الفهرس 
Hematopoietic Stem Cell TransplantationOnly 14 pages are availabe for public view
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Abstract
Hematopoietic stem cell transplantation (HSCT) is performed worldwide to treat various diseases, mainly hematologic malignancies. Intensive chemotherapy in patients who under go HSCT can result in immune dysfuntion and those patients are at high risk for various infections including viral infections.
Major progress has been made in the diagnosis and prevention of viral infections HCT over the last decade. Perhaps the most impressive examples are the prevention of CMV disease by ganciclovir and the rccognition of the host defense mechanisms that control CMV. During the same time period, the significance and our knowledge of other viral infections has increased, especially that of respiratory viruses, HHV-6, 3K, and adenoviruses.
Hepatitis C virus is a single -stranded RNA virus that belongs to the Flaviviridae family and affects 3% of the world’s population. The majority of the patients infected with HCV will develop chronic infection. HCV is still one of the most common causes of abnormal liver enzymes and needs to be suspected in any patient with abnormal liver chemistries.
Recent prospective study of the European group for blood and marrow transplantation (EBMT),which included patients who received transfusion in the ”post screening”era, showed that the prevalence of HCV RNA-positive stem cell transplant recipients was 6.0%.Thus chronic hepatitis C in long-term survivors remains an important clinical issue in this setting. Chronic hepatitis C is often asymptomatic, with fluctuating transaminase levels and no signs or symptoms of decompensated liver disease at least during the first decade following HSCT.
Chronic hepatitis B virus infection is one of the most common viral infection in human, with more than 350 million HBV carriers worldwide. The most important sequelae of chronic HBV infection are liver cirrhosis and hepatocellular carcinoma.
Hepatitis due to reactivation of hepatitis B virus (HBV) is a well recognized complication in patients with chronic HBV infection undergoing cytotoxic therapy. It has been observed in patients positive for hepatitis B surface antigen (HbsAg) and in HbsAg-negative patients who had HBV infection in the past (hepatitis B surface antibody positive and hepatitis B core antibody positive).
Cytomegalovirus (CMV) infection is a significant cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation. The majority of cases of active CMV infection are considered to be due to reactivation of latent infection. Consequently, CMV serology status of the recipient rather than the donor is the primary determinant of risk for CMV conversion after T-cell-depleted allogeneic hematopoietic stem cell transplantation.