Viral infections in acute graft-versus-host disease: A review of diagnostic and therapeutic approaches

BackgroundWhile immunosuppressive therapy for acute graft-versus-host disease (aGVHD) advances, viral reactivation has been found to be an increasingly common complication in these patients. Dermatologists may often be consulted on inpatient services for evaluation.ObjectiveWe investigated the literature for the role of viral infections in aGVHD and review the current evidence regarding management.MethodsArticles in the public domain regarding aGVHD, cytomegalovirus, Epstein–Barr virus, varicella zoster virus, hepatitis viruses, parvovirus B19, and respiratory viruses were included.ResultsDermatologic findings vary between different viral antigens, and some infections may be a marker for the development of aGVHD or worsen prognosis.LimitationsThe heterogeneous cohorts of the studies reviewed often preclude direct comparison between results.ConclusionThe relationship between viral reactivation and aGVHD may be bidirectional and is worthy of further exploration. Additional studies are needed to determine appropriate prophylaxis and treatment.