Community Acquired Respiratory Viruses
Community acquired respiratory infections (CARV) are associated with severe acute illness and potentially long term sequelae in lung transplant patients. CARV triggers innate and adaptive immune responses that may amplify lung allograft injury and lead to chronic lung allograft disease.
Paramyxoviridea, the most important of which include respiratory syncytial, parainfluenzae and human metapneumovirus, have a propensity to cause a necrotizing bronchiolitis with an acute severe illness and long-term loss of allograft function; hence the need for specific therapy including corticosteroids and ribavirin. Human rhinovirus can persist and has been associated with bronchiolitis obliterans in lung transplant patients. Influenza has been associated with severe complications and death in immunosuppressed patients. Unfortunately, the efficacy of the influenza vaccine is variable ranging from 16 to 60%.
The rapid and accurate detection of CARV by means of nasopharyngeal swabs for viral PCR has had a major impact on the early diagnosis and management of these infections.
KeywordsLung transplant Viruses Chronic lung allograft dysfunction Bronchiolitis obliterans
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