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Antiviral Treatment and Prophylaxis in Immunocompromised Hosts

  • Ella J. Ariza-Heredia
  • Firas El Chaer
  • Roy F. Chemaly
Chapter

Abstract

In recent years, advances in the treatment of viral infections have slowly been emerging. Early diagnosis and detection of the virus continue to be of paramount importance in order to achieve effective treatment, because once viral replication and invasive infections are evident, prognosis could be poor. New advances in molecular techniques, mainly polymerase chain reaction (PCR), have allowed early detection of viral infections, and quantification of the viral load is useful not only for diagnosis but also for monitoring therapy, e.g., in cytomegalovirus (CMV) infections. Intact host immune response is important for recovery from viral infection. Viral pathogens have emerged in recent years as significant microbial agents that may have deleterious effects on immunocompromised patients. Response to antiviral therapy could be suboptimal, with subsequent recurrent infections and risk of selecting for multidrug-resistant strains in immunocompromised patients in particular. An important aspect of antiviral therapy in this patient population is the widespread use of chemoprophylaxis, which involves the administration of medications to abort transmission of viral infection, avoid reactivation of infection, or prevent progression to invasive disease. Herein, we describe the most relevant antivirals used in immunocompromised patients, focusing on the main groups of viruses: the Herpesviridae (cytomegalovirus, herpes simplex viruses, varicella-zoster virus, and the emerging herpesviruses 6, 7, and 8), the respiratory viruses (influenza, parainfluenza, respiratory syncytial virus, and adenovirus), and the hepatitis viruses.

Keywords

Antiviral therapy Prophylaxis Preventive therapy Herpesviruses Hepatitis viruses Respiratory viruses Infection Immunocompromised patients Hematopoietic stem cell transplant Solid organ transplant 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Ella J. Ariza-Heredia
    • 1
  • Firas El Chaer
    • 1
  • Roy F. Chemaly
    • 1
  1. 1.Department of Infectious Diseases, Infection Control and Employee HealthThe University of Texas MD Anderson Cancer CenterHoustonUSA

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