Wirusy paragrypy w aspekcie zakażeń wirusowych osób po przeszczepach szpiku lub płuc


Human parainfluenza viruses as the cause of viral infectionsin patients after stem cells or lung transplantation
E. Abramczuk, K. Pancer, B. Litwińska

1. Wstęp. 2. Ogólna charakterystyka hPIV oraz zakażeń przez nie wywołanych. 3. Zakażenia hPIV u pacjentów po przeszczepach narządów. 4. Diagnostyka i leczenie. 5. Podsumowanie

Abstract: The characteristics of human parainfluenza viruses (hPIVs) are presented. These viruses are well known as the agents of respiratory tract infections (RTI) in children. The incidence of hPIV infections varieds depending on the year/season. The reinfections occurre throughout the life. In immunocompromised patients such reinfections might be a cause of severe disease (pneumonia, GVPD) beading also to death. Nowadays, transplantation has become a successful worldwide practice. According to WHO, more than 50.000 stem cells transplantations are carried out annually, the lung transplantation – 3500/year. In lung recipients, hPIV is the first agent of RTI; in stem cells recipients – the second (after RSV). The hPIVs infections have been observed in 1,5–10% of lung recipients and in 2,2–60% of stem cells recipients and the predominant virus was hPIV-3. The patients after transplantation receive high doses of corticosteroids which increase the risk of hPIV-pneumonia, a life threating disease, and quick diagnosis is required. Moreover, hPIVs are also the cause of nosocomial infections. Such outbreak/cases occur simultaneously to the activity of the viruses in the environment. In immunocompromised patients the shedding of hPIVs is significantly longer than in immunocompetent persons, also the infection can be asymptomatic for the weeks. Such patients, visitors of their families, especially children, and staff members are the source of nosocomial hPIVs infections. Considering the lack of specific and effective anti-hPIVs therapy it is very important to prevent them. The most effective way of prevention is the compliance with the fundamental hygienic behaviours and the restriction of contact with ill people.

1. Introduction. 2. General characteristic of hPIVs and infection caused by them. 3. hPIV infection in patients after organ transplants. 4. Diagnosis and treatment. 5. Summary