Approach to infection and disease due to adenoviruses in solid organ transplantation

Diana F. Florescu, Erica J. Stohs

Research output: Contribution to journalReview article

Abstract

Purpose of reviewAdenoviruses are an important cause of morbidity and mortality of solid organ transplant patients and remain a clinical challenge with regard to diagnosis and treatment. In this review, we provide an approach to identification and classification of adenovirus infection and disease, highlight risk factors, and outline management options for adenovirus disease in solid organ transplant patients.Recent findingsAdditional clinical data and pathologic findings of adenovirus disease in different organs and transplant recipients are known. Unlike hematopoietic cell transplant recipients, adenovirus blood PCR surveillance and preemptive therapy is not supported in solid organ transplantation. Strategies for management of adenovirus disease continue to evolve with newer antivirals, such as brincidofovir and adjunctive immunotherapies, but more studies are needed to support their use.SummaryDistinguishing between adenovirus infection and disease is an important aspect in adenovirus management as treatment is warranted only in symptomatic solid organ transplant patients. Supportive care and decreasing immunosuppression remain the mainstays of management. Cidofovir remains the antiviral of choice for severe or disseminated disease. Given its significant nephrotoxic effect, administration of probenecid and isotonic saline precidofovir and postcidofovir infusion is recommended.

Original languageEnglish (US)
Pages (from-to)300-306
Number of pages7
JournalCurrent Opinion in Infectious Diseases
Volume32
Issue number4
DOIs
StatePublished - Aug 1 2019

Fingerprint

Organ Transplantation
Adenoviridae
Transplants
Adenoviridae Infections
Infection
Antiviral Agents
Probenecid
Disease Management
Immunotherapy
Immunosuppression
Therapeutics
Morbidity
Polymerase Chain Reaction
Mortality
Transplant Recipients

Keywords

  • adenovirus
  • cidofovir
  • solid organ transplantation

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Approach to infection and disease due to adenoviruses in solid organ transplantation. / Florescu, Diana F.; Stohs, Erica J.

In: Current Opinion in Infectious Diseases, Vol. 32, No. 4, 01.08.2019, p. 300-306.

Research output: Contribution to journalReview article

@article{dfc66869c0394c01b0603babba984935,
title = "Approach to infection and disease due to adenoviruses in solid organ transplantation",
abstract = "Purpose of reviewAdenoviruses are an important cause of morbidity and mortality of solid organ transplant patients and remain a clinical challenge with regard to diagnosis and treatment. In this review, we provide an approach to identification and classification of adenovirus infection and disease, highlight risk factors, and outline management options for adenovirus disease in solid organ transplant patients.Recent findingsAdditional clinical data and pathologic findings of adenovirus disease in different organs and transplant recipients are known. Unlike hematopoietic cell transplant recipients, adenovirus blood PCR surveillance and preemptive therapy is not supported in solid organ transplantation. Strategies for management of adenovirus disease continue to evolve with newer antivirals, such as brincidofovir and adjunctive immunotherapies, but more studies are needed to support their use.SummaryDistinguishing between adenovirus infection and disease is an important aspect in adenovirus management as treatment is warranted only in symptomatic solid organ transplant patients. Supportive care and decreasing immunosuppression remain the mainstays of management. Cidofovir remains the antiviral of choice for severe or disseminated disease. Given its significant nephrotoxic effect, administration of probenecid and isotonic saline precidofovir and postcidofovir infusion is recommended.",
keywords = "adenovirus, cidofovir, solid organ transplantation",
author = "Florescu, {Diana F.} and Stohs, {Erica J.}",
year = "2019",
month = "8",
day = "1",
doi = "10.1097/QCO.0000000000000558",
language = "English (US)",
volume = "32",
pages = "300--306",
journal = "Current Opinion in Infectious Diseases",
issn = "0951-7375",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Approach to infection and disease due to adenoviruses in solid organ transplantation

AU - Florescu, Diana F.

AU - Stohs, Erica J.

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Purpose of reviewAdenoviruses are an important cause of morbidity and mortality of solid organ transplant patients and remain a clinical challenge with regard to diagnosis and treatment. In this review, we provide an approach to identification and classification of adenovirus infection and disease, highlight risk factors, and outline management options for adenovirus disease in solid organ transplant patients.Recent findingsAdditional clinical data and pathologic findings of adenovirus disease in different organs and transplant recipients are known. Unlike hematopoietic cell transplant recipients, adenovirus blood PCR surveillance and preemptive therapy is not supported in solid organ transplantation. Strategies for management of adenovirus disease continue to evolve with newer antivirals, such as brincidofovir and adjunctive immunotherapies, but more studies are needed to support their use.SummaryDistinguishing between adenovirus infection and disease is an important aspect in adenovirus management as treatment is warranted only in symptomatic solid organ transplant patients. Supportive care and decreasing immunosuppression remain the mainstays of management. Cidofovir remains the antiviral of choice for severe or disseminated disease. Given its significant nephrotoxic effect, administration of probenecid and isotonic saline precidofovir and postcidofovir infusion is recommended.

AB - Purpose of reviewAdenoviruses are an important cause of morbidity and mortality of solid organ transplant patients and remain a clinical challenge with regard to diagnosis and treatment. In this review, we provide an approach to identification and classification of adenovirus infection and disease, highlight risk factors, and outline management options for adenovirus disease in solid organ transplant patients.Recent findingsAdditional clinical data and pathologic findings of adenovirus disease in different organs and transplant recipients are known. Unlike hematopoietic cell transplant recipients, adenovirus blood PCR surveillance and preemptive therapy is not supported in solid organ transplantation. Strategies for management of adenovirus disease continue to evolve with newer antivirals, such as brincidofovir and adjunctive immunotherapies, but more studies are needed to support their use.SummaryDistinguishing between adenovirus infection and disease is an important aspect in adenovirus management as treatment is warranted only in symptomatic solid organ transplant patients. Supportive care and decreasing immunosuppression remain the mainstays of management. Cidofovir remains the antiviral of choice for severe or disseminated disease. Given its significant nephrotoxic effect, administration of probenecid and isotonic saline precidofovir and postcidofovir infusion is recommended.

KW - adenovirus

KW - cidofovir

KW - solid organ transplantation

UR - http://www.scopus.com/inward/record.url?scp=85069237281&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85069237281&partnerID=8YFLogxK

U2 - 10.1097/QCO.0000000000000558

DO - 10.1097/QCO.0000000000000558

M3 - Review article

C2 - 31116132

AN - SCOPUS:85069237281

VL - 32

SP - 300

EP - 306

JO - Current Opinion in Infectious Diseases

JF - Current Opinion in Infectious Diseases

SN - 0951-7375

IS - 4

ER -