新型免疫抑制劑的使用使移植腎的存活率明顯增加,但機(jī)會(huì)性感染的發(fā)生也隨之增多。巨細(xì)胞病毒(CMV)感染是腎移植術(shù)后常見(jiàn)的并發(fā)癥,除可引起直接損害外,還可對(duì)機(jī)體產(chǎn)生間接影響?,F(xiàn)就腎移植術(shù)后巨細(xì)胞病毒感染的途徑、危險(xiǎn)因素、臨床表現(xiàn)、實(shí)驗(yàn)室檢查及防治進(jìn)展作一綜述。
引用本文: 于笑笑,柳飛,陶冶. 腎移植術(shù)后巨細(xì)胞病毒感染研究進(jìn)展. 華西醫(yī)學(xué), 2012, 27(4): 630-633. doi: 復(fù)制
1. | Humar A, Snydman D, AST Infectious Diseases Community of Practice. Cytomegalovirus in solid organ transplant recipients[J]. Am J Transplant,2009,9 (4): 78-86. |
2. | De Keyzer K, Van Laecke S, Peeters P, et al. Human cytomegalovirus and kidney transplantation: a clinician’s update[J]. Am J Kidney Dis, 2011, 58(1): 118-126. |
3. | Hu JH, Zhao H, Huang YP, et al. Opportunistic posttransplantation virus infections in renal transplant recipients[J]. Transplant Proc, 2011, 43(10): 3715-3719. |
4. | Fortun J, Martin-Davila P, Pascual J, et al. Immunosuppressive therapy and infection after kidney transplantation[J]. Transpl Infect Dis, 2010, 12(5): 397-405. |
5. | Tian JH, Wang X, Yang KH, et al. Induction with and without antithymocyte globulin combined with cyclosporine/tacrolimus-based immunosuppression in renal transplantation: a meta-analysis of randomized controlled trials[J]. Transplant Proc, 2009 , 41(9): 3671-3676. |
6. | Prichard MN, Kern ER. The search for new therapies for human cytomegalovirus infections[J]. Virus Res, 2011, 157(2): 212-221. |
7. | 魏強(qiáng), 于立新, 鄧文鋒, 等. 腎移植術(shù)后感染巨細(xì)胞病毒性肺炎的多因素分析[J]. 南方醫(yī)科大學(xué)學(xué)報(bào), 2009, 29(6): 1182-1184. |
8. | Crough T, Khanna R. Immunobiology of human cytomegalovi-rus: from bench to bedside[J]. Clin Microbiol Rev, 2009, 2(1): 76-98. |
9. | Razonable RR, Paya CV. Herpesvirus infections in transplant recipients: current challenges in the clinical management of cytomegalovirus and epstein-barr virus infections[J]. Herpes, 2003, 10(3): 60-65. |
10. | 滕東海, 田靜. 巨細(xì)胞病毒感染與腎移植[J]. 華西醫(yī)學(xué), 2003, 3(2): 411-412. |
11. | Dzabic M, Rahbar A, Yaiw KC, et al. Intragraft cytomegalovirus protein expression is associated with reduced renal allograft survival[J]. Clin Infect Dis, 2011, 53(10): 969-976. |
12. | Helanterä I, Loqinov R, Koskinen P, et al. Persistent cytomegalovirus infection is associated with increased expression of TGF-b 1, PDGF-AA and ICAM-1 and arterial intimal thickening in kidney allografts[J]. Nephrol Dial Transplant, 2005, 20(4): 790-796. |
13. | Reischiq T, Jindra P, Hes O, et al. Effect of cytomegalovirus viremia on subclinical rejection or interstitial fibrosis and tubular atrophy in protocol biopsy at 3 months in renal allograft recipients managed by preemptive therapy or antiviral prophylaxis[J]. Transplantation, 2009, 87(3): 436-444. |
14. | Hjelmesæth J, Sagedal S, Hartmann A, et al. Asymptomatic cytomegalovirus infection is associated with increased risk of new-onset diabetes mellitus and impaired insulin release after renal transplantation[J]. Diabetologia, 2004, 47(9): 1550-1556. |
15. | De Keyzer K, Van Laecke S, Peeters P, et al. Denovo thrombotic microangiopathy induced by cytomegalovirus infection leading to renal allograft loss[J]. Am J Nephrol, 2010, 32(5): 491-496. |
16. | Sagedal S, Hartmann A, Nordal KP, et al. Impact of early cytomegalovirus infection and disease on long-term recipient and kidney graft survival[J]. Kidney Int, 2004, 66(1): 329-337. |
17. | Kalis RS, Hudson SL, Gaston RS. Determinants of Cardiovascular Mortality After Renal Transplantation: A Role For Cytomegalovirus?[J]. Am J Transplant, 2003, 3(1): 79-81. |
18. | Kim CK, Song JH, Kim SM, et al. Clinical usefulness of human cytomegalovirus antigenemia assay after kidney transplantation[J]. Transplantation, 2003, 75(12): 2151-2155. |
19. | 范文勇. 實(shí)時(shí)熒光定量-PCR和酶聯(lián)免疫吸附法檢測(cè)巨細(xì)胞病毒-IgM抗體的比較[J]. 醫(yī)學(xué)檢驗(yàn), 2011, 8(2): 83-85. |
20. | Rhee JY, Peck KR, Lee NY, et al. Clinical usefulness of plasma quantitative polymerase chain reaction assay: diagnosis of cytomegalovirus infection in kidney transplant recipients[J]. Transplant Proc, 2011, 43(7): 2624-2629. |
21. | Kotton CN, Kumar D, Caliendo AM, et al. International consensus guidelines on the management of cytomegalovirus in solid organ transplantation[J]. Transplantation, 2010, 89(7): 779-795. |
22. | Winston DJ, Young JA, Pullarkat V, et al. Maribavir prophylaxis for prevention of cytomegalovirus infection in allogeneic stem-cell transplant recipients: a multicenter, randomized, double-blind,placebo-controlled, dose-ranging study[J]. Blood, 2008, 111(11): 5403-5410. |
23. | Hodson EM, Jones CA, Webster AC, et al. Antiviral medications to prevent cytomegalovirus disease and early death in recipients of solid-organ transplants: a systematic review of randomized con-trolled trials[J]. Lancet, 2005, 365: 2105-2115. |
24. | Johnson RJ, Clatworthy MR, Brich R, et al. CMV mismatch does not affect patient and graft survival in UK renal transplant recipients[J]. Transplantation, 2009, 88(1): 77-82. |
25. | Chamberlain CE, Penzak SR, Alfaro RM, et al. Pharmacokinetics of low and maintenance dose valganciclovir in kidney transplant recipients[J]. Am J Transplant, 2008, 8(6): 1297-1302. |
26. | Humar A, Lebranchu Y, Vincenti F, et al. The efficacy and safety of 200 days valganciclovir cytomegalovirus prophylaxis in high-risk kidney transplant recipients[J]. Am J Transplant, 2010, 10(5): 1228-1237. |
27. | Humar A, Limaye AP, Blumberq EA, et al. Extended valganciclovir prophylaxis in D+/R- kidney transplant recipients is associated with long-term reduction in cytomegalovirus disease: two-year results of the IMPACT study[J]. Transplantation, 2010, 90(12): 1427-1431. |
28. | San Juan R, Yebra M, Lumbreras C, et al. A new strategy of delayed long-term prophylaxis could prevent cytomegalovirus disease in (D+/R-) solid organ transplant recipients[J]. Clin Transplant, 2009, 23(5): 666-671. |
29. | Boillat Blanc N, Pascual M, Venetz JP, et al. Impact of a preemptive strategy after 3 months of valganciclovir cytomegalovirus prophylaxis in kidney transplant recipients [J]. Transplantation, 2011, 91(2): 251-255. |
30. | Sun HY, Waqener MM, Sinqh N. Prevention of posttransplant cytomegalovirus disease and related outcomes with valganciclovir: a systematic review[J]. Am J Transplant, 2008, 8(10): 2111-2118. |
31. | Alberú J, Morales-Buenrostro LE, Correa-Rotter R, et al. Long-term renal graft function and survival in patients with high-risk for cytomegalovirus infection receiving preemptive therapy[J]. Rev Invest Clin, 2008, 60(5): 365-374. |
32. | Small LN, Lau J, Snydman DR. Preventing post-organ transplantation cytomegalovirus disease with ganciclovir: a meta-analysis comparing prophylactic and preemptive therapies[J]. Clin Infect Dis, 2006, 43(7): 869-880. |
33. | Spinner ML, Saab G, Casabar E, et al. Impact of prophylactic versus preemptive valganciclovir on long-term renal allograft outcomes[J]. Transplantation, 2010, 90(4): 412-418. |
34. | Kliem V, Fricke L, Wollbrink T, et al. Improvement in long-term renal graft survival due to CMV prophylaxis with oral ganciclovir: results of a randomized clinical trial[J]. Am J Transplant, 2008, 8(5): 975-983. |
35. | Kalil AC, Levitsky J, Lyden E, et al. Meta-analysis: the efficacy of strategies to prevent organ disease by cytomegalovirus in solid organ transplant recipients[J]. Ann Intern Med, 2005, 143: 870-880. |
36. | Asberq A, Humar A, Rollaq H, et al. Oral valganciclovir is noninferior to intravenous ganciclovir for the treatment of cytomegalovirus disease in solid organ transplant recipients[J]. Am J Transplant, 2007, 7(9): 2106-2113. |
37. | 郭紅梅. 巨細(xì)胞病毒耐藥性研究進(jìn)展[J]. 國(guó)外醫(yī)學(xué)·流行病學(xué)傳染病學(xué)分冊(cè), 2003, 30(3): 179-181. |
38. | Baldanti F, Lurain N, Gerna G. Clinical and biologic aspects of human cytomegalovirus resistance to antiviral drugs[J]. Hum Immunol, 2004, 65(5): 403- 409. |
39. | West P, Schmiedekamp M, Neeley H, et al. Use of high-dose ganciclovir for ganciclovir-resistant cytomegalovirus infection due to UL97 mutation[J]. Transpl Infect Dis, 2008, 10(2): 129-132. |
40. | Avery RK. Update in management of ganciclovir-resistant cytomegalovirus infection[J]. Curr Opin Infect Dis, 2008, 21(4): 433-437. |
- 1. Humar A, Snydman D, AST Infectious Diseases Community of Practice. Cytomegalovirus in solid organ transplant recipients[J]. Am J Transplant,2009,9 (4): 78-86.
- 2. De Keyzer K, Van Laecke S, Peeters P, et al. Human cytomegalovirus and kidney transplantation: a clinician’s update[J]. Am J Kidney Dis, 2011, 58(1): 118-126.
- 3. Hu JH, Zhao H, Huang YP, et al. Opportunistic posttransplantation virus infections in renal transplant recipients[J]. Transplant Proc, 2011, 43(10): 3715-3719.
- 4. Fortun J, Martin-Davila P, Pascual J, et al. Immunosuppressive therapy and infection after kidney transplantation[J]. Transpl Infect Dis, 2010, 12(5): 397-405.
- 5. Tian JH, Wang X, Yang KH, et al. Induction with and without antithymocyte globulin combined with cyclosporine/tacrolimus-based immunosuppression in renal transplantation: a meta-analysis of randomized controlled trials[J]. Transplant Proc, 2009 , 41(9): 3671-3676.
- 6. Prichard MN, Kern ER. The search for new therapies for human cytomegalovirus infections[J]. Virus Res, 2011, 157(2): 212-221.
- 7. 魏強(qiáng), 于立新, 鄧文鋒, 等. 腎移植術(shù)后感染巨細(xì)胞病毒性肺炎的多因素分析[J]. 南方醫(yī)科大學(xué)學(xué)報(bào), 2009, 29(6): 1182-1184.
- 8. Crough T, Khanna R. Immunobiology of human cytomegalovi-rus: from bench to bedside[J]. Clin Microbiol Rev, 2009, 2(1): 76-98.
- 9. Razonable RR, Paya CV. Herpesvirus infections in transplant recipients: current challenges in the clinical management of cytomegalovirus and epstein-barr virus infections[J]. Herpes, 2003, 10(3): 60-65.
- 10. 滕東海, 田靜. 巨細(xì)胞病毒感染與腎移植[J]. 華西醫(yī)學(xué), 2003, 3(2): 411-412.
- 11. Dzabic M, Rahbar A, Yaiw KC, et al. Intragraft cytomegalovirus protein expression is associated with reduced renal allograft survival[J]. Clin Infect Dis, 2011, 53(10): 969-976.
- 12. Helanterä I, Loqinov R, Koskinen P, et al. Persistent cytomegalovirus infection is associated with increased expression of TGF-b 1, PDGF-AA and ICAM-1 and arterial intimal thickening in kidney allografts[J]. Nephrol Dial Transplant, 2005, 20(4): 790-796.
- 13. Reischiq T, Jindra P, Hes O, et al. Effect of cytomegalovirus viremia on subclinical rejection or interstitial fibrosis and tubular atrophy in protocol biopsy at 3 months in renal allograft recipients managed by preemptive therapy or antiviral prophylaxis[J]. Transplantation, 2009, 87(3): 436-444.
- 14. Hjelmesæth J, Sagedal S, Hartmann A, et al. Asymptomatic cytomegalovirus infection is associated with increased risk of new-onset diabetes mellitus and impaired insulin release after renal transplantation[J]. Diabetologia, 2004, 47(9): 1550-1556.
- 15. De Keyzer K, Van Laecke S, Peeters P, et al. Denovo thrombotic microangiopathy induced by cytomegalovirus infection leading to renal allograft loss[J]. Am J Nephrol, 2010, 32(5): 491-496.
- 16. Sagedal S, Hartmann A, Nordal KP, et al. Impact of early cytomegalovirus infection and disease on long-term recipient and kidney graft survival[J]. Kidney Int, 2004, 66(1): 329-337.
- 17. Kalis RS, Hudson SL, Gaston RS. Determinants of Cardiovascular Mortality After Renal Transplantation: A Role For Cytomegalovirus?[J]. Am J Transplant, 2003, 3(1): 79-81.
- 18. Kim CK, Song JH, Kim SM, et al. Clinical usefulness of human cytomegalovirus antigenemia assay after kidney transplantation[J]. Transplantation, 2003, 75(12): 2151-2155.
- 19. 范文勇. 實(shí)時(shí)熒光定量-PCR和酶聯(lián)免疫吸附法檢測(cè)巨細(xì)胞病毒-IgM抗體的比較[J]. 醫(yī)學(xué)檢驗(yàn), 2011, 8(2): 83-85.
- 20. Rhee JY, Peck KR, Lee NY, et al. Clinical usefulness of plasma quantitative polymerase chain reaction assay: diagnosis of cytomegalovirus infection in kidney transplant recipients[J]. Transplant Proc, 2011, 43(7): 2624-2629.
- 21. Kotton CN, Kumar D, Caliendo AM, et al. International consensus guidelines on the management of cytomegalovirus in solid organ transplantation[J]. Transplantation, 2010, 89(7): 779-795.
- 22. Winston DJ, Young JA, Pullarkat V, et al. Maribavir prophylaxis for prevention of cytomegalovirus infection in allogeneic stem-cell transplant recipients: a multicenter, randomized, double-blind,placebo-controlled, dose-ranging study[J]. Blood, 2008, 111(11): 5403-5410.
- 23. Hodson EM, Jones CA, Webster AC, et al. Antiviral medications to prevent cytomegalovirus disease and early death in recipients of solid-organ transplants: a systematic review of randomized con-trolled trials[J]. Lancet, 2005, 365: 2105-2115.
- 24. Johnson RJ, Clatworthy MR, Brich R, et al. CMV mismatch does not affect patient and graft survival in UK renal transplant recipients[J]. Transplantation, 2009, 88(1): 77-82.
- 25. Chamberlain CE, Penzak SR, Alfaro RM, et al. Pharmacokinetics of low and maintenance dose valganciclovir in kidney transplant recipients[J]. Am J Transplant, 2008, 8(6): 1297-1302.
- 26. Humar A, Lebranchu Y, Vincenti F, et al. The efficacy and safety of 200 days valganciclovir cytomegalovirus prophylaxis in high-risk kidney transplant recipients[J]. Am J Transplant, 2010, 10(5): 1228-1237.
- 27. Humar A, Limaye AP, Blumberq EA, et al. Extended valganciclovir prophylaxis in D+/R- kidney transplant recipients is associated with long-term reduction in cytomegalovirus disease: two-year results of the IMPACT study[J]. Transplantation, 2010, 90(12): 1427-1431.
- 28. San Juan R, Yebra M, Lumbreras C, et al. A new strategy of delayed long-term prophylaxis could prevent cytomegalovirus disease in (D+/R-) solid organ transplant recipients[J]. Clin Transplant, 2009, 23(5): 666-671.
- 29. Boillat Blanc N, Pascual M, Venetz JP, et al. Impact of a preemptive strategy after 3 months of valganciclovir cytomegalovirus prophylaxis in kidney transplant recipients [J]. Transplantation, 2011, 91(2): 251-255.
- 30. Sun HY, Waqener MM, Sinqh N. Prevention of posttransplant cytomegalovirus disease and related outcomes with valganciclovir: a systematic review[J]. Am J Transplant, 2008, 8(10): 2111-2118.
- 31. Alberú J, Morales-Buenrostro LE, Correa-Rotter R, et al. Long-term renal graft function and survival in patients with high-risk for cytomegalovirus infection receiving preemptive therapy[J]. Rev Invest Clin, 2008, 60(5): 365-374.
- 32. Small LN, Lau J, Snydman DR. Preventing post-organ transplantation cytomegalovirus disease with ganciclovir: a meta-analysis comparing prophylactic and preemptive therapies[J]. Clin Infect Dis, 2006, 43(7): 869-880.
- 33. Spinner ML, Saab G, Casabar E, et al. Impact of prophylactic versus preemptive valganciclovir on long-term renal allograft outcomes[J]. Transplantation, 2010, 90(4): 412-418.
- 34. Kliem V, Fricke L, Wollbrink T, et al. Improvement in long-term renal graft survival due to CMV prophylaxis with oral ganciclovir: results of a randomized clinical trial[J]. Am J Transplant, 2008, 8(5): 975-983.
- 35. Kalil AC, Levitsky J, Lyden E, et al. Meta-analysis: the efficacy of strategies to prevent organ disease by cytomegalovirus in solid organ transplant recipients[J]. Ann Intern Med, 2005, 143: 870-880.
- 36. Asberq A, Humar A, Rollaq H, et al. Oral valganciclovir is noninferior to intravenous ganciclovir for the treatment of cytomegalovirus disease in solid organ transplant recipients[J]. Am J Transplant, 2007, 7(9): 2106-2113.
- 37. 郭紅梅. 巨細(xì)胞病毒耐藥性研究進(jìn)展[J]. 國(guó)外醫(yī)學(xué)·流行病學(xué)傳染病學(xué)分冊(cè), 2003, 30(3): 179-181.
- 38. Baldanti F, Lurain N, Gerna G. Clinical and biologic aspects of human cytomegalovirus resistance to antiviral drugs[J]. Hum Immunol, 2004, 65(5): 403- 409.
- 39. West P, Schmiedekamp M, Neeley H, et al. Use of high-dose ganciclovir for ganciclovir-resistant cytomegalovirus infection due to UL97 mutation[J]. Transpl Infect Dis, 2008, 10(2): 129-132.
- 40. Avery RK. Update in management of ganciclovir-resistant cytomegalovirus infection[J]. Curr Opin Infect Dis, 2008, 21(4): 433-437.