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Antiviral Consideration for Transplantation Including Drug Resistance

  • Sunwen ChouEmail author
  • Nell S. Lurain
Chapter

Abstract

Antiviral therapy is required in the transplant setting for viral infections that arise from preexisting latent or persistent infection in the recipient and/or donor as well as from nosocomial or community sources. A preventive or prophylactic antiviral approach where feasible is preferable to the treatment of symptomatic viral disease. Acute infections need prompt diagnosis and antiviral treatment for the best outcome. Selection of antiviral therapy involves multiple considerations including potential benefit, toxicity, logistical complexity, and the possibility of drug resistance. This chapter reviews antiviral drug therapy for the most common viruses affecting transplant recipients: herpesviruses including herpes simplex virus, varicella-zoster virus, and cytomegalovirus, influenza, respiratory syncytial virus (RSV), and hepatitis viruses B and C. The mechanism of action, major pharmacologic features, therapeutic uses related to transplant recipients, and genetic pathways of antiviral drug resistance are described for the FDA-approved drugs and some experimental compounds in late stage clinical trial.

Keywords

Antiviral agents Antiviral drug resistance Acyclovir Valacyclovir Penciclovir Famciclovir Ganciclovir Valganciclovir Foscarnet Cidofovir Brincidofovir Brivudine Amenamevir Pritelivir Maribavir Letermovir Oseltamivir Peramivir Zanamivir Ribavirin Paritaprevir Grazoprevir Voxilaprevir Glecaprevir Daclatasvir Ledipasvir Ombitasvir Velpatasvir Elbasvir Pibrentasvir Sofosbuvir Dasabuvir Adefovir Lamivudine Entecavir Tenofovir 

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Oregon Health and Science University, Division of Infectious DiseasesPortlandUSA
  2. 2.Rush University Medical Center, Department of Microbial Pathogens and ImmunityChicagoUSA

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