Follow up with viral load monitoring for Epstein-Barr virus in pediatric pacients with hepatic transplant
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Universidad Industrial de Santander
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Introducción: Los pacientes trasplantados son un reto desde todo punto de vista. La infección por el virus de Epstein-Barr es frecuente y su manejo suele ser difícil por la falta de medicamentos efectivos. Los pacientes con trasplante hepático tienen una alta incidencia de infección/reactivación por virus Epstein-Barr por el riesgo de primoinfección durante este periodo o la reactivación por inmunosupresión. Objetivos: Describir los hallazgos obtenidos con el uso de la carga viral para el virus de Epstein-Barr en el seguimiento de los pacientes pediátricos sometidos a trasplante hepático en una institución de cuarto nivel en Medellín, Colombia. Selección de pacientes: Se revisaron siete historias clínicas de pacientes con trasplante hepáticos escogidos al azar, obteniendo de ellas los datos demográficos, motivo de trasplante, momento de la aparición de la de la carga viral positiva por el virus de Epstein-Barr, evolución de la carga viral, efectos de los medicamentos inmunosupresores y antivirales, y el desenlace de los pacientes. Descripción de casos: La edad promedio de los pacientes al momento del trasplante fue de 28,4 meses, el efecto de los medicamentos antivirales como gangiclovir, valganciclovir, inmunoglobulina contra citomegalovirus, no parece ejercer una disminución adecuada y sostenida de la carga viral. Conclusiones: A pesar de las opciones terapéuticas disponibles para el herpes virus, según lo encontrado en la literatura actual y lo visto los pacientes evaluados, el grado de inmunosupresión parece ser el principal factor para el control de la replicación del virus de Epstein-Barr. MÉD UIS. 2015;28(3):393-401.Palabras clave: Herpesvirus humano 4. Inmunosupresión. Trasplante de hígado.
Introduction: Transplant patients are a challenge from every point of view. Infection with Epstein- Barr virus is common and management is often hampered by the lack of effective medicaments available. Liver transplant patients have a high incidence of Epstein-Barr virusinfection / reactivation because of the the risk of primary infection during this period or immunosuppression associated reactivation. Objectives: Describe the findings when using EBV viral load monitoring in liver transplant patients in an institution of the fourth level in Medellin, Colombia. Selection of patients: Seven medical records from liver transplant patients were randomly chosen obtaining from them demographic data, cause of transplantation, time of the Epstein-Barr virus detection, viral load evolution, effects of immunosuppressive medications over them and the patient´s outcome. Description of patients: Average patient age at transplant was 28,4 months, the effect of antiviral drugs (gangiclovir, valganciclovir, cytomegalovirus immunoglobulin) seems not to be adequate and sustained in decreasing viral load. Conclusions: Although the therapeutic options available for Herpes virus , as found in current literature and seen in our patients, immunosupression degree seems to be the main factor for controlling EBV replication. MÉD UIS. 2015;28(3):393-401.Keywords: Epstein-Barr virus infections. Immunosupresion. Liver transplantation.
Introduction: Transplant patients are a challenge from every point of view. Infection with Epstein- Barr virus is common and management is often hampered by the lack of effective medicaments available. Liver transplant patients have a high incidence of Epstein-Barr virusinfection / reactivation because of the the risk of primary infection during this period or immunosuppression associated reactivation. Objectives: Describe the findings when using EBV viral load monitoring in liver transplant patients in an institution of the fourth level in Medellin, Colombia. Selection of patients: Seven medical records from liver transplant patients were randomly chosen obtaining from them demographic data, cause of transplantation, time of the Epstein-Barr virus detection, viral load evolution, effects of immunosuppressive medications over them and the patient´s outcome. Description of patients: Average patient age at transplant was 28,4 months, the effect of antiviral drugs (gangiclovir, valganciclovir, cytomegalovirus immunoglobulin) seems not to be adequate and sustained in decreasing viral load. Conclusions: Although the therapeutic options available for Herpes virus , as found in current literature and seen in our patients, immunosupression degree seems to be the main factor for controlling EBV replication. MÉD UIS. 2015;28(3):393-401.Keywords: Epstein-Barr virus infections. Immunosupresion. Liver transplantation.