cytomegalovirus

Dr. Felicia Goodrum, Ph.D. ( https://profiles.arizona.edu/person/fgoodrum ) is Interim Associate Department Head and Professor of Immunobiology, as well as Professor, BIO5 Institute, Cellular and Molecular Medicine, Molecular and Cellular Biology, Cancer Biology And Genetics Graduate Interdisciplinary Programs, at the University of Arizona. Dr. Goodrum earned her Ph.D. from Wake Forest University School of Medicine studying cell cycle restrictions to adenovirus replication and then trained as a postdoctoral fellow at Princeton University in the laboratory of Dr. Thomas Shenk studying human cytomegalovirus latency. Dr. Goodrum joined the faculty at the University of Arizona in 2006, and her long-standing research focus is to understand the molecular virus-host interactions important to human cytomegalovirus (CMV) latency and persistence in the host. She has focused on identifying viral and host determinants mediating the switch between latent and replicative states. The goal of her research program is to define the mechanistic underpinnings of HCMV latency and reactivation to lay the foundation for clinical interventions to control CMV disease in all settings. Dr. Goodrum is the recipient of the Howard Temin Award from the National Cancer Institute, the Pew Scholar in Biomedical Sciences Award, and the Presidential Award for Early Career Scientists and Engineers. 

In this episode from the series “Key Decisions in HIV Care,” Cristina Mussini, MD, and William R. Short, MD, MPH, AAHIVS, discuss important considerations for ART with opportunistic infections, including: 

• When to start ART with pneumocystis pneumonia including discussion of the ACTG 5164 study of immediate vs delayed ART with opportunistic infections
• EACS, DHHS, and IAS-USA guideline recommendations for starting ART in the setting of most opportunistic infections
• Considerations for the administration of ART to patients who are unable to swallow or critically ill and intubated
• Treatment of Kaposi sarcoma and considerations for starting ART to avoid drug–drug interactions with Kaposi sarcoma treatment
• Considerations for starting ART with cytomegalovirus and the risk for IRIS from cytomegalovirus
• Discussion of treatment of cytomegalovirus and overlapping toxicities between its treatment and ART
• When to start ART with cryptococcal meningitis and the data to support delayed treatment initiation with this particular opportunistic infection
• EACS, DHHS, and IAS-USA guideline recommendations for starting ART in the setting of cryptococcal meningitis specifically
• Treatment of cryptococcal meningitis and managing drug–drug interactions between ART and antifungal therapy

Presenters:
Cristina Mussini, MD
Head of Department of Infectious Diseases and Tropical Medicine
Full Professor of Infectious Diseases
Infectious Diseases Clinics 
University Hospital
University of Modena and Reggio Emilia
Reggio Emilia, Italy 

William R. Short, MD, MPH, AAHIVS
Associate Professor of Medicine
Division of Infectious Diseases
Department of Medicine
Perelman School of Medicine at the University of Pennsylvania
Philadelphia, Pennsylvania 

Content based on an online CME program supported by educational grants from Gilead Sciences, Inc.; Janssen Therapeutics, Division of Janssen Products, LP; and ViiV Healthcare.

Follow along with the slides at:
https://bit.ly/3uktrm1

Link to full program:
https://bit.ly/3q2DlGd

Congenital Cytomegalovirus (CMV) and Covid-19.

This topic of infectious diseases is a really timely one. Our job as clinicians is face to face with children - we might be at arms length away or we may also be really up close too! This not only presents as a potential spread of an infectious disease, but it is also a point of contact where families might have some questions or potentially may be sitting on some misinformation about diseases such as CMV or COVID-19. 

There is so much information out there and not everything we read or are presented with represents the true state of science. When developing prevention and treatment approaches, we rely so much on science to provide the solutions because it is based on large data sets that can then be generalised to the wider population.

The power of infection control - hand hygiene, applying barriers and staying at home when sick! They are all seemingly simple but also incredibly effective. The world has changed so much now so coughing into our elbow and even wearing a face mask isn’t something that draws a second glance anymore. This is a good thing because these are important measures to have in place when we are treating children either within their home, the community or hospital setting.

It is so important to look at reliable sources of information so that we can do the right thing to keep both ourselves and our patients safe. Prevention is a key strategy and the power is literally in our hands!

Now when it comes to COVID-19, it was so timely to hear Asha’s passion about the importance of school. For the first time, our government has issued a lock down but with a clear directive to keep schools open. It is intriguing that children don’t respond the same way to COVID-19 as adults do and this has some really important implications for prevention and scientists are still trying to unpack this. Schools are the best place for children to be - to be stimulated and to be in a learning environment sets them up for success and for a better future. 

When Sharon Minton's husband Rob broke out in a strange rash, his primary doctor thought it might be an allergic reaction to laundry detergent. What it turned out to be was an extraordinarily rare cancer called Sezary Syndrome, an aggressive form of cutaneous T-cell lymphoma.  In 2013, he was told he had a 25% chance of surviving the next five years. Sharon shares the importance of being YOUR loved one's advocate, even if you have to speak up and be bold at times. 

After researching with doctors and the Sezary Syndrome community, they decided Rob's best hope would be allogeneic stem cell transplant.  They got on the registry and found an 8 out of 10 match.

Sharon walks us through the inspiring story of Rob's transplant, hospital stay, and move to an apartment nearby following the transplant.  She credits exercise (even walking around the unit), friends and family, and her faith for helping them both survive this ordeal.

There were setbacks along the way, including cytomegalovirus (CMV), sepsis, and even fungal pneumonia.  But today, Rob and Sharon are both doing well, with Rob running, fishing, and playing pickleball.  

The information in this podcast should not be construed as medical advice. Please consult with your health care provider regarding your medical decisions and treatment. The listed resources are not intended to be endorsements.

For more from the National Bone Marrow Transplant Link, visit us online at nbmtlink.org or call us at 800-546-5268.

This season of Marrow Masters is sponsored by the nbmtLINK, Incyte Corporation and The Leukemia & Lymphoma Society.

nbmtLINK website: https://www.nbmtlink.org/

The Leukemia & Lymphoma Society: https://www.lls.org/