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在成年波兰异基因造血干细胞移植受者中,巨细胞病毒和人类疱疹病毒 7 型的合并感染。

Co-infections with cytomegalovirus and human herpesvirus type 7 in adult Polish allogeneic haematopoietic stem cell transplant recipients.

机构信息

Department of Haematopoetic Stem Cell Transplantation, Institute of Hematology and Transfusion Medicine, Warsaw, Poland.

出版信息

Arch Immunol Ther Exp (Warsz). 2014 Feb;62(1):77-80. doi: 10.1007/s00005-013-0252-z. Epub 2013 Aug 18.

Abstract

Human herpesvirus 7 (HHV-7) is widespread around the world and may also be a possible cofactor for cytomegalovirus (CMV) infection in haematopoietic stem cell transplant (HSCT) recipients. In case of viral diseases where specific treatment is available, real-time PCR assays constitute reliable diagnostic tools enabling timely initiation of appropriate therapy and rapid assessment of the efficacy of antiviral treatment strategies. The presence of CMV and HHV-7 was confirmed by the detection of viral DNA isolated from 1,027 plasma samples. A group of 69 allogeneic HSCT (alloHSCT) recipients was examined in early post-transplant period using quantitative real-time PCR methods. Within the study period, 62 % of patients had at least once CMV DNA-emia, while HHV-7 DNA was found in 43 % of subjects. Co-infection between these β-herpesviruses was detected in the plasma samples collected from 18 patients (26 %). Patients with concomitant HHV-7 DNA-emia had significantly higher number of CMV DNA copies compared with those without HHV-7 infection (1986 vs. 432 copies/ml, p < 0.001) but there was no difference in duration of CMV DNA-emia between these groups. On the other hand, while the load of HHV-7 DNA was comparable between patients with CMV DNA-emia and without CMV DNA-emia, the duration of HHV-7 DNA-emia was significantly longer in the first group (38.5 vs. 14 days, p < 0.001). HHV-7 DNA-emia is very frequently detected in Polish alloHSCT recipients. In those, who have subsequent CMV reactivation, the coexistence of the viruses may negatively affect the kinetics of infection with either of them. Therefore the investigation of concomitant HHV-7 DNA-emia could affect the prognosis of post-transplant patients suffering from CMV reactivation.

摘要

人疱疹病毒 7(HHV-7)在全球范围内广泛存在,也可能是造血干细胞移植(HSCT)受者巨细胞病毒(CMV)感染的一个潜在协同因素。在有特定治疗方法的病毒病中,实时 PCR 检测构成了可靠的诊断工具,能够及时启动适当的治疗,并快速评估抗病毒治疗策略的效果。通过检测从 1027 份血浆样本中分离的病毒 DNA,证实了 CMV 和 HHV-7 的存在。使用定量实时 PCR 方法,对 69 例异基因 HSCT(alloHSCT)受者在移植后早期进行了检查。在研究期间,62%的患者至少有一次 CMV DNA 血症,而 43%的患者检测到 HHV-7 DNA。在从 18 例患者(26%)采集的血浆样本中检测到这些β疱疹病毒的合并感染。与没有 HHV-7 感染的患者相比,合并 HHV-7 DNA 血症的患者 CMV DNA 拷贝数明显更高(1986 与 432 拷贝/ml,p<0.001),但两组 CMV DNA 血症的持续时间没有差异。另一方面,虽然 CMV DNA 血症患者与无 CMV DNA 血症患者的 HHV-7 DNA 载量相当,但前者 HHV-7 DNA 血症的持续时间明显更长(38.5 与 14 天,p<0.001)。HHV-7 DNA 血症在波兰 alloHSCT 受者中非常常见。在那些随后发生 CMV 再激活的患者中,病毒的共存可能会对它们中的任何一种感染的动力学产生负面影响。因此,同时检测 HHV-7 DNA 血症可能会影响发生 CMV 再激活的移植后患者的预后。

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