Abstract：
BACKGROUND: Herpesviruses represent common and significant infectious complications after allogeneic haematopoietic cell transplantation (HCT). In the last decade, major advances in the prevention and treatment of these infections were accomplished.
OBJECTIVE: The aim of this paper is to review the recent advances in the prophylaxis and treatment of herpesvirus infections after allogeneic HCT, to assess the persisting challenges, and to offer future directions for the prevention and management of these infections.
METHODS: We searched PubMed for relevant literature regarding specific herpesviruses complicating allogeneic HCT through March 2024.
BACKGROUND: The largest advances in this past decade were witnessed for cytomegalovirus (CMV) with the advent of letermovir for primary prophylaxis and the development of maribavir as an option for refractory and/or resistant CMV infections in transplant recipients. For varicella zoster virus, prevention of reactivation with the recombinant zoster vaccine offers an additional prophylactic intervention. Pritelivir is being explored for the treatment of drug-resistant or refractory Herpes simplex virus infections. Although rituximab is now an established option for preemptive therapy for Epstein-Barr virus, Human Herpesvirus-6 remains the most elusive virus of the herpesvirus family, with a lack of evidence supporting the benefit of any agent for prophylaxis or for optimal preemptive therapy.
CONCLUSIONS: Although considerable advances have been achieved for the treatment and prevention of herpes virus infections, most notably with CMV, the coming years should hold additional opportunities to tame the beast in these herpesviruses postallogeneic HCT, with the advent of new antivirals, cell-mediated immunity testing, and cytotoxic T lymphocytes infusions.
OBJECTIVE: The aim of this paper is to review the recent advances in the prophylaxis and treatment of herpesvirus infections after allogeneic HCT, to assess the persisting challenges, and to offer future directions for the prevention and management of these infections.
METHODS: We searched PubMed for relevant literature regarding specific herpesviruses complicating allogeneic HCT through March 2024.
BACKGROUND: The largest advances in this past decade were witnessed for cytomegalovirus (CMV) with the advent of letermovir for primary prophylaxis and the development of maribavir as an option for refractory and/or resistant CMV infections in transplant recipients. For varicella zoster virus, prevention of reactivation with the recombinant zoster vaccine offers an additional prophylactic intervention. Pritelivir is being explored for the treatment of drug-resistant or refractory Herpes simplex virus infections. Although rituximab is now an established option for preemptive therapy for Epstein-Barr virus, Human Herpesvirus-6 remains the most elusive virus of the herpesvirus family, with a lack of evidence supporting the benefit of any agent for prophylaxis or for optimal preemptive therapy.
CONCLUSIONS: Although considerable advances have been achieved for the treatment and prevention of herpes virus infections, most notably with CMV, the coming years should hold additional opportunities to tame the beast in these herpesviruses postallogeneic HCT, with the advent of new antivirals, cell-mediated immunity testing, and cytotoxic T lymphocytes infusions.
摘要：
背景：疱疹病毒代表异基因造血细胞移植（HCT）后常见且重要的感染性并发症。在过去的十年里，在预防和治疗这些感染方面取得了重大进展。
目的：本文的目的是综述近年来同种异体HCT后疱疹病毒感染的预防和治疗进展，为了评估持续存在的挑战，并为这些感染的预防和管理提供未来的方向。
方法：我们搜索了PubMed关于特定疱疹病毒并发同种异体HCT的相关文献，直至2024年3月。
背景：在过去的十年中，巨细胞病毒（CMV）取得了最大的进步，随着Letermovir用于初级预防的出现以及maribavir作为难治性和/或耐药性CMV感染的选择的发展移植受者。对于水痘带状疱疹病毒，预防重组带状疱疹疫苗的再激活提供了额外的预防性干预。正在探索Pritelivir用于治疗耐药或难治性单纯疱疹病毒感染。虽然利妥昔单抗现在是爱泼斯坦巴尔病毒先发制人治疗的既定选择，HHV-6仍然是疱疹病毒家族中最难以捉摸的病毒，缺乏证据支持任何药物用于预防或最佳抢先治疗的益处。
结论：虽然在治疗和预防疱疹病毒感染方面取得了相当大的进展，最值得注意的是CMV，未来几年应该有更多的机会来驯服同种异体HCT后这些疱疹病毒中的野兽，随着新抗病毒药物的出现，细胞介导的免疫检测，和细胞毒性T淋巴细胞输注。
目的：本文的目的是综述近年来同种异体HCT后疱疹病毒感染的预防和治疗进展，为了评估持续存在的挑战，并为这些感染的预防和管理提供未来的方向。
方法：我们搜索了PubMed关于特定疱疹病毒并发同种异体HCT的相关文献，直至2024年3月。
背景：在过去的十年中，巨细胞病毒（CMV）取得了最大的进步，随着Letermovir用于初级预防的出现以及maribavir作为难治性和/或耐药性CMV感染的选择的发展移植受者。对于水痘带状疱疹病毒，预防重组带状疱疹疫苗的再激活提供了额外的预防性干预。正在探索Pritelivir用于治疗耐药或难治性单纯疱疹病毒感染。虽然利妥昔单抗现在是爱泼斯坦巴尔病毒先发制人治疗的既定选择，HHV-6仍然是疱疹病毒家族中最难以捉摸的病毒，缺乏证据支持任何药物用于预防或最佳抢先治疗的益处。
结论：虽然在治疗和预防疱疹病毒感染方面取得了相当大的进展，最值得注意的是CMV，未来几年应该有更多的机会来驯服同种异体HCT后这些疱疹病毒中的野兽，随着新抗病毒药物的出现，细胞介导的免疫检测，和细胞毒性T淋巴细胞输注。
