New strategies for the control of viral infection in organ transplantation.
Control of viral infection in organ transplant recipients requires attention to the following interventions: prevention, whenever possible of viral acquisition; the proper deployment of active and passive immunization, with hyperimmune globulin preparations directed against cytomegalovirus, hepatitis B, varicella, and, perhaps, respiratory syncytial virus, offering significant benefit when used appropriately; and the prescription of antiviral agents at critical points in the post-transplant course. Two important principles should be kept in mind when approaching this problem: prevention is the goal, as treatment of established infection is fraught with difficulty; and effective preventative strategies must be linked to the intensity of the immunosuppressive program being employed. To achieve these goals, the addition of pre-emptive therapy (therapy geared to a laboratory marker of impending disease or to escalation in the immunosuppressive program) to standard prophylactic regimens represents a significant advance.
Tolkoff-Rubin
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NE
Massachusetts General Hospital, Department of Medicine, Harvard Medical School, Boston 02114, USA.
Rubin
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H
D000998:Antiviral Agents / Q000627:therapeutic use; D006801:Humans; D007114:Immunization; D017053:Infection Control / Q000379:methods; D016377:Organ Transplantation; D014777:Virus Diseases / Q000517:prevention & control*
D000998:Antiviral Agents