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- W2988512655 abstract "L’infection par le virus d’Epstein-Barr (EBV) est une infection ubiquitaire, le plus souvent asymptomatique, et touchant plus de 95 % de la population mondiale ; c’est également une infection virale persistante associée à des cancers chez des individus immunocompétents ou immunodéprimés. Chez le patient greffé de cellules souches hématopoïétiques (CSH) ou transplanté d’organe solide, le déficit de contrôle de l’infection à EBV par le système immunitaire peut conduire à une lymphoprolifération ou syndrome lymphoprolifératif post-transplantation (SLPT). Le diagnostic du SLPT repose sur un faisceau d’arguments cliniques, biologiques et d’imagerie. La charge virale EBV (CVEBV) dans le sang est un marqueur sensible mais peu spécifique de la survenue d’un SLPT. Elle est utilisée dans tous les centres dans le suivi des patients transplantés, mais aucun consensus n’existe à ce jour sur le seuil de CVEBV à partir duquel un traitement préemptif doit être conduit. Chaque centre doit faire sa propre expérience de suivi de la CVEBV : le laboratoire de virologie (matrice, unité de mesure ou seuil de CVEBV) et les services cliniques (interprétation des résultats dans le contexte clinique). Chez un patient dont la CVEBV augmente rapidement, le traitement préemptif EBV peut comprendre la levée de l’immunodépression et/ou l’instauration d’un traitement par le rituximab, un anticorps monoclonal anti-CD20 ciblant les lymphocytes B.Download : Download high-res image (187KB)Download : Download full-size image© SPL/PHANIE © SPL/PHANIE Epstein-Barr virus (EBV) infection is ubiquitous, most often asymptomatic, affecting more than 95 % of the world’s population; it is also a persistent viral infection associated with cancers in immunocompetent or immunocompromised individuals. In the hematopoietic stem cell (HSCT) transplant recipient or solid organ transplant recipient, the lack of control of EBV infection by the immune system may lead to lymphoproliferation or post-transplantation lymphoproliferative disorder (PTLD). The diagnosis of PTLD is based on clinical, biological and imaging arguments. The EBV viral load in the blood is a sensitive but not very specific marker of the occurrence of an PTLD. It is used in all centers in the follow-up of transplant patients, but no consensus exists to date on the viral load threshold from which preemptive treatment must be conducted. Each center should have its own experience of viral load monitoring: the virology laboratory (matrix, unit of measure or viral load threshold) and clinical services (interpretation of results in the clinical context). In a patient with rapidly increasing EBV viral load, preemptive EBV therapy may include the reduction of immunosuppression and / or the initiation of treatment with Rituximab, a monoclonal anti-CD20 monoclonal antibody targeting B cells." @default.
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- W2988512655 date "2019-09-01" @default.
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- W2988512655 title "Virus d’Epstein-Barr et syndromes lymphoprolifératifs post-transplantation" @default.
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- W2988512655 doi "https://doi.org/10.1016/s1773-035x(19)30452-6" @default.
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