Viral primary infections and reactivations are common complications in patients after solid organ transplantation (SOT) and hematopoietic stem cell transplantation (HSCT) and are associated with high morbidity and mortality. Among these patients, viral infections are frequently associated with viremia. Beyond the usual well-known viruses that are part of the routine clinical management of transplant recipients, numerous other viral signatures or genomes can be identified in the blood of these patients. The identification of novel viral species and variants by metagenomic next-generation sequencing has opened up a new field of investigation and new paradigms. Thus, there is a need to thoroughly describe the state of knowledge in this field with a review of all viral infections that should be scrutinized in high-risk populations. Here, we review the eukaryotic DNA and RNA viruses identified in blood, plasma, or serum samples of pediatric and adult SOT/HSCT recipients and the prevalence of their detection, with a particular focus on recently identified viruses and those for which their potential association with disease remains to be investigated, such as members of the Polyomaviridae, Anelloviridae, Flaviviridae, and Astroviridae families. Current knowledge of the clinical significance of these viral infections with associated viremia among transplant recipients is also discussed. To ensure a comprehensive description in these two populations, individuals described as healthy (mostly blood donors) are considered for comparative purposes. The list of viruses that should be on the clinicians’ radar is certainly incomplete and will expand, but the challenge is to identify those of possible clinical significance.

中文翻译：

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超越巨细胞病毒和爱泼斯坦-巴尔病毒：构成实体器官移植和造血干细胞移植受者血液病毒组的病毒综述。

病毒原发感染和再激活是实体器官移植 (SOT) 和造血干细胞移植 (HSCT) 后患者的常见并发症，并且与高发病率和死亡率相关。在这些患者中，病毒感染常常与病毒血症有关。除了作为移植受者常规临床管理一部分的常见病毒之外，还可以在这些患者的血液中识别出许多其他病毒特征或基因组。通过宏基因组下一代测序鉴定新的病毒种类和变体开辟了一个新的研究领域和新的范式。因此，有必要通过审查所有应在高危人群中仔细检查的病毒感染来彻底描述该领域的知识状态。这里，多瘤病毒科、指环病毒科、黄病毒科和星状病毒科。还讨论了移植受者中这些病毒感染与相关病毒血症的临床意义的当前知识。为确保对这两个人群进行全面描述，将被描述为健康（主要是献血者）的个人用于比较目的。临床医生应该关注的病毒清单肯定是不完整的，而且还会扩大，但挑战在于确定那些可能具有临床意义的病毒。