Infections in solid organ transplant recipients.
Delineation of the pathogenic potential and assessment of the efficacy of newer therapeutic modalities for a number of viruses have been among the more notable developments in solid organ transplant infections within the past year. Infection caused by the novel herpesvirus, human herpesvirus-6, was proposed to be a significant cause of fever of unknown origin and a predictor of subsequent cytomegalovirus infection. Interleukin-2-primed isologous T lymphocytes led to the complete regression of Epstein-Barr virus-positive post-transplant lymphoproliferative disorder. Although interferon-alpha alone was shown to be largely ineffective as prophylaxis and treatment for hepatitis C virus hepatitis, the combination of interferon-alpha and ribavirin appeared promising. Documentation within the past year, however, of lamivudine and famciclovir resistance in hepatitis B virus, ganciclovir resistance in cytomegalovirus, and azole resistance in Candida, is a sobering reminder that antimicrobial prophylaxis must be utilized rationally and selectively.
Singh
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Veterans Affairs Medical Center and University of Pittsburgh, Thomas E. Starzl Transplantation Institute, Pittsburgh, PA 15240, USA.