Endemic viral infections in immunocompromised hosts: Dengue, Chikungunya, Zika.

IF 3.6 3区 医学 Q2 INFECTIOUS DISEASES Current Opinion in Infectious Diseases Pub Date : 2024-08-01 Epub Date: 2024-06-04 DOI:10.1097/QCO.0000000000001026
Marcia Garnica, Jessica Fernandes Ramos, Clarisse Martins Machado
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Abstract

Purpose of review: Arbovirus infections are a challenge for immunocompromised hosts who travel to or live in endemic regions or who receive organs or tissues from donors who travel or live in such areas. This review addresses Dengue (DENV), Chikungunya (CHIKV), and Zika (ZIKV) infections in hematological patients, hematopoietic cell or solid organ transplant recipients, and people with HIV (PWH).

Recent findings: Transmission is mainly due through Aedes mosquito bite. DENV and ZIKV may also be transmitted through blood, tissues or donor grafts. Clinical manifestations are quite similar and diagnosis requires laboratory confirmation to provide appropriate management. The best diagnostic method is PCR since serology may present false negative results in immunocompromised patients, or cross-reactivity as in the case of DENV and ZIKV. There is no specific treatment for any of these infections.

Summary: Educational and preventive measures are the best strategy: vector control, knowledge of the vector's habits, protection against mosquito bites, avoiding travel to endemic areas or with a current epidemic, and avoiding nonvector transmission according to local recommendations for donor deferral. Vaccination, currently only available for DENV, has not yet been studied in immunocompromised patients and is not currently recommended.

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免疫力低下人群中的地方性病毒感染:登革热、基孔肯雅病毒、寨卡病毒。
综述的目的:虫媒病毒感染对于前往或居住在虫媒病毒流行地区的免疫功能低下的宿主或接受来自前往或居住在这些地区的捐赠者的器官或组织的宿主来说是一个挑战。本综述探讨了血液病患者、造血细胞或实体器官移植受者以及艾滋病病毒感染者(PWH)中的登革热(DENV)、基孔肯雅(CHIKV)和寨卡(ZIKV)感染:最新发现:主要通过伊蚊叮咬传播。DENV 和 ZIKV 也可能通过血液、组织或捐献者移植物传播。临床表现非常相似,诊断需要实验室确认,以便提供适当的治疗。最好的诊断方法是 PCR,因为血清学检查在免疫力低下的患者中可能会出现假阴性结果,或出现 DENV 和 ZIKV 的交叉反应。小结:教育和预防措施是最好的策略:病媒控制、了解病媒的习性、防止蚊虫叮咬、避免前往流行地区或正在流行的地区,并根据当地建议避免非病媒传播。目前只有针对 DENV 的疫苗,尚未对免疫力低下的患者进行研究,因此目前不建议接种。
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来源期刊
CiteScore
6.70
自引率
2.60%
发文量
121
审稿时长
6-12 weeks
期刊介绍: This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on two topics, every issue of Current Opinion in Infectious Disease delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as HIV infection and AIDS; skin and soft tissue infections; respiratory infections; paediatric and neonatal infections; gastrointestinal infections; tropical and travel-associated diseases; and antimicrobial agents.
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