Molecular diagnosis and management of viral infections in hematopoietic stem cell transplant recipients

Mol Diagn Ther. 2012 Apr 1;16(2):63-77. doi: 10.1007/BF03256431.

Abstract

Viral infections after allogeneic hematopoietic stem cell transplantation (HSCT) are important complications associated with high morbidity and mortality. In this setting, reactivations of persisting latent viral pathogens from donor and/or recipient cells play a central role whereas the sterile environment of transplant units renders new infections less likely. The viruses currently regarded as most relevant in the HSCT setting include particularly the herpes virus family--specifically cytomegalovirus (CMV), Epstein-Barr virus (EBV), and human herpesvirus 6 (HHV-6)--as well as human adenoviruses (AdVs) and the polyoma virus BK (BKV). Timely detection and monitoring of virus copy numbers are prerequisites for successful preemptive treatment approaches. Pre- and post-transplant surveillance by sensitive and quantitative molecular methods has therefore become an essential part of the diagnostic routine. In this review, we discuss diagnostic aspects and the clinical management of the most important viral infections in HSCT recipients, with a focus on pediatric patients.

Publication types

  • Review

MeSH terms

  • Adenoviridae Infections / diagnosis
  • Adenoviridae Infections / therapy
  • Cytomegalovirus Infections / diagnosis
  • Cytomegalovirus Infections / therapy
  • Epstein-Barr Virus Infections / diagnosis
  • Epstein-Barr Virus Infections / therapy
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Herpes Simplex / diagnosis
  • Herpes Simplex / therapy
  • Humans
  • Molecular Diagnostic Techniques
  • Polyomavirus Infections / diagnosis
  • Polyomavirus Infections / therapy
  • Post-Exposure Prophylaxis
  • Reproducibility of Results
  • Roseolovirus Infections / diagnosis
  • Roseolovirus Infections / therapy
  • Tumor Virus Infections / diagnosis
  • Tumor Virus Infections / therapy
  • Virus Diseases / complications
  • Virus Diseases / diagnosis*
  • Virus Diseases / drug therapy*