Microbiology 13 - Opportunistic viral infection Flashcards
What is the Baltimore classification?
Virus classification system
What class of viruses form latent infections?
DNA viruses
How is most viral serology performed?
Indirectc ELISA
Recall 3 reasons for immunosuppression
- Solid organ transplant
- Hematopoietic stem cell transplant (short term, or long term if they have significant GVHD)
- HIV/AIDS
Recall 4 types of immunosuppressing drugs
- Steroids
- Calcineurin inhibitors
- Anti-proliferative agent (eg. Azothioprine/ mycophenolate)
- Antibodies
What is the most important opportunistic virus in transplant patients?
CMV
What virus causes multifocal leukoencephalopathy?
JC virus
What is a common re-activator of latent HSV?
Stressful situations
What is HHV4?
EBV
What is HHV8?
Kaposi’s sarcoma associated herpesvirus
What drug would you give to someone who has CMV AND is immunosuppressed?
Valganciclovir
For which hepatitis viruses are there vaccines?
Hep A and B
Why is adenovirus particularly problematic in post-bone marrow transplant children?
You get disseminated disease
What is the treatment for CMV virus?
Ganciclovir (IV) (can cause bone marrow suppression in 30% of patients)
PO Valganciclovir (Pro drug of ganciclovir)
Foscarnet (anti-dna polymerase) (IV) – nephrotoxicity
Cidofovir – nephrotoxicity
For SOT: give prophylaxis for 100 days (typically oral valganciclovir/ganciclovir)
For HSCT: pre-emptive treatment: regularly monitor CMV PCR and if you see a rise, give GCV/vGCV/foscarnet
In which patients does JC virus cause PML?
AIDS patients