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1.
Clin Transplant ; 22(2): 222-8, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18339143

RESUMO

Consistent data for using CMV quantitative PCR (QnPCR) on initial presentation to predict outcomes after solid organ transplantation (SOT) are lacking. Recipients with measurable CMV QnPCR and either CMV-V (asymptomatic viremia) or CMV-D (symptomatic CMV infection) were analyzed over 24 months. Risk factors and outcomes were evaluated in relation to initial QnPCR by regression analysis and time-to-event curves. Twenty-eight recipients were identified: five CMV-V, 23 CMV-D. Patients with CMV-D had a higher median initial QnPCR (230 000 copies/mL) compared with CMV-V (2500 copies/mL; p < 0.05). No patients with CMV-V had an initial QnPCR > 10 000 copies/mL compared with 83% of the CMV-D (p = 0.004). The initial QnPCR was higher (250 000 copies/mL) in patients who did not clear CMV PCR than those who cleared (8000 copies/mL) after 14 d of treatment (p = 0.03). Risk factors and indirect CMV effects were not associated with initial QnPCR. Our results highlight the importance of the initial CMV QnPCR in relation to the development of symptomatic CMV and a slower response to therapy. Alternatively, late asymptomatic viremia and recurrent CMV are associated with lower PCR levels and a low likelihood to progress and result in clinical disease.


Assuntos
Infecções por Citomegalovirus/complicações , Citomegalovirus/patogenicidade , Transplantes/virologia , Carga Viral , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Fatores de Risco , Transplantes/efeitos adversos , Resultado do Tratamento , Viremia
2.
Clin Infect Dis ; 40(5): 764-6, 2005 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-15714427

RESUMO

We describe 2 patients with West Nile virus (WNV) encephalitis who were treated experimentally with interferon (IFN)-alpha. Both patients demonstrated substantial improvement in mentation and speech on the second day of experimental therapy, and neither required endotracheal intubation or admission to the intensive care unit during hospitalization. Moreover, during the 9-month follow-up period, one patient achieved complete recovery, and the other nearly achieved complete resolution of sequelae. To our knowledge, this is the first published report of the use of IFN-alpha to treat WNV encephalitis. Clinical trials are underway to further define the role of this therapy in persons with WNV encephalitis.


Assuntos
Antivirais/uso terapêutico , Interferon-alfa/uso terapêutico , Febre do Nilo Ocidental/tratamento farmacológico , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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