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Pharmacotherapy of post-transplant viral infections
Abstract:Background: Management of a number of significant viral pathogens in transplant recipients remains challenging. Objectives: To define an optimal antiviral approach to the management of cytomegalovirus (CMV), human herpes virus-6 (HHV-6), Epstein–Barr (EBV)-associated post-transplant lymphoproliferative disorder (PTLD), and polyoma virus-associated nephropathy in transplant recipients. Methods: Clinical trials and existing data regarding use of antiviral agents for these viruses were reviewed to develop evidence-based recommendations for their management. Conclusions: Weighing the current evidence regarding the use of valganciclovir as pre-emptive therapy or prophylaxis, the former approach offers a greater benefit for the overall prevention of CMV disease. Limited data show that prophylaxis with antiviral agents is associated with a reduction in the risk of EBV-associated PTLD. Treatment options for HHV-6 and polyoma virus-associated nephropathy are still limited.
Keywords:cidofovir  cytomegalovirus  Epstein–Barr virus  foscarnet  antiviral ganciclovir  human herpes virus-6  leflunomide  maribavir  polyoma virus nephropathy  post-transplant lymphoproliferative disorder  rituximab  transplants  valganciclovir
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