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Ann-Camilla Worsøe Christensen1, Camilla Heldbjerg Drabe1, Anne-Mette Lebech1,2

  • 1Infektionsmedicinsk Klinik, Københavns Universitetshospital - Rigshospitalet.

Ugeskrift for Laeger
|March 31, 2023
PubMed
Summary
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Norovirus infection typically causes acute gastroenteritis. However, in immunocompromised individuals, it can lead to chronic illness with severe complications, necessitating further research into effective treatments.

Area of Science:

  • Virology
  • Immunology
  • Gastroenterology

Context:

  • Norovirus causes acute gastroenteritis in the general population.
  • Immunocompromised patients face prolonged norovirus infection (years).
  • Chronic norovirus leads to villous atrophy, malnutrition, dehydration, and electrolyte imbalance.

Purpose:

  • To summarize the clinical presentation and complications of norovirus in immunocompromised patients.
  • To review potential treatment strategies for chronic norovirus infection.

Summary:

  • Norovirus infection is acute (24-48 hours) in healthy individuals.
  • In immunocompromised patients, it causes persistent gastroenteritis, villous atrophy, malnutrition, dehydration, and electrolyte imbalance.
  • Reported treatments like nitazoxanide, ribavirin, and immunoglobulin show variable results; favipiravir is suggested but untested in humans.

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Impact:

  • Highlights the severe, chronic nature of norovirus in immunocompromised individuals.
  • Underscores the need for novel and effective therapeutic interventions.
  • Emphasizes the critical gap in evidence-based treatment for this vulnerable population.