Norovirusinfektionen bei immunsupprimierten Patienten [thesis]

Verena König, Universitätsbibliothek Der FU Berlin
Introduction The Norovirus (NV) is the most common cause of acute non-bacterial gastroenteritides (GE) worldwide. The Norovirusgastroenteritis (NVGE) is usually mild and self-limiting in immunocompetent individuals. In immunocompromised patients, NV infections (NVI) could result in prolonged symptoms and viral shedding. In this group of patients, NV is recognized increasingly as a cause for chronic diseases potentially resulting in devastating consequences. Treatment of chronic NVGE in
more » ... ic NVGE in immunocompromised individuals remains challenging due to the lack of causative antiviral therapies and vaccines. The available therapeutic options are limited and show inconsistent efficacies. Methods We identified patients with polymerase chain reaction (PCR)-confirmed NVGE from a clinical and a laboratory database. Clinical data were retrieved from patient files. The severity of GE was assessed by the Vesikari-scale. Continuous variables were compared by Kruskal-Wallis test and time-dependent variables were compared by Kaplan-Meier analyses and Log-rank test. Results Overall, 101 patients at an age ranging from 1 to 90 years with solid organ transplantation (SOT, n=36), hematopoietic stem cell transplantation (HSCT, n=23), hematological malignancies (HM, n=20), solid tumor (ST, n=8), and other non-immunocompromising conditions (n=14) and treated for NVGE at the Charité between 2005 and 2016 were identified. Patients with SOT had received kidney (n=30), combined kidney and pancreas (n=4), combined liver, pancreas, stomach and small bowel (n=1), or combined liver and small bowel (n=1) transplantation. The median duration of symptoms was significantly longer in patients with SOT compared to those with other conditions (SOT m=26 days, HSCT m=12 days, HM m=5 days, ST m=4 days, other conditions m=3 days; p<0,0001). The disease severity was not significantly different across the risk groups. The age, the time since transplantation, the use of calcineurin inhibitors (CNI) versus other drugs for immunosuppression (IS) and the compariso [...]
doi:10.17169/refubium-27386 fatcat:fqbguukyfrd6jefb2em43oghri