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CMV treatment guidelines

Ryung Kim, Dai Joung, Sunghee Lee, Insook Jeong, Seak Hee Oh, Jung-Man Namgoong, Dae Yeon Kim, Kyung Mo Kim
PURPOSE: To evaluate the outcomes of a hybrid prophylactic strategy to prevent cytomegalovirus (CMV) disease in pediatric liver transplantation (LT) patients. METHODS: CMV DNAemia was regularly monitored by quantitative nucleic acid amplification test (QNAT) and was quantified in all children. CMV infection and disease were defined according to the International Consensus Guidelines. The hybrid strategy against CMV infection consisted of universal 3-week prophylaxis and preemptive treatment of intravenous ganciclovir regardless of the recipient's serostatus...
September 2017: Pediatric Gastroenterology, Hepatology & Nutrition
Marina Giuliano, Maria Franca Pirillo, Giuseppe Liotta, Mauro Andreotti, Haswell Jere, Jean-Baptiste Sagno, Fausto Ciccacci, Roberta Amici, Maria Cristina Marazzi, Stefano Vella, Leonardo Palombi, Sandro Mancinelli
BACKGROUND: Virtually all HIV-infected women in sub-Saharan Africa have evidence of Cytomegalovirus (CMV) infection and levels of specific anti-CMV IgG have been suggested to represent more intense reactivation of subclinical infection. Studies have also shown direct influence of CMV on lymphocytes. OBJECTIVE: The aim of this study was to determine if levels of anti-CMV specific antibodies could impact on the immunological response to antiretroviral treatment (ART) in HIV-infected pregnant women...
September 5, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
David Navarro, Rafael San-Juan, Oriol Manuel, Estela Giménez, Mario Fernández-Ruiz, Hans H Hirsch, Paolo Antonio Grossi, José María Aguado
BACKGROUND: Scant information is available about how transplant centers are managing their use of quantitative molecular testing (QNAT) assays for active cytomegalovirus (CMV) infection monitoring in solid organ transplant (SOT) recipients. The current study was aimed at gathering information on current practices in the management of CMV infection across European centers in the era of molecular testing assays. METHODS: A questionnaire-based cross-sectional survey study was conducted by the European Study Group of Infections in Immunocompromised Hosts (ESGICH) of the Society of Clinical Microbiology and Infectious Diseases (ESCMID)...
December 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
J Gunkel, J Nijman, M A Verboon-Maciolek, Tfw Wolfs, L S de Vries
AIM: This study evaluated the recognition and management practices with regard to congenital cytomegalovirus (cCMV) infections by a select group of experts and through a national surveillance study. METHOD: A questionnaire was sent to international experts involved in mother and infant care in 2014-2015. Monthly surveillance was conducted among Dutch paediatricians for cases of cCMV infections from 2013 until 2015. RESULTS: The questionnaire was completed by 63/103 (62%) respondents, who indicated that recognition and management practices varied...
September 2017: Acta Paediatrica
Cynthia E Fisher, Janine L Knudsen, Erika D Lease, Keith R Jerome, Robert M Rakita, Michael Boeckh, Ajit P Limaye
Background: Ganciclovir-resistant (ganR) cytomegalovirus (CMV) is an emerging and important problem in solid organ transplant (SOT) recipients. Only through direct comparison of ganR- and ganciclovir-sensitive (ganS) CMV infection can risk factors and outcomes attributable specifically to ganciclovir resistance appropriately be determined. Methods: We performed a retrospective, case-control (1:3) study of SOT recipients with genotypically confirmed ganR-CMV (n = 37) and ganS-CMV infection (n = 109), matched by donor/recipient CMV serostatus, year and organ transplanted, and clinical manifestation...
July 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Rubén López-Aladid, Alba Guiu, Gemma Sanclemente, Francisco López-Medrano, Frederic Cofán, M Mar Mosquera, Julián Torre-Cisneros, Elisa Vidal, Asunción Moreno, Jose Maria Aguado, Elisa Cordero, Cecilia Martin-Gandul, Pilar Pérez-Romero, Jordi Carratalá, Nuria Sabé, Jordi Niubó, Carlos Cervera, Anna Cervilla, Marta Bodro, Patricia Muñoz, Carmen Fariñas, M Gemma Codina, Maitane Aranzamendi, Miguel Montejo, Oscar Len, M Angeles Marcos
BACKGROUND: Current guidelines recommend that treatment of resistant cytomegalovirus (CMV) in solid organ transplant (SOT) recipients must be based on genotypic analysis. However, this recommendation is not systematically followed. OBJECTIVES: To assess the presence of mutations associated with CMV resistance in SOT recipients with suspected resistance, their associated risk factors and the clinical impact of resistance. STUDY DESIGN: Using Sanger sequencing we prospectively assessed the presence of resistance mutations in a nation-wide prospective study between September 2013-August 2015...
May 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
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)...
November 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...
May 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
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