Treatment and detection of cytomegalovirus infection

Cytomegalovirus treatment more trouble. General use of ganciclovir (Ganciclovir, GCV) treatmentProposal to refer to adult programs to give t

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Cytomegalovirus treatment more trouble. General use of ganciclovir (Ganciclovir, GCV) treatment

Proposal to refer to adult programs to give two stage treatment. Induction therapy: 5mg/kg (> 1H), q12h, lasting 2 to 3 weeks; maintenance treatment: 5mg/kg, QD, for a period of 5 to 7 days, the total treatment course of 3 to. If by 3 weeks of treatment virological examination should be considered invalid, or secondary infection resistant strains resistant to maintain stage if the progression of the disease, can consider re induction therapy; antiviral efficacy evaluation (1): HCMV clinical assessment of symptoms and signs of the disease and improve organ function. (2) virology assessment: virus specific antigens and virus titer quantitative analysis helps to evaluate the effect of antiviral drugs for HCMV DNA in many patients with symptoms after a long time still persists, it is not suitable for monitoring the efficacy of antiviral drugs. With reference:

Cytomegalovirus infection can cause congenital microcephaly, mental retardation and deafness and other damage, the baby infection involving the liver, in immunocompromised individuals such as AIDS patients and organ transplantation can lead to disseminated infection, serious cause death.

The antibody positive rate of the general population in our country is 86% ~ 96%, and the number of pregnant women is about 95%. It reaches about 80%.

The anti HCMV IgM

Is a sign of primary infection or active infection. It usually occurs in the primary infection after about two weeks, lasting 12 to 28 weeks. Recurrent infection (latent virus reactivation or reinfection with exogenous virus) is often reproduced, but its level is generally lower than that of primary infection.

The anti HCMV IgG

Lifetime after infection. It is observed that the positive seroconversion is a reliable indicator for the diagnosis of primary infection. Paired serum antibody titer is no less than 4 times higher activity signs of infection, but it is difficult to distinguish the primary and recurrent infection. The following 6 months of the baby should pay attention to in addition to tire antibody exists.

1 indications of anti HCMV drugs

Antiviral therapy is beneficial for immunosuppressed patients;

There is a dispute about the newborn with severe HCMV disease;

Asymptomatic or mild symptomatic HCMV infection in immunocompetent individuals without antiviral therapy.

The main indications include:

There is obvious HCMV diseases such as interstitial pneumonia, jaundice or cholestatic hepatitis, encephalitis and chorioretinitis (involving the macular and blindness), especially in immunosuppressed individuals such as AIDS patients;

Preventive medicine after transplantation;

Congenital CMV infection in children with central nervous system injury in order to prevent deterioration of hearing impairment.

 

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