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对接受异基因造血干细胞移植的波兰患者体内三种β疱疹病毒DNA脱落情况的分析:六年随访

Analysis of the shedding of three β-herpesviruses DNA in Polish patients subjected to allogeneic hematopoietic stem cell transplantation: Six-year follow up.

作者信息

Dzieciatkowski Tomasz, Tomaszewska Agnieszka, Przybylski Maciej, Rusicka Patrycja, Basak Grzegorz W, Jedrzejczak Wieslaw W, Wroblewska Marta, Halaburda Kazimierz

机构信息

Department of Microbiology, Central Clinical Hospital in Warsaw, 1A Banacha Str., 02-097 Warsaw, Poland; Chair and Department of Medical Microbiology, Medical University of Warsaw, 5 Chalubinskiego Str., 02-004 Warsaw, Poland.

Department of Haematopoietic Stem Cell Transplantation, Institute of Haematology and Transfusion Medicine, 14 Gandhi Str., 02-776 Warsaw, Poland.

出版信息

J Clin Virol. 2016 Mar;76:30-5. doi: 10.1016/j.jcv.2016.01.005. Epub 2016 Jan 12.

Abstract

BACKGROUND

Infections with human β-herpesviruses are common worldwide and are still frequent in patients after hematopoietic stem cell transplantation. Some data suggest that HHV-6 and HHV-7 could take part in CMV reactivation from latency and/or progression of CMV disease in immunosupressed patients.

OBJECTIVES

The aims of this study were: (1) to summarise retrospectively the results of β-herpesviruses DNA detection in a large group of adult allogeneic haematopoietic stem cell transplant recipients; and (2) to find a potential correlation between viruses belonging to this subfamily.

STUDY DESIGN

AlloHSCT recipients (N=142) were examined in the early post-transplant period (median=89 days). The presence of CMV, HHV-6 and HHV-7 was confirmed through detection and quantification of viral DNA, isolated from 1679 sera samples.

RESULTS

CMV DNA alone was detected in 23.9% of patients, while single HHV-6 and HHV-7 were detected in 14.8% and 9.9% of individuals, respectively. The reactivation of more than one virus was identified in 31% of analysed patients. In cases of concurrent infection, HHV-7 was detected at the same time as HHV-6, and both of them were usually reactivated before CMV. The kinetics of virus reactivation and measured viral load may suggest a potential role of HHV-6 and HHV-7 as co-factors in CMV reactivation.

CONCLUSIONS

The observed kinetics of virus reactivation may strongly suggest a potential role of HHV-6 and/or HHV-7 as co-factors of CMV reactivation. The co-infection with these β-herpesviruses could predispose patients after hematopoietic stem cell transplantation to a longer and more severe CMV infection.

摘要

背景

人类β疱疹病毒感染在全球范围内普遍存在,在造血干细胞移植后的患者中仍很常见。一些数据表明,HHV-6和HHV-7可能参与免疫抑制患者中巨细胞病毒(CMV)从潜伏状态的重新激活和/或CMV疾病的进展。

目的

本研究的目的是:(1)回顾性总结一大群成年异基因造血干细胞移植受者中β疱疹病毒DNA检测的结果;(2)找出该亚科病毒之间的潜在相关性。

研究设计

对142名异基因造血干细胞移植受者在移植后早期(中位数=89天)进行检查。通过从1679份血清样本中分离并检测和定量病毒DNA,确认CMV、HHV-6和HHV-7的存在。

结果

仅在23.9%的患者中检测到CMV DNA,而分别在14.8%和9.9%的个体中检测到单一的HHV-6和HHV-7。在31%的分析患者中发现了不止一种病毒的重新激活。在合并感染的情况下,HHV-7与HHV-6同时被检测到,并且它们两者通常在CMV之前重新激活。病毒重新激活的动力学和测量的病毒载量可能表明HHV-6和HHV-7作为CMV重新激活的辅助因子的潜在作用。

结论

观察到的病毒重新激活动力学可能强烈表明HHV-6和/或HHV-7作为CMV重新激活辅助因子的潜在作用。这些β疱疹病毒的合并感染可能使造血干细胞移植后的患者易患更长时间和更严重的CMV感染。

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