[Cytomegalovirus and other herpes virus infections in systemic diseases].
Reactivation of Herpesviridae is well known among transplant patients, but has not been sufficiently studied in patients who receive immunosuppressive treatment for systemic inflammatory diseases. CMV infection seems relatively rare; it is easily diagnosed by real-time PCR, a fast and reliable diagnostic tool. CMV disease is most often manifested in the form of lung disease, hepatitis, or colitis. The highest risks are associated with steroid or cyclophosphamide boluses and methotrexate. Prophylactic treatment cannot be recommended in clinical practice. The utility of monitoring viremia and of preemptive therapy must be evaluated. Herpes zoster is the most frequent viral infection in systemic diseases. Most immunosuppressive treatments, except methotrexate, promote its occurrence. Visceral involvement is quite rare, and outcome almost always favorable. Prophylactic treatment cannot be recommended.
Michaux
Christian
C
Service de médecine interne et maladies infectieuses, Hôpital Saint-André, CHU de Bordeaux, F-33075 Bordeaux, France.
Morlat
Philippe
P
Bonnet
Fabrice
F
D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D003587:Cytomegalovirus / Q000502:physiology; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000821:virology; D006562:Herpes Zoster / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000821:virology; D014645:Herpesvirus 3, Human / Q000502:physiology; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016133:Polymerase Chain Reaction; D014775:Virus Activation
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents