Ahmadi Ghezeldasht Sanaz, Hassannia Tahereh, Rafatpanah Houshang, Hekmat Reza, Valizadeh Narges, Ghayour Mobarhan Majid, Rezaee Seyed Abdolrahim
Research Center for HIV/AIDS, HTLV and Viral Hepatitis, Iranian Academic Center for Education, Culture and Research (ACECR), Mashhad Branch, Mashhad, IR Iran.
Internal Medicine Department, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
Jundishapur J Microbiol. 2015 Mar 21;8(3):e14920. doi: 10.5812/jjm.14920. eCollection 2015 Mar.
Globally, almost 20% of cancers are related to infectious agents that can be prevented. Oncogenicity refers to viruses that may cause cancers, more importantly in immunocompromised subjects such as transplant and hemodialysis patients. Therefore, epidemiological studies are the first line for understanding the importance of these agents in public health, particularly, in mobile populations, tourism and pilgrimage regions.
Oncogenic viral infections, such as hepatitis B virus (HBV), hepatitis C virus (HCV) and Epstein-barr virus (EBV) are the most common viral agents in immunocompromised patients. Furthermore, human T lymphocyte virus type I (HTLV-I), due to endemicity in Khorasan Razavi province located northeast of Iran as a pilgrimage region, and Kaposi's sarcoma associated herpes virus (KSHV), as an oncogenic herpesvirus in immunocompromised subjects have been investigated among the general population and those with end-stage renal diseases (ESRD).
A cross-sectional study was carried out among 1227 randomly selected individuals; 25 donors and 195 patients with ESRD, including 60 kidney transplant recipients and 135 dialysis patients from the Khorasan Razavi province, Iran. Serological tests were carried out using commercial enzyme-immunoassay kits. To confirm positive serology tests, the extracted viral DNA or RNA was examined for the presence of KSHV, HTLV-I and HCV by conventional PCR.
The prevalence of KSHV infection in the general population was 1.71% (21/1227); 2.60% (10/384) males and 1.30% (11/843) females. In kidney transplants, viral infections occurred in 23.3% of subjects; including EBV, HTLV-I and HBV-HCV co-infection in 8.3%, 3.3% and 1.7%, respectively. In patients on hemodialysis, viral infections were present in 29.6% including EBV, HTLV-I and HBV-HCV co-infection in 2.2%, 5.9% and 16.3%, respectively. Seroprevalence of KSHV in patients with kidney transplants was 1.7% and in patients on dialysis was 3.0%. Furthermore, KSHV and HTLV-I genome was detected in 25% and 100% of seropositive subjects, respectively.
In conclusion, this study demonstrated that these tumor virus infections including HTLV-I, KSHV and particularly hepatitis viruses (HBV plus HCV) are prevalent in the general population and in patients on hemodialysis, which might be an important health concern in this region due to the mobile population.
在全球范围内，近20%的癌症与可预防的感染因子有关。致癌性是指可能引发癌症的病毒，在免疫功能低下的人群（如移植和血液透析患者）中更为重要。因此，流行病学研究是了解这些病原体在公共卫生领域重要性的首要途径，特别是在流动人口、旅游和朝圣地区。
致癌性病毒感染，如乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）和爱泼斯坦-巴尔病毒（EBV）是免疫功能低下患者中最常见的病毒病原体。此外，由于伊朗东北部作为朝圣地区的呼罗珊拉扎维省存在人类嗜T淋巴细胞病毒I型（HTLV-I）地方性流行，以及卡波西肉瘤相关疱疹病毒（KSHV）作为免疫功能低下人群中的致癌疱疹病毒，已在普通人群和终末期肾病（ESRD）患者中进行了调查。
对1227名随机选择的个体进行了横断面研究；其中25名捐赠者和195名ESRD患者，包括来自伊朗呼罗珊拉扎维省的60名肾移植受者和135名透析患者。使用商业酶免疫分析试剂盒进行血清学检测。为确认血清学检测阳性结果，通过常规PCR检测提取的病毒DNA或RNA中是否存在KSHV、HTLV-I和HCV。
普通人群中KSHV感染率为1.71%（21/1227）；男性为2.60%（10/384），女性为1.30%（11/843）。在肾移植患者中，23.3%的受试者发生病毒感染；其中EBV、HTLV-I和HBV-HCV合并感染分别为8.3%、3.3%和1.7%。在血液透析患者中，病毒感染率为29.6%，其中EBV、HTLV-I和HBV-HCV合并感染分别为2.2%、5.9%和16.3%。肾移植患者中KSHV血清阳性率为1.7%，透析患者中为3.0%。此外，在血清阳性受试者中分别检测到25%的KSHV和100%的HTLV-I基因组。
总之，本研究表明，包括HTLV-I、KSHV，特别是肝炎病毒（HBV加HCV）在内的这些肿瘤病毒感染在普通人群和血液透析患者中普遍存在，由于该地区的流动人口，这可能是一个重要的健康问题。
