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CMV treatment guidelines

Lei Zhang, Jianling Tao, Yubing Wen, Li Li, Xueyi Wu, Xuewang Li, Xuemei Li
To better clarify the clinical features and therapeutic strategy of CMV infection in lupus nephritis patients, we retrospectively surveyed a total of 40 lupus nephritis patients, who had been hospitalized and underwent renal biopsy and diagnosed as having CMV infection during their hospitalization at our institution within the last 10 years. The percentage of CMV infections in the entire hospitalized lupus nephritis population was 5.3% (40/755). The principal clinical features of the 40 CMV-infected patients were hematological disorders (n = 25), fever (n = 21), liver dysfunction (n = 19), and respiratory symptoms (n = 12)...
February 17, 2017: Clinical and Experimental Medicine
Louise E Kimball, Terry Stevens-Ayers, Margaret L Green, Hu Xie, Mary E D Flowers, Keith R Jerome, Renee LeBlanc, Christi Dahlgren, W Garrett Nichols, Roy F Chemaly, G Papanicolaou, Michael Boeckh
PURPOSE: The logistics of conducting double-blinded phase III clinical trials with participants residing in remote locations are complex. Here we describe the implementation of an interventional trial for the prevention of late cytomegalovirus (CMV) disease in hematopoietic cell transplantation (HCT) subjects in a long-term follow-up environment. METHODS: A total of 184 subjects at risk for late CMV disease surviving 80 days following allogeneic HCT were randomized to receive six months of valganciclovir or placebo...
December 15, 2016: Contemporary Clinical Trials Communications
Bethany A Wattles, Abby J Kim, Alexandra C Cheerva, Kenneth G Lucas, Joshua J Elder
Cytomegalovirus (CMV) is a frequent complication of hematopoietic stem cell transplant in pediatric patients, with significant morbidity and mortality. Antiviral drugs are used as prophylactic, preemptive or therapeutic medicines; however, no uniform guidelines exist for the best strategy to prevent CMV disease. Resistance to standard antiviral therapies can lead to further difficulty in managing CMV disease. Studies for investigational therapies are underway and could provide options for treatment of resistant CMV, while limiting toxicities associated with currently used antiviral therapies...
January 5, 2017: Journal of Pediatric Hematology/oncology
Dorota Pytka, Bożena Czarkowska-Pączek
Cytomegalovirus (CMV) infects approximately 40-90% of the world population. The infection is usually asymptomatic in immunocompetent persons. However, it may have negative impact on physiological status or accompanying diseases especially in the elderly. In particular, increasing number of data suggests that persistent infection with CMV is associated with accelerated aging of the immune system accompanying by the decrease in the number of naïve T cells, the increase in in the number of late-differentiated T cells, and reduced TCD4/ TCD8 ratio...
2016: Przegla̧d Lekarski
Maryam Mozaffar, Shahrzad Shahidi, Shirinsadat Badri
OBJECTIVE: In this study, we evaluated certain aspects of the usage and administration of one lifesaving, high-cost medication, i.e., Ganciclovir for the prevention and treatment of cytomegalovirus (CMV) infection in transplant patients. METHODS: This study was performed from 2013 to 2015 by conducting a medication use evaluation (MUE) program in the kidney transplantation departments of two tertiary care hospitals in Isfahan, Iran. The MUE criteria for the drug were developed by applying drug information references...
July 2016: Journal of Research in Pharmacy Practice
J Torre-Cisneros, J M Aguado, J J Caston, L Almenar, A Alonso, S Cantisán, J Carratalá, C Cervera, E Cordero, M C Fariñas, M Fernández-Ruiz, J Fortún, E Frauca, J Gavaldá, D Hernández, I Herrero, O Len, F Lopez-Medrano, N Manito, M A Marcos, P Martín-Dávila, V Monforte, M Montejo, A Moreno, P Muñoz, D Navarro, P Pérez-Romero, A Rodriguez-Bernot, J Rumbao, R San Juan, J M Vaquero, E Vidal
Cytomegalovirus (CMV) infection remains a major complication of solid organ transplantation. Because of management of CMV is variable among transplant centers, in 2011 the Spanish Transplantation Infection Study Group (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) developed consensus guidelines for the prevention and treatment of CMV infection in solid organ transplant recipients. Since then, new publications have clarified or questioned the aspects covered in the previous document...
July 2016: Transplantation Reviews
Martina Loibner, Walter Buzina, Christian Viertler, Daniel Groelz, Anja Hausleitner, Gintare Siaulyte, Iris Kufferath, Bettina Kölli, Kurt Zatloukal
BACKGROUND: Requirements on tissue fixatives are getting more demanding as molecular analysis becomes increasingly relevant for routine diagnostics. Buffered formaldehyde in pathology laboratories for tissue fixation is known to cause chemical modifications of biomolecules which affect molecular testing. A novel non-crosslinking tissue preservation technology, PAXgene Tissue (PAXgene), was developed to preserve the integrity of nucleic acids in a comparable way to cryopreservation and also to preserve morphological features comparable to those of formalin fixed samples...
2016: PloS One
Anders Åsberg, Atul Humar, Halvor Rollag, Alan G Jardine, Deepali Kumar, Pål Aukrust, Thor Ueland, Angelo A Bignamini, Anders Hartmann
The VICTOR study showed comparable efficacy of treatment with intravenous ganciclovir and oral valganciclovir for cytomegalovirus (CMV) disease in solid organ transplant recipients. Oral therapy is now recommended treatment in clinical practice and guidelines. The VICTOR biobank was used in a series of post hoc analyses that yielded unique and clinically valuable insights into CMV treatment and pathogenesis. For example, the importance of tailoring therapy to initial viral load, the effect of immunosuppression on outcomes, and the need to continue therapy until undetectable viral load to prevent recurrence and emergence of resistant strains...
May 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Alexei Shimanovsky, Devbala Patel, Jeffrey Wasser
Immune thrombocytopenic purpura (ITP) is characterized by a decreased platelet count caused by excess destruction of platelets and inadequate platelet production. In many cases, the etiology is not known, but the viral illness is thought to play a role in the development of some cases of ITP. The current (2011) American Society of Hematology ITP guidelines recommend initial diagnostic studies to include testing for HIV and Hepatitis C. The guidelines suggest that initial treatment consist of observation, therapy with corticosteroids, IVIG or anti D...
2016: Mediterranean Journal of Hematology and Infectious Diseases
Hannah Kaminski, Lionel Couzi, Julie Déchanet-Merville, Pierre Merville
Cytomegalovirus infection in kidney transplantation is associated with increased morbidity and mortality through direct and indirect effects. International guidelines had been recently updated, focusing on diagnostic, prevention strategies and curative treatment. Cytomegalovirus-specific immune response plays also an important function in controlling the virus. Here, we propose to present the different components of this specific immune response and the advantages of immune monitoring for patient's management: identification of patients who require a treatment, adaptation of curative treatment length, guidance for resistance genotypic testing...
November 2015: Néphrologie & Thérapeutique
Omar Alsuhaibani, Winston Costa Pereira, Mohammed Tareeqanwar, Nora El Khizzi, Saadia Bakheswain, Amira Shaker, Ghaleb Elyamany
BACKGROUND: Hematopoietic stem cell transplantation (HSCT) involves the infusion of hematopoietic stem cells from a suitable donor to a patient who has undergone chemotherapy. Stem Cell transplantation is used for the treatment for a wide variety of diseases, including leukemia and lymphoma. PURPOSE: This study highlights prevention strategies of infectious diseases among HSCT donors and recipients in our institute as guided by International guidelines. We aim to highlight the strategy for extensive screening of HIV, Hepatitis B and C, CMV infection and syphilis cases in all the stem cell units stored in our facility...
April 2015: Annals of Neurosciences
Jonathan C Gullett, Frederick S Nolte
BACKGROUND: Over the past 2 decades there have been substantial improvements in the methods used to quantify viral nucleic acid in body fluids and in our understanding of how to use viral load measurements in the diagnosis and management of patients with a number of viral infections. These methods are now integrated into a wide range of diagnostic and treatment guidelines and commonly deployed in a variety of clinical settings. CONTENT: Quantitative nucleic acid amplification methods that are used to measure viral load are described along with key issues and important variables that affect their performance...
January 2015: Clinical Chemistry
James Ian Stuart, Johan Delport, Robert Lannigan, George Zahariadis
BACKGROUND: Disease monitoring of viruses using real-time polymerase chain reaction (PCR) requires knowledge of the precision of the test to determine what constitutes a significant change. Calculation of quantitative PCR confidence limits requires bivariate statistical methods. OBJECTIVE: To develop a simple-to-use graphical user interface to determine the uncertainty of measurement (UOM) of BK virus, cytomegalovirus (CMV) and Epstein-Barr virus (EBV) real-time PCR assays...
July 2014: Canadian Journal of Infectious Diseases & Medical Microbiology
Nuria Montero, Angela C Webster, Ana Royuela, Javier Zamora, Marta Crespo Barrio, Julio Pascual
BACKGROUND: Pancreas or kidney-pancreas transplantation improves survival and quality of life for people with type 1 diabetes mellitus and kidney failure. Immunosuppression after transplantation is associated with complications. Steroids have adverse effects on cardiovascular risk factors such as hypertension, hyperglycaemia or hyperlipidaemia, increase risk of infection, obesity, cataracts, myopathy, bone metabolism alterations, dermatologic problems and cushingoid appearance. Whether avoiding steroids changes outcomes is unclear...
2014: Cochrane Database of Systematic Reviews
Jasmine Riviere Marcelin, Elena Beam, Raymund R Razonable
Cytomegalovirus (CMV) infection is a common complication after liver transplantation, and it is associated with multiple direct and indirect effects. Management of CMV infection and disease has evolved over the years, and clinical guidelines have been recently updated. Universal antiviral prophylaxis and a pre-emptive treatment strategy are options for prevention. A currently-recruiting randomized clinical trial is comparing the efficacy and safety of the two prevention strategies in the highest risk D+R- liver recipients...
August 21, 2014: World Journal of Gastroenterology: WJG
Jackrapong Bruminhent, Raymund R Razonable
Cytomegalovirus (CMV) is one of the most common viral pathogens causing clinical disease in liver transplant recipients, and contributing to substantial morbidity and occasional mortality. CMV causes febrile illness often accompanied by bone marrow suppression, and in some cases, invades tissues including the transplanted liver allograft. In addition, CMV has been significantly associated with an increased predisposition to acute and chronic allograft rejection, accelerated hepatitis C recurrence, and other opportunistic infections, as well as reduced overall patient and allograft survival...
June 27, 2014: World Journal of Hepatology
E Beam, V Dioverti, R R Razonable
Cytomegalovirus (CMV) remains as one of the most common pathogens after solid organ transplantation (SOT). During the past year, management guidelines were updated, and numerous studies were published-all collectively emphasizing the ongoing efforts to improve management of CMV after SOT. Improvement in laboratory diagnostics was aided by the WHO international calibration standard for nucleic acid testing, which allows for meaningful comparison of viral load values among laboratories. The potential translation of methods for assessing CMV-specific cellular immunity could provide tools for CMV risk assessment and management...
September 2014: Current Infectious Disease Reports
Benjamin Savenkoff, Perrine Aubertin, Marc Ladriere, Cyril Hulin, Jacqueline Champigneulle, Luc Frimat
INTRODUCTION: Myeloma following kidney transplantation is a rare entity. It can be divided into two groups: relapse of a previous myeloma and de novo myeloma. Some of these myelomas can be complicated by a monoclonal immunoglobulin deposition disease, which is even less common. Less than ten cases of monoclonal immunoglobulin deposition disease after renal graft have been reported in the literature. The treatment of these patients is not well codified. CASE PRESENTATION: We report the case of a 43-year-old white European man who received a renal transplant for a nephropathy of unknown etiology and developed a nephrotic syndrome with kidney failure at 2-years follow-up...
2014: Journal of Medical Case Reports
Andrea Poretti, Eugen Boltshauser, Dan Doherty
Cerebellar hypoplasia (CH) refers to a cerebellum with a reduced volume, and is a common, but non-specific neuroimaging finding. The etiological spectrum of CH is wide and includes both primary (malformative) and secondary (disruptive) conditions. Primary conditions include chromosomal aberrations (e.g., trisomy 13 and 18), metabolic disorders (e.g., molybdenum cofactor deficiency, Smith-Lemli-Opitz syndrome, and adenylosuccinase deficiency), genetic syndromes (e.g., Ritscher-Schinzel, Joubert, and CHARGE syndromes), and brain malformations (primary posterior fossa malformations e...
June 2014: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
G Maschmeyer, J Carratalà, D Buchheidt, A Hamprecht, C P Heussel, C Kahl, J Lorenz, S Neumann, C Rieger, M Ruhnke, H Salwender, M Schmidt-Hieber, E Azoulay
Up to 25% of patients with profound neutropenia lasting for >10 days develop lung infiltrates, which frequently do not respond to broad-spectrum antibacterial therapy. While a causative pathogen remains undetected in the majority of cases, Aspergillus spp., Pneumocystis jirovecii, multi-resistant Gram-negative pathogens, mycobacteria or respiratory viruses may be involved. In at-risk patients who have received trimethoprim-sulfamethoxazole (TMP/SMX) prophylaxis, filamentous fungal pathogens appear to be predominant, yet commonly not proven at the time of treatment initiation...
January 2015: Annals of Oncology: Official Journal of the European Society for Medical Oncology
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