Anti-Cytomegalovirus Therapy: Whether and When to Initiate, Those Are the Questions
Cytomegalovirus (CMV) reactivation in patients with autoimmune bullous disease (AIBD) or severe drug eruption treated with immunosuppressive therapy was traditionally thought to be merely an epiphenomenon of the underlying immunosuppression. However, a detailed review of the clinical course of these...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-06-01
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| Series: | Pharmaceuticals |
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| Online Access: | https://www.mdpi.com/1424-8247/15/7/797 |
| _version_ | 1827618700433293312 |
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| author | Yumi Aoyama Seiko Sugiyama Takenobu Yamamoto |
| author_facet | Yumi Aoyama Seiko Sugiyama Takenobu Yamamoto |
| author_sort | Yumi Aoyama |
| collection | DOAJ |
| description | Cytomegalovirus (CMV) reactivation in patients with autoimmune bullous disease (AIBD) or severe drug eruption treated with immunosuppressive therapy was traditionally thought to be merely an epiphenomenon of the underlying immunosuppression. However, a detailed review of the clinical course of these patients revealed that CMV reactivation occurs upon rapid immune recovery, which is termed immune reconstitution inflammatory syndrome (IRIS), and that the timely initiation of anti-CMV therapy, when combined with maintenance doses of immunosuppressive agents, contributes to a rapid resolution of severe infectious complications thought to be refractory to conventional immunosuppressive therapies and unrelated to CMV reactivation. Thus, CMV reactivation resulting in fatal outcomes (CMV-IRIS) can be prevented by the timely detection of CMV DNA or antigens in the blood and by rapidly starting anti-CMV therapy while maintaining immunosuppressive therapy. Anti-CMV therapy is highly recommended for patients with CMV-IRIS or severe drug eruption who have risk factors for CMV reactivation resulting in fatal outcomes. |
| first_indexed | 2024-03-09T10:13:12Z |
| format | Article |
| id | doaj.art-2e10d6b52f0a4d4ea96aff42394ee397 |
| institution | Directory Open Access Journal |
| issn | 1424-8247 |
| language | English |
| last_indexed | 2024-03-09T10:13:12Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmaceuticals |
| spelling | doaj.art-2e10d6b52f0a4d4ea96aff42394ee3972023-12-01T22:33:13ZengMDPI AGPharmaceuticals1424-82472022-06-0115779710.3390/ph15070797Anti-Cytomegalovirus Therapy: Whether and When to Initiate, Those Are the QuestionsYumi Aoyama0Seiko Sugiyama1Takenobu Yamamoto2Department of Dermatology, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Dermatology, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Dermatology, Kawasaki Medical School, Kurashiki 701-0192, JapanCytomegalovirus (CMV) reactivation in patients with autoimmune bullous disease (AIBD) or severe drug eruption treated with immunosuppressive therapy was traditionally thought to be merely an epiphenomenon of the underlying immunosuppression. However, a detailed review of the clinical course of these patients revealed that CMV reactivation occurs upon rapid immune recovery, which is termed immune reconstitution inflammatory syndrome (IRIS), and that the timely initiation of anti-CMV therapy, when combined with maintenance doses of immunosuppressive agents, contributes to a rapid resolution of severe infectious complications thought to be refractory to conventional immunosuppressive therapies and unrelated to CMV reactivation. Thus, CMV reactivation resulting in fatal outcomes (CMV-IRIS) can be prevented by the timely detection of CMV DNA or antigens in the blood and by rapidly starting anti-CMV therapy while maintaining immunosuppressive therapy. Anti-CMV therapy is highly recommended for patients with CMV-IRIS or severe drug eruption who have risk factors for CMV reactivation resulting in fatal outcomes.https://www.mdpi.com/1424-8247/15/7/797cytomegalovirus reactivationanti-CMV therapyimmune reconstitution inflammatory syndromedipeptidyl peptidase 4 inhibitor-associated bullous pemphigoidautoimmune bullous disease |
| spellingShingle | Yumi Aoyama Seiko Sugiyama Takenobu Yamamoto Anti-Cytomegalovirus Therapy: Whether and When to Initiate, Those Are the Questions Pharmaceuticals cytomegalovirus reactivation anti-CMV therapy immune reconstitution inflammatory syndrome dipeptidyl peptidase 4 inhibitor-associated bullous pemphigoid autoimmune bullous disease |
| title | Anti-Cytomegalovirus Therapy: Whether and When to Initiate, Those Are the Questions |
| title_full | Anti-Cytomegalovirus Therapy: Whether and When to Initiate, Those Are the Questions |
| title_fullStr | Anti-Cytomegalovirus Therapy: Whether and When to Initiate, Those Are the Questions |
| title_full_unstemmed | Anti-Cytomegalovirus Therapy: Whether and When to Initiate, Those Are the Questions |
| title_short | Anti-Cytomegalovirus Therapy: Whether and When to Initiate, Those Are the Questions |
| title_sort | anti cytomegalovirus therapy whether and when to initiate those are the questions |
| topic | cytomegalovirus reactivation anti-CMV therapy immune reconstitution inflammatory syndrome dipeptidyl peptidase 4 inhibitor-associated bullous pemphigoid autoimmune bullous disease |
| url | https://www.mdpi.com/1424-8247/15/7/797 |
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