title: Treatment of alpha and beta herpesvirus infections in solid organ transplant recipients.
abstract: Human herpesviruses frequently cause infections in solid organ transplant (SOT) recipients. Areas covered: We provide an overview of the clinical impact of alpha and beta herpesviruses and highlight the mechanisms of action, pharmacokinetics, clinical indications, and adverse effects of antiviral drugs for the management of herpes simplex virus, varicella zoster virus and cytomegalovirus. We comprehensively evaluated key clinical trials that led to drug approval, and served as the foundation for management guidelines. We further provide an update on investigational antiviral agents for alpha and beta herpesvirus infections after SOT. Expert commentary: The therapeutic armamentarium for herpes infections is limited by the emergence of drug resistance. There have been major efforts for discovery of new drugs against these viruses, but the results of early-phase clinical trials have been less than encouraging. We believe, however, that more antiviral drug options are needed given the adverse side effects associated with current antiviral agents, and the emergence of drug-resistant virus populations in SOT recipients. Likewise, optimized use and strategies are needed for existing and novel antiviral drugs against alpha and beta-herpesviruses in SOT recipients.
authors.affiliation: a Division of Infectious Diseases, Department of Medicine , Mayo Clinic , Rochester , MN , USA.|b Department of Medicine, Section of Infectious Diseases , University of the Philippines - Philippine General Hospital , Manila , Philippines.
authors.forename: C L
authors.initials: CL
authors.lastname: Abad
authors.affiliation: a Division of Infectious Diseases, Department of Medicine , Mayo Clinic , Rochester , MN , USA.|c The William J. Von Liebig Center for Transplantation and Clinical Regeneration , Mayo Clinic , Rochester , MN , USA.
authors.forename: R R
authors.initials: RR
authors.lastname: Razonable
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003586:Cytomegalovirus Infections / Q000517:prevention & control* / Q000821:virology; D015507:Drugs, Investigational / Q000008:administration & dosage / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D006561:Herpes Simplex / Q000517:prevention & control* / Q000821:virology; D006562:Herpes Zoster / Q000517:prevention & control* / Q000821:virology; D006801:Humans; D015394:Molecular Structure; D016377:Organ Transplantation
chemical_list: D000998:Antiviral Agents; D015507:Drugs, Investigational
keywords: Herpesvirus; infection; solid organ transplant