Información del artículo
Abstract
Despite great advances in solid organ transplantation (SOT) in recent decades, infection remains a major cause of morbidity and mortality among SOT recipients. Members of the herpesvirus family are the most common viral pathogens causing disease in this patient population. Herpes viruses are large enveloped DNA viruses that commonly reactivate during periods of severe immunosuppression. Currently, infections caused by herpes viruses continue to complicate clinical management of transplant patients. Although cytomegalovirus (CMV) is the most important virus of this family and is the subject of active research, herpes simplex virus (HSV) and varicella-zoster virus (VZV) can also lead to severe disease. Epstein-Barr virus (EBV) associated with post-transplant lymphoproliferative disease is increasingly recognized as a major complication of SOT. There is less information available on the role and impact of other viruses of the herpesvirus family, such as the human herpes virus 6 (HHV-6), human herpes virus 7 (HHV-7) and human herpes virus 8 (HHV-8). This review summarizes current knowledge regarding epidemiology, clinical manifestations, diagnosis, treatment and prevention of infections caused by herpes viruses other than CMV in SOT recipients.
Keywords:
Epstein-Barr virus
Herpes simplex virus
Other human herpes viruses
Post-transplant lymphoproliferative disorder
Solid organ transplantation
Varicella-zoster virus
Resumen
A pesar de los grandes avances en el trasplante de órgano sólido (TOS) en las últimas décadas, la infección sigue siendo la mayor causa de morbimortalidad entre los receptores de TOS. Los miembros de la familia herpes virus son los patógenos virales más frecuentes causantes de enfermedad en esta población de pacientes. Los herpesvirus son virus ADN grandes envueltos, que habitualmente se reactivan durante períodos de inmunodepresión grave. Actualmente, las infecciones causadas por herpesvirus continúan siendo un desafío para el tratamiento clínico de los pacientes trasplantados. Aunque el citomegalovirus (CMV) es el virus más importante de esta familia y sobre el que se realiza una investigación activa, el virus herpes simple (VHS) y el virus varicela-zoster (VVZ) pueden también producir una enfermedad grave. La enfermedad linfoproliferativa asociada al virus de Epstein-Barr (VEB) se reconoce cada vez más como una complicación importante del TOS. Existe menos información disponible sobre el papel y el impacto de otros virus de la familia de los herpesvirus, como por ejemplo el virus del herpes humano 6 (VHH-6) y el virus del herpes humano 8 (VHH-8). Esta revisión resume el conocimiento actual respecto a la epidemiología, las manifestaciones clínicas, diagnóstico, tratamiento y prevención de las infecciones causadas por otros herpesvirus distintos al CMV en receptores de TOS.
Palabras clave:
Otros herpesvirus humanos
Trasplante de órgano sólido
Trastorno linfoproliferativo postrasplante
Virus herpes simple
Virus varicela-zoster
Virus de Epstein-Barr
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