Infectious complications after hematopoietic stem cell transplantation: current status and future perspectives in Korea

Cho, Sung-Yeon; Lee, Hyeon-Jeong; Lee, Dong-Gun

The Korean Journal of Internal Medicine Vol. 33, No. 2, March 2018 beyond the usual duration in cases of severe influenza LRTI [134, 139, 143] . Aerosolized ribavirin and intravenous immunoglobulin (IVIG) combination treatment significantly reduces RSV-LRTI-related mortality and is thus recommended by most guidelines [129, 137, 140, 141] . Although evidence is lacking, if aerosolized ribavirin cannot be used, oral ribavirin or intravenous ribavirin may be considered [129, 137, 140, 141] . A recent double-blind, placebo-controlled study of GS-5806 (presatovir), an oral RSV-entry inhibitor, involved 54 RSV-infected healthy adult volunteers who received RSV challenge intranasally. GS-5806 reduced the viral load and the severity of clinical disease [143] . Proven PIV-LRTI should be treated with aerosolized ribavirin and IVIG in combination [129, 137, 140] . Unfortunately, aerosolized ribavirin is costly and available only through the Korea Orphan & Essential Drug Center in Korea, so its use is limited. No antiviral is available to treat CRV, rhinovirus, human metapneumovirus, and bocavirus LRTIs, so supportive care is the mainstay.