VIRAL INFECTIONS IN IMMUNOCOMPROMISED HOST

Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.

VIRAL INFECTIONS IN IMMUNOCOMPROMISED HOST

Serono Symp Publ Raven Press; 59:327-36 1989. Unique Identifier : AIDSLINE ICDB/90660606
Galli M; Irato L; Vago L; Boldorini R; Caredda F; Barbi M; Balotta C; Riva A; Corbellino M; Moroni M; Infectious Diseases Clinic, Univ. of Milan, L. Sacco Hosp., Via; G. Baresi, 74, 20157 Milan, Italy

Abstract: The increasing use of organ and bone marrow transplantation, the wide use of immunosuppressive drugs, and the appearance of AIDS have all increased the likelihood of practitioners encountering immunocompromised patients (pts) in clinical practice. Viral diseases in the immunocompromised host (herpes viruses, hepatic viruses) and opportunistic viral infections in HIV-infected pts are discussed, with presentation of information from the authors' case records. In a prospective study of pts with viral hepatitis, 83 pts older than 60 yr were compared with groups of pts aged 20-39 yr and 40-59 yr. In terms of clinical and biochemical characteristics, acute B and non-A, non-B (NANB) hepatitis in the elderly pts did not differ from that in the other two groups, but the acute phase (hospitalization period) in the elderly group was longer. The frequency of a biphasic course of post-transfusion or 'sporadic' NANB among the elderly pts was three times as high as among the other groups. In both post-transfusional and 'sporadic' cases, the frequency of chronic evolution of NANB hepatitis was twice as high among elderly pts as among those aged 20-59 yr. The three main viral infections found at autopsy in 214 consecutive pts dying of AIDS were cytomegalovirus (CMV, 41.6%), progressive multifocal encephalopathy (PML, 6.5%), and herpes simplex virus (3.2%). CMV was found mainly in the adrenals and lungs. The revised clinical histories of about 150 of the pts showed that CMV infection was suspected in 10% and confirmed by culture in 6%. Frank Addison disease was found in one pt. The pts with PML (14) included 11 drug addicts and 2 homosexuals. The neurologic picture was characterized by focal or generalized limb weakness, visual-field defects, ataxia, and dementia. Computerized tomography and magnetic resonance imaging showed marked white matter rarefaction with a subcortical pattern of distribution. (26 Refs)

Keywords: Adult Cytomegalovirus Infections/DIAGNOSIS Female Human HIV Infections/DIAGNOSIS Leukoencephalopathy, Progressive Multifocal/DIAGNOSIS Male Middle Age Opportunistic Infections/*DIAGNOSIS Prognosis Risk Factors Virus Diseases/*DIAGNOSIS JOURNAL ARTICLE
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