Effect of maintenance immunosuppressive drugs on virus pathobiology: Evidence and potential mechanisms

Daniel C. Brennan, José M. Aguado, Luciano Potena, Alan G. Jardine, Christophe Legendre, Marcus D. Säemann, Nicolas J. Mueller, Pierre Merville, Vincent Emery, Björn Nashan

Research output: Contribution to journalReview articlepeer-review

45 Scopus citations


Recent evidence suggesting a potential anti-CMV effect of mTORis is of great interest to the transplant community. However, the concept of an immunosuppressant with antiviral properties is not new, with many accounts of the antiviral properties of several agents over the years. Despite these reports, to date, there has been little effort to collate the evidence into a fuller picture. This manuscript was developed to gather the evidence of antiviral activity of the agents that comprise a typical immunosuppressive regimen against viruses that commonly reactivate following transplant (HHV1 and 2, VZV, EBV, CMV and HHV6, 7, and 8, HCV, HBV, BKV, HIV, HPV, and parvovirus). Appropriate immunosuppressive regimens posttransplant that avoid acute rejection while reducing risk of viral reactivation are also reviewed. The existing literature was disparate in nature, although indicating a possible stimulatory effect of tacrolimus on BKV, potentiation of viral reactivation by steroids, and a potential advantage of mammalian target of rapamycin (mTOR) inhibition in several viral infections, including BKV, HPV, and several herpesviruses.

Original languageEnglish (US)
Pages (from-to)97-125
Number of pages29
JournalReviews in Medical Virology
Issue number2
StatePublished - Mar 2013
Externally publishedYes

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases


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