在实体器官移植接受者中,对人类疹病毒-8相关疾病的临床管理
Alessia Dalla Pria1, Ines Ushiro-Lumb2, Mark Bower1
1Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK; Centre for Immunology and Vaccinology, Department of Infectious Diseases, Imperial College, London, UK.
The Journal of infection
|January 4, 2025
概括
人类疹病毒-8 (HHV-8) 导致卡波西肉瘤和其他疾病在固体器官移植接受者 (SOTRs). 管理因疾病阶段而异,通常依赖于降低免疫抑制或化疗,而修复药对MCD和KICS至关重要.
科学领域:
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 固体器官移植接受者 (SOTRs) 容易感染致癌的人类疹病毒-8 (HHV-8),也称为卡波西肉瘤疹病毒 (KSHV).
- 在SOTRs中,HHV-8感染表现为四种不同的临床综合征:卡波西肉瘤 (KS),初级输液淋巴瘤 (PEL),多中心卡斯特曼病 (MCD) 和KSHV炎症性细胞因子综合征 (KICS).
- 尽管已有几十年的认识,但SOTR中HHV-8相关的疾病仍未得到报道,这凸显了需要提高临床意识的必要性.
研究的目的:
- 审查SOTRs中HHV-8/KSHV相关疾病的临床表现.
- 概述这些条件的当前管理策略.
- 强调识别HHV-8表现的重要性,以改善患者的治疗结果.
主要方法:
- 本综述综合了SOTRs中HHV-8/KSHV临床疾病的现有文献.
- 讨论了管理指南,从其他免疫受损人群的研究中得到证据,特别是艾滋病毒感染者.
- 治疗方法根据特定的HHV-8相关条件进行分类.
主要成果:
- 早期的卡波西肉瘤可以通过减少免疫抑制和从氨尿素抑制剂转换为mTOR抑制剂来管理.
- 晚期KS和KSHV相关的淋巴瘤通常需要全身化疗.
- 多中心卡斯特曼病和KSHV炎症性细胞因子综合征,通常是由于初级HHV-8感染引起的,主要用基于Rituximab的免疫化学疗法治疗.
结论:
- 在SOTR中有效管理HHV-8/KSHV疾病需要根据临床表现和疾病阶段进行量身定制的方法.
- 提高对HHV-8表现的认识和及时诊断对于改善这种脆弱患者群体的治疗结果至关重要.
- 需要进一步的研究,以建立强大的,基于证据的治疗方案,专门针对SOTRs中的HHV-8/KSHV.
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