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Chikungunya,Dengue, and Zika in Immunocompromised Hosts
Authors:Luiz Guilherme DarrigoJr.  Alexandre Machado de Sant’Anna Carvalho  Clarisse Martins Machado
Affiliation:1.Bone Marrow Transplant Unit - Ribeir?o Preto Medical School,University of S?o Paulo,Ribeir?o Preto,Brazil;2.Virology Laboratory – Institute of Tropical Medicine,University of S?o Paulo,S?o Paulo,Brazil;3.HSCT Program, Amaral Carvalho Foundation,Jahu,Brazil
Abstract:

Purpose of Review

Describe the characteristics of chikungunya, dengue, and Zika in transplant recipients and immunocompromised hosts.

Recent Findings

Stem cell/bone marrow grafts, organs, and blood transfusions can transmit CHIKV/DENV/ZIKV infections, which are clinically similar, resembling influenza-like illness. Laboratory confirmation is necessary. In the acute phase, RT-PCR is preferred. DENV and ZIKV serology may cross-react. Delayed engraftment and extended viruria is observed in ZIKV+/HSCT recipients, while longer viremia is observed in DENV+/HSCT patients. Arbovirus persistence in organ tissues is generally unknown. Vaccine development is in early stages for CHIKV/ZIKV. No data is available to recommend the licensed DENV vaccine in transplant recipients.

Summary

In endemic areas, the assessment of epidemiological risk is mandatory. Donor deferral for 120 days in suspected or confirmed ZIKV+ has been recommended, while CHIKV+ donors should wait 30 days. No deferral is recommended for DENV+ donors. CHIKV/DENV/ZIKV tests should be included in the differential of febrile neutropenia and other transplant syndromes. Reassessment of DENV serology is urgently needed. Prospective studies are necessary to determine the impact of CHIKV/DENV/ZIKV in this special population.
Keywords:
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