Micro 4 - Opportunistic viral infections Flashcards
at what CD4 count do HIV opportunistic infections start to occur?
CD4<200
2 examples of calcineurin inhibitors of T cell function
Tacrolimus, cyclosporin
2 examples of anti-proliferative agents used in transplant patients
Mycophenolate mofetil (T>B) Azathioprine (T>B)
Renal transplant highest risk for CMV based on what donor and recipient virus status?
Donor + recipient -
BM transplant highest risk for CMV based on what donor and recipient virus status?
Donor - recipient +
which virus typically presents >12 months after transplant?
VZV (NOVEL VIRUS)
what is the most important virus to screen for pre renal transplant?
CMV
what are HHV-1 and HHV-2?
HSV-1 and HSV-2
Name some herpes viruses
EBV, VZV, CMV, Roseola virus
pain on swallowing after a liver transplant - which virus?
HSV
pathognomic histology feature of CMV pneumonitis
Owl’s eye lung pneumocytes (inclusion Bodies)
what is the prophylaxis regimen in those undergoing SOT
Valganciclovir (PO) for 100 days
treatment of CMV post transplant
Ganciclovir (IV)
management of CMV post HSCT
IV Foscarnet, NEVER GIVE GANCICLOVIR (HAS BM SUPPRESSIVE EFFECTS)
WHAT IS THE biggest concern with EBV in transplant patients?
PTLD = Post transplant lymphoproliferative disease
mx of PTLD
Rituximab to deplete the B cells + reduce the immunosuppression
virus causing progressive multifocal leukoencephalopathy
JC Virus
Risk factors for PML
Natalizumab (monoclonal antibody for MS)
Mycophenolate mofetil
Rituximab
name 2 types of polyoma virus
JK virus and BK virus
what two conditions can BK virus cause and in which population of people?
Post SOT –> BK Nephropathy
Post HSCT –> BK cystitis
Tx of adenovirus infection?
cidofovir
When is adenovirus problematic?
Post BMT pts
diagnosis of parvovirus 19
PCR of blood (serology is NOT useful)
treatment of parvovirus B19
IVIG
