Vol 3, No 3 (2010)
Prace poglądowe
Published online: 2010-08-28
Leczenie zakażenia wirusem cytomegalii po transplantacji nerki
Forum Nefrologiczne 2010;3(3):162-168.
Abstract
Infekcja wirusem cytomegalii (CMV, cytomegalovirus)
po transplantacji nerki może przebiegać bezobjawowo
lub jako zespół objawów klinicznych,
który nazywamy chorobą CMV. Do środków przeciwwirusowych
stosowanych w praktyce klinicznej
w leczeniu zakażenia CMV po przeszczepieniu nerki
należą: gancyklowir, cydofowir, foskarnet, walgancyklowir
oraz hiperimmunoglobulina anty-CMV.
Strategie lecznicze zakażenia CMV obejmują leczenie
wyprzedzające (preemptive), leczenie objawowego
zakażenia lub choroby CMV oraz redukcję
podtrzymującej terapii immunosupresyjnej. W przypadku
narastania wiremii lub nasilenia ciężkości
choroby podczas trwającej dłużej niż 6 tygodni terapii
gancyklowirem należy podejrzewać oporność
na lek. Wówczas zalecane są: wykonanie genotypowego
badania oporności oraz redukcja stosowanego
leczenia immunosupresyjnego.
Forum Nefrologiczne 2010, tom 3, nr 3, 162-168
Forum Nefrologiczne 2010, tom 3, nr 3, 162-168
Keywords: wirus cytomegaliitransplantacjaleczenieleczenie wyprzedzająceopornośćgancyklowir
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