RT Book, Section A1 Khawaja, Fareed A1 Chemaly, Roy F. A2 Kantarjian, Hagop M. A2 Wolff, Robert A. A2 Rieber, Alyssa G. SR Print(0) ID 1190839435 T1 Viral Infections in Patients with Cancer T2 The MD Anderson Manual of Medical Oncology, 4e YR 2022 FD 2022 PB McGraw Hill Education PP New York, NY SN 9781260467642 LK accessmedicine.mhmedical.com/content.aspx?aid=1190839435 RD 2024/03/28 AB KEY CONCEPTSViral infections caused by herpes simplex virus (HSV) 1 and 2, varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus, and human herpesvirus 6, can reactivate in immunosuppressed patients and lead to increased morbidity and mortality.Cutaneous HSV and VZV infections have characteristic appearances on physical examination, and confirmation can be obtained with polymerase chain reaction–based molecular assays. Treatment of patients with severe HSV and VZV infections requires the use of intravenous treatment dose of acyclovir, and if started early, it may reduce serious complications.CMV reactivation has varied clinical presentations in patients with hematologic malignancies and hematopoietic cell transplantation (HCT) recipients. Specific viral loads thresholds trigger initiation of antiviral therapy to prevent end-organ disease and serious complications.Adenovirus infections can range from upper respiratory tract infection, pneumonia, gastrointestinal infections, or asymptomatic viremia. Treatment is indicated in immunocompromised patients, such as HCT recipients, with disseminated disease. Cidofovir is the only commercially available agent with in vitro activity against adenoviruses.Community respiratory viral infections are commonly diagnosed in patients with cancer and are associated with increased morbidity and mortality in immunosuppressed patients in particular.Hepatitis B and C viral infections are common in certain parts of the world. Patients with cancer should undergo testing for both viruses before chemotherapy. Prevention of hepatitis B with entecavir or tenofovir is recommended in high-risk patients to prevent fulminant liver failure. Hepatitis C is treated with intent to cure and can be postponed until after chemotherapy.