Abstract

Viral infections are commonplace and often innocuous. Nevertheless, within the population of patients with primary immunodeficiencies (PIDDs), viral infections can be the feature that drives a diagnostic evaluation or can be the most significant morbidity for the patient. This review is focused on the viral complications of PIDDs. It will focus on respiratory viruses, the most common type of viral infection in the general population. Children and adults with an increased frequency or severity of respiratory viral infections are often referred for an immunologic evaluation. The classic teaching is to investigate humoral function in people with recurrent sinopulmonary infections, but this is often interpreted to mean recurrent bacterial infections. Recurrent or very severe viral infections may also be a harbinger of a primary immunodeficiency as well. This review will also cover persistent cutaneous viral infections, systemic infections, central nervous system infections, and gastrointestinal infections. In each case, the specific viral infections may drive a diagnostic evaluation that is specific for that type of virus. This review also discusses the management of these infections, which can become problematic in patients with PIDDs.

Highlights

  • Frequent infections are a common reason for physician visits

  • A study by the PIDTC found that 21% of their cohort had a respiratory infection prior to transplant with the most common being parainfluenza followed by RSV, rhinovirus, and influenza [11]

  • There are, significant T cell disorders not identified by this test, and T cell disorders still represent a concern in the setting of a prolonged viral infection

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Summary

Recurrent and Sustained viral infections in Primary immunodeficiencies

Reviewed by: Alexandra Freeman, National Institutes of Health, United States Elham Hossny, Ain Shams University, Egypt Jolan Eszter Walter, University of South Florida, United States. Viral infections are commonplace and often innocuous. Within the population of patients with primary immunodeficiencies (PIDDs), viral infections can be the feature that drives a diagnostic evaluation or can be the most significant morbidity for the patient. This review is focused on the viral complications of PIDDs. This review is focused on the viral complications of PIDDs It will focus on respiratory viruses, the most common type of viral infection in the general population. Children and adults with an increased frequency or severity of respiratory viral infections are often referred for an immunologic evaluation. Recurrent or very severe viral infections may be a harbinger of a primary immunodeficiency as well. The specific viral infections may drive a diagnostic evaluation that is specific for that type of virus. This review discusses the management of these infections, which can become problematic in patients with PIDDs

INTRODUCTION
RESPIRATORY VIRAL INFECTIONS IN PIDD
Diagnostic Approach
SYSTEMIC VIRAL INFECTIONS IN PIDD
Gene dependent
CHRONIC VIRAL SKIN INFECTIONS IN PRIMARY IMMUNODEFICIENCY
Papillomaviridae HPV
Susceptibility to mycobacteria
Broad infectious susceptibility
Diagnostic Considerations for Patients with Cutaneous Viral Infections
Hepatitis C
Other GI Viruses
VIRAL INFECTIONS OF THE CNS IN PIDD
Herpes Simplex Encephalitis
Enteroviral Meningoencephalitis
Findings
Diagnostic Approaches

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