ABSTRACT
Mycophenolate mofetil (MMF) is currently used for prophylaxis of acute rejection in solid organ transplantation. There have been diverging reports regarding an association between MMF and the risk of cytomegalovirus (CMV) infection. We reviewed the main published studies in an attempt to clarify the association between the use of MMF and the risk, frequency and severity of CMV infections. In a search of the Medline database with the terms "mycophenolate" and "cytomegalovir*", 42 articles were found to be relevant; among these, 29 articles were thoroughly analyzed. The first studies on MMF in renal transplantation already showed a tendency towards an association between this drug and the occurrence of CMV disease. Further studies were designed specifically to study this association; with the conclusion that an immunosuppressive regimen containing MMF increases the likelihood of CMV disease. Most studies were performed with kidney transplant recipients. We conclude that the use of MMF apparently increases the incidence of CMV disease in renal transplant patients; however, further studies are needed to confirm this association.
Subject(s)
Humans , Cytomegalovirus Infections/chemically induced , Immunosuppressive Agents/adverse effects , Kidney Transplantation , Liver Transplantation , Mycophenolic Acid/analogs & derivatives , Cytomegalovirus Infections/epidemiology , Graft Rejection/prevention & control , Incidence , Mycophenolic Acid/adverse effects , Risk Factors , Severity of Illness IndexABSTRACT
A utilizaçäo de drogas imunossusprssoras na terapêutica de certos pacientes oferece um risco de infecçöes oportunísticas às quais devemos estar preparados. É apresentado um caso de vasculite reumatóide cujo uso de ciclofosfamida determinou extrema imunodepressäo, permitindo o surgimento de grave infecçäo pelo citomegalovírus, com acometimento pulmonar e digestivo, com evoluçäo fatal. Säo levantados casos semelhantes da literatura e discutida a conduta diante do problema