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Update in the treatment of non-influenza respiratory virus infection in solid organ transplant recipients

Journal

EXPERT OPINION ON PHARMACOTHERAPY
Volume 18, Issue 8, Pages 767-779

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/14656566.2017.1322063

Keywords

Adenovirus; coronavirus; human metapneumovirus; respiratory syncytial virus; parainfluenza; rhinovirus; cidofovir; brincidofovir; ribavirin

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Introduction: Despite the improved outcomes in solid organ transplantation with regard to prevention of rejection and increased patient and graft survival, infection remains a common cause of morbidity and mortality. Respiratory viruses are a frequent and potentially serious cause of infection after solid organ transplantation. Furthermore, clinical manifestations of respiratory virus infection (RVI) may be more severe and unusual in solid organ transplant recipients (SOTRs) compared with the non-immunocompromised population.Areas covered: This article reviews the non-influenza RVIs that are commonly encountered in SOTRs. Epidemiologic and clinical characteristics are highlighted and available treatment options are discussed.Expert opinion: New diagnostic tools, particularly rapid molecular assays, have expanded the ability to identify specific RVI pathogens in SOTRs. This is not only useful from a treatment standpoint but also to guide infection control practices. More data are needed on RVIs in the solid organ transplant population, particularly regarding their effect on rejection and graft dysfunction. There is also a need for new antiviral agents active against these infections as well as markers that can identify which patients would most benefit from treatment.

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