title: [HCMV infections after hematopoietic stem cell transplantation--diagnostic methods and importance of viral DNA level monitoring].
abstract: HCMV infection is very common. The virus infects 30-90% of population. In immunocompromised patients effective elimination of the virus by immune system is limited by immunosuppressive therapy. Active hCMV infection after HSCT can lead to severe posttransplant complications, graft failure or even death. In addition to direct effects of hCMV infection the virus can cause indirect effects in transplant recipients such as increased immunosuppression or GvHD development/progression. Laboratory diagnostic of hCMV infections after HSCT is now routinely used. Fast and sensitive molecular methods that detect hCMV genetic material are found particularly useful. Quantitative methods, such as R-T PCR, enable identification of patients at high risk of developing hCMV disease and fast employment of appropriate prophylaxis or treatment. Moreover it allows precise monitoring of treatment efficiency and facilitates therapy - related decisions. In last years pre-emptive therapy, which depends on viral load molecular monitoring, significantly reduced morbidity and mortality of active hCMV infections in HSCT recipients. Selective prophylaxis approach enables reduction of patients treated with toxic antiviral therapy which is associated with delayed restoration of virus - specific immune response. Occurrence of symptomatic hCMV disease is still associated with high mortality among HSCT recipients. HCMV infection diagnosis requires further development. Quantitative methods should be unified and optimized.
authors.affiliation: Zakład Diagnostyki Medycznej w Poznaniu.
authors.forename: Joanna
authors.initials: J
authors.lastname: Bocian
authors.affiliation: Zakład Diagnostyki Medycznej w Poznaniu; Instytut Genetyki Człowieka PAN w Poznaniu; Uniwersytet Medyczny im. K. Marcinkowskiego Klinika Onkologii Hematologii i Transplantologii Pediatrycznej w Poznaniu.
authors.forename: Danuta
authors.initials: D
authors.lastname: Januszkiewicz-Lewandowska
mesh_terms: D000956:Antigens, Viral / Q000097:blood; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000628:therapy / Q000821:virology*; D004279:DNA, Viral / Q000097:blood*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D016867:Immunocompromised Host; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D019562:Viral Load
chemical_list: D000956:Antigens, Viral; D004279:DNA, Viral; D012367:RNA, Viral