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ISSN 0016-3813 (Impreso)

2011, Número 2

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Gac Med Mex 2011; 147 (2)


Reactivación de citomegalovirus en el enfermo grave internado en la Unidad de Terapia Intensiva

Carrillo ER

Idioma: Español
Referencias bibliográficas: 34
Paginas: 159-162
Archivo PDF: 80.83 Kb.


RESUMEN

Citomegalovirus (CMV) es un patógeno frecuente en los humanos que pertenece a la familia de los herpesvirus β. Después de la primoinfección permanece en estado latente. En individuos inmunocompetentes, la respuesta inmune mediada por células previene la reactivación de la infección. Recientemente se ha reconocido que los enfermos graves están en riesgo de reactivación del CMV. Los factores de riesgo asociados a esta reactivación son los procesos infecciosos, sepsis, trauma, transfusiones, cirugía mayor, ventilación mecánica prolongada y uso de vasopresores y esteroides. En la patogénesis de la reactivación están involucradas la inmunodisfunción y el imbalance de mediadores inmunomoduladores, en especial el factor de necrosis tumoral (TNF) y el factor nuclear κB (NF-κB). Varios estudios han mostrado una asociación entre la reactivación de CMV en el enfermo grave inmunocompetente y un mal pronóstico. Se requieren estudios para identificar el subgrupo de enfermos de mayor riesgo y para evaluar el papel de los agentes antivirales, ya sea en forma profiláctica o terapéutica, en los patrones evolutivos de los enfermos en los que se presenta la reactivación.


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