Management strategies for common viral infections in pediatric renal transplant recipients

Table 3 Treatment of viral infections kidney transplant recipients

CMV	CMV load copy no < 500 - below quantifiable level - no action
	CMV load copy no 500-3000 - active CMV infection - repeat CMV in 1 week, consider treatment if clinically indicated
	CMV load copy no > 3000 - Active CMV infection - commence pre-emptive treatment
	Intravenous ganciclovir or oral valganciclovir
EBV	Immunosuppressive drug reduction
	Ganciclovir and valganciclovir have antiviral impact against EBV
BKPyV	Immunosuppressive drug reduction
	No specific antiviral therapy
HSV	Acyclovir
	Intravenous or oral
VZV	Intravenous acyclovir, while less severe infection can be treated with oral acyclovir
Hepatitis B & C	Immunosuppressive drug reduction
	Hepatitis B – Lamivudine
	Hepatitis C - IFN and ribavirin
Respiratory viruses	Reduce immunosuppressive drugs
	Supportive care and, in some cases, the use of antivirals

CMV: Cytomegalovirus, EBV: Epstein-Barr virus, BKPyV: Human BK polyomavirus, HSV: Herpes simplex viruses, VZV: Varicella zoster virus.