Montoro, Juan; Salavert, Miguel; Tormo, Mar; Amat, Paula; Molés, Paula; Carretero, Carlos; Balaguer‐Roselló, Aitana; Sanz, Jaime; Sanz, Guillermo; Solano, Carlos; Navarro, David

doi:10.1016/j.jinf.2019.02.009

Cited by 18 publications

(14 citation statements)

References 37 publications

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“… 6 , 7 Furthermore, viral shedding can occur from the lungs in the absence of invasive disease, although it may be associated with a higher overall mortality. 8 …”

Section: Discussionmentioning

confidence: 99%

Delayed Onset of COVID-19 in an Immunosuppressed Patient

Liroff

Fleury

Dumitrescu

et al. 2021

Infect Dis Clin Pract

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“… 6 , 7 Furthermore, viral shedding can occur from the lungs in the absence of invasive disease, although it may be associated with a higher overall mortality. 8 …”

Section: Discussionmentioning

confidence: 99%

Delayed Onset of COVID-19 in an Immunosuppressed Patient

Liroff

Fleury

Dumitrescu

et al. 2021

Infect Dis Clin Pract

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“…The utility of CMV viral load in diagnosis of end-organ diseases like pulmonary and gastrointestinal (GI) disease is still being explored. Establishing appropriate thresholds to differentiate between CMV pneumonia and pulmonary shedding in HSCT remains a challenge [26][27][28]. CMV GI disease may not cause significant viremia in plasma or whole blood.…”

Section: Diagnosticsmentioning

confidence: 99%

CMV Infection in Hematopoietic Stem Cell Transplantation: Prevention and Treatment Strategies

Jakharia

Howard

Riedel

2021

Curr Treat Options Infect Dis

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Purpose of Review Cytomegalovirus (CMV) remains a major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (Allo-HSCT). New strategies and methods for prevention and management of CMV infection are urgently needed. We aim to review the new developments in diagnostics, prevention, and management strategies of CMV infection in Allo-HSCT recipients. Recent Findings The approval of the novel anti-CMV drug letermovir in 2017 has led to an increase in the use of antiviral prophylaxis as a preferred approach for prevention in many centers. Real-world studies have shown efficacy similar to the clinical trial. CMV-specific T cellmediated immunity assays identify patients with immune reconstitution and predict disease progression. Phase 2 trials of maribavir have shown its efficacy as preemptive therapy and treatment of resistant and refractory CMV infections. Adoptive T cell therapy is an emerging option for treatment of refractory and resistant CMV. Of the different CMV vaccine trials, PepVax has shown promising results in a phase 1 trial.Summary CMV cell-mediated immunity assays have potential to be used as an adjunctive test to develop individualized management plan by identifying the patients who develop immune reconstitution; however, further prospective interventional studies are needed. Maribavir and adoptive T cell therapy are promising new therapies for treatment of CMV infections. CMV vaccine trials for prevention are also under way.

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“…Thus, the diagnosis of suspected HCMV pneumonitis is made by a combination of positive CMV serostatus together with detection of virus DNA in blood and/or bronchoalveolar lavage samples. However, the amount of HCMV DNA in bronchoalveolar fluids cannot differentiate between HCMV pneumonitis and asymptomatic pulmonary virus shedding [21]. Lung biopsy may allow to directly detect HCMV infection via immunohistopathology.…”

Section: Clinical Problem—hcmv Pneumonitismentioning

confidence: 99%

Cytomegalovirus (CMV) Pneumonitis: Cell Tropism, Inflammation, and Immunity

Brito

Brune

Stahl

2019

IJMS

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Human cytomegalovirus (HCMV) is an opportunistic pathogen causing disease mainly in immunocompromised patients or after congenital infection. HCMV infection of the respiratory tract leads to pneumonitis in the immunocompromised host, which is often associated with a bad clinical course. The related mouse cytomegalovirus (MCMV) likewise exhibits a distinct tropism for the lung and thus provides an elegant model to study host-pathogen interaction. Accordingly, fundamental features of cytomegalovirus (CMV) pneumonitis have been discovered in mice that correlate with clinical data obtained from humans. Recent studies have provided insight into MCMV cell tropism and localized inflammation after infection of the respiratory tract. Accordingly, the nodular inflammatory focus (NIF) has been identified as the anatomical correlate of immune control in lungs. Several hematopoietic cells involved in antiviral immunity reside in NIFs and their key effector molecules have been deciphered. Here, we review what has been learned from the mouse model with focus on the microanatomy of infection sites and antiviral immunity in MCMV pneumonitis.

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Pulmonary cytomegalovirus (CMV) DNA shedding in allogeneic hematopoietic stem cell transplant recipients: Implications for the diagnosis of CMV pneumonia

Cited by 18 publications

References 37 publications

Delayed Onset of COVID-19 in an Immunosuppressed Patient

Delayed Onset of COVID-19 in an Immunosuppressed Patient

CMV Infection in Hematopoietic Stem Cell Transplantation: Prevention and Treatment Strategies

Cytomegalovirus (CMV) Pneumonitis: Cell Tropism, Inflammation, and Immunity

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