Changing epidemiology of respiratory viral infections in hematopoietic cell transplant recipients and solid organ transplant recipients

Abstract

Purpose of review New respiratory viruses have been discovered in recent years and new molecular diagnostic assays have been developed that improve our understanding of respiratory virus infections. This article will review the changing epidemiology of these viruses after hematopoietic stem cell and solid organ transplantation. Recent findings Respiratory viruses are frequently detected in transplant recipients. A number of viruses have been newly discovered or emerged in the last decade, including human metapneumovirus, human bocavirus, new human coronaviruses and rhinoviruses, human polyomaviruses, and a new 2009 pandemic strain of influenza A/H1N1. The potential for these viruses to cause lower respiratory tract infections after transplantation varies, and is greatest for human metapneumovirus and H1N1 influenza, but appears to be limited for the other new viruses. Acute and long term complications in hematopoietic and solid organ transplant recipients are active areas of research. Summary Respiratory viral infections are frequently associated with significant morbidity following transplantation and are therefore of great clinical and epidemiologic interest. As new viruses are discovered, and more sensitive diagnostic methods are developed, defining the full impact of emerging respiratory viruses in transplant recipients must be elucidated by well-designed clinical studies.

Human parvoviruses B19, PARV4 and bocavirus in pediatric patients with allogeneic hematopoietic SCT

“…Virus detection is of key importance in early diagnosis among these patients. [1][2][3] Only a few years ago parvovirus B19 (B19V) was the only known member of Parvoviridae causing illness in humans. 4 Since then the emerging parvoviruses, parvovirus 4 (PARV4) and human bocavirus 1 (HBoV1), have also been shown to infect humans.…”

Human Metapneumovirus Infection in Immunocompromised Patients

“…17 Respiratory tract infections are a significant source of morbidity and mortality in immunocompromised patients, and this is especially true for individuals with hematological malignancies and in those receiving hematopoietic stem cell transplantation (HSCT). 18 Prospective and retrospective studies of patients receiving HSCT have provided data on the incidence of upper and lower respiratory tract infections caused by HMPV infection and the associated mortality rates. 19,20 In these studies, cohorts of symptomatic and asymptomatic patients with HSCT were followed for 4 years, and the virus was identified through PCR testing of nasopharyngeal specimens.…”

Häufung von RSV-Erkrankungen in einer hämato-onkologischen Abteilung

“…Erkrankungen bei sonst gesunden Erwachsenen sind eher leichterer Natur, schwere klinische Verläufe durch RSV-Infektionen treten häufig auf bei: █ Neugeborenen und Kleinkindern █ immunsupprimierten Patienten █ älteren Personen, v. a. wenn diese an kardialen oder pulmonalen Vorerkrankungen leiden [2,3,7,9] In einer Studie bei hämato-onkologischen Patienten wurde gezeigt, dass ein Drittel der Atemwegsinfekte durch respiratorische Viren ausgelöst wurden, und wiederum ein Drittel davon durch RSV [9]. Bis zu 40 % der RSV-Infektionen in dieser Patientengruppe können zu einer Pneumonie führen [10,11].…”