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异基因造血干细胞移植受者中人类鼻病毒和冠状病毒的检测。

Human rhinovirus and coronavirus detection among allogeneic hematopoietic stem cell transplantation recipients.

机构信息

Fred Hutchinson Cancer Research Center, Seattle, WA, USA.

出版信息

Blood. 2010 Mar 11;115(10):2088-94. doi: 10.1182/blood-2009-09-244152. Epub 2009 Dec 30.

Abstract

Little is known about clinical and virologic manifestations of rhinovirus (HRV) and coronavirus (HCoV) infections after hematopoietic cell transplantation (HCT). We performed surveillance for 1 year and describe the natural history of these infections during the first 100 days after allogeneic HCT, when symptom surveys and upper respiratory samples were collected weekly. Samples were tested using RT-PCR for HRVs and HCoVs (OC43, 229E, HKU1, and NL63). Among 215 patients, 64 (30%) patients had 67 infections. Day 100 cumulative incidence estimate was 22.3% for HRV and 11.1% for HCoV. Median duration of viral shedding was 3 weeks; prolonged shedding of at least 3 months occurred in 6 of 45 patients with HRV and 3 of 22 with HCoV. Six patients with HRV and 9 with HCoV were asymptomatic. HRV infection was associated with rhinorrhea, congestion, postnasal drip, sputum, and cough; HCoV infection was not associated with respiratory symptoms or hepatic dysfunction. Lower respiratory infection developed in 2 patients with HRV before day 100, and 1 each with HRV and HCoV after day 100. HRV and HCoV infections are common in the first 100 days after HCT, viral shedding lasts more than 3 weeks in half, and lower respiratory infection is rare.

摘要

人们对造血细胞移植(HCT)后鼻病毒(HRV)和冠状病毒(HCoV)感染的临床和病毒学表现知之甚少。我们进行了为期 1 年的监测,并描述了同种异体 HCT 后 100 天内这些感染的自然史,当时每周采集症状调查和上呼吸道样本。使用 RT-PCR 对 HRV 和 HCoV(OC43、229E、HKU1 和 NL63)进行了检测。在 215 名患者中,64 名(30%)患者发生了 67 次感染。HRV 和 HCoV 的第 100 天累积发病率估计值分别为 22.3%和 11.1%。病毒排出的中位持续时间为 3 周;45 例 HRV 中有 6 例和 22 例 HCoV 中有 3 例病毒排出持续时间至少为 3 个月。6 例 HRV 和 9 例 HCoV 患者无症状。HRV 感染与流鼻涕、充血、鼻后滴注、痰和咳嗽有关;HCoV 感染与呼吸道症状或肝功能障碍无关。2 例 HRV 患者在第 100 天前发生下呼吸道感染,1 例 HRV 和 1 例 HCoV 患者在第 100 天后发生下呼吸道感染。HRV 和 HCoV 感染在 HCT 后 100 天内很常见,病毒排出持续时间超过 3 周的占一半,下呼吸道感染很少见。

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