title: Viral infections in acute graft-versus-host disease: a review of diagnostic and therapeutic approaches.
abstract: BACKGROUND
  While immunosuppressive therapy for acute graft-versus-host disease (aGVHD) advances, viral reactivation has been found to be an increasingly common complication in these patients. Dermatologists may often be consulted on inpatient services for evaluation.
  
  
  OBJECTIVE
  We investigated the literature for the role of viral infections in aGVHD and review the current evidence regarding management.
  
  
  METHODS
  Articles in the public domain regarding aGVHD, cytomegalovirus, Epstein-Barr virus, varicella zoster virus, hepatitis viruses, parvovirus B19, and respiratory viruses were included.
  
  
  RESULTS
  Dermatologic findings vary between different viral antigens, and some infections may be a marker for the development of aGVHD or worsen prognosis.
  
  
  CONCLUSIONS
  The heterogeneous cohorts of the studies reviewed often preclude direct comparison between results.
  
  
  CONCLUSIONS
  The relationship between viral reactivation and aGVHD may be bidirectional and is worthy of further exploration. Additional studies are needed to determine appropriate prophylaxis and treatment.
authors.affiliation: Division of Dermatology, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, California.
authors.forename: Lana X
authors.initials: LX
authors.lastname: Tong
authors.affiliation: Division of Dermatology, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, California. Electronic address: sworswick@mednet.ucla.edu.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Worswick
mesh_terms: D000208:Acute Disease; D000257:Adenoviridae Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D004198:Disease Susceptibility; D006086:Graft vs Host Disease / Q000150:complications* / Q000188:drug therapy; D006525:Hepatitis, Viral, Human / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D006566:Herpesviridae Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D054884:Host-Pathogen Interactions; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D010322:Parvoviridae Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D016732:Parvovirus B19, Human; D012141:Respiratory Tract Infections / Q000150:complications / Q000821:virology; D014775:Virus Activation; D014777:Virus Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*
chemical_list: D007166:Immunosuppressive Agents
keywords: Epstein–Barr virus; cytomegalovirus; graft-versus-host disease; human herpesvirus 6; human herpesvirus 7; inpatient dermatology; transplant dermatology; viral infections