Article information
Resumen
La infección por citomegalovirus (CMV) es una complicación frecuente tras el trasplante cardíaco, pudiendo afectar a casi el 50% de los pacientes. El espectro clínico de esta infección incluye, de menor a mayor gravedad, la infección latente, la viremia asintomática, el síndrome CMV y la enfermedad por CMV. Se asocia con rechazo cardíaco, enfermedad vascular del injerto y es una importante causa de morbimortalidad. Los factores más implicados en la susceptibilidad y gravedad de la infección son el estatus serológico frente al CMV de donante y receptor, la intensidad de la inmunosupresión y el tipo de agentes inmunosupresores. Las estrategias de manejo de esta infección incluyen la profilaxis universal o dirigida, la terapia anticipada y el tratamiento de la enfermedad establecida. La utilización de medidas preventivas ha demostrado reducir de forma muy significativa la incidencia de infección sintomática o enfermedad por CMV, siendo < 3% en algunas series recientes.
Palabras clave:
Citomegalovirus
Trasplante de corazón
Profilaxis
Infección
Abstract
Cytomegalovirus (CMV) is a common complication after heart transplantation, affecting almost half of all recipients. The clinical spectrum of this infection includes, in order of greater to lesser severity, latent infection, asymptomatic viremia, CMV syndrome and CMV disease. CMV is associated with rejection and vascular graft disease and is a major cause of morbidity and mortality. The factors most frequently involved in susceptibility to this infection and its severity are donor and recipient CMV serological status, the intensity of immunosuppression and the type of immunosuppressive agents used. The management strategies of this infection include universal or targeted prophylaxis, preemptive therapy and treatment of established disease. The use of preventive measures significantly reduces the incidence of symtomatic infection or CMV disease, which has been reported to be less than 3% in some recent series.
Keywords:
Cytomegalovirus
Heart transplantation
Prophylaxis
Infection
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