Przybylski Maciej, Majewska Anna, Dzieciatkowski Tomasz, Rusicka Patrycja, Basak Grzegorz W, Nasilowska-Adamska Barbara, Bilinski Jaroslaw, Jedrzejczak Wieslaw W, Wroblewska Marta, Halaburda Kazimierz, Mlynarczyk Grazyna, Tomaszewska Agnieszka
Department of Microbiology, Independent Public 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.
Chair and Department of Medical Microbiology, Medical University of Warsaw, 5 Chalubinskiego Str., 02-004 Warsaw, Poland.
J Clin Virol. 2017 Feb;87:67-72. doi: 10.1016/j.jcv.2016.12.008. Epub 2016 Dec 21.
Infections caused by human α-herpesviruses usually have a benign course with recurrencies. However, they may become dangerous in immunocompromised hosts. In this case, molecular methods constitute a reliable diagnostic tool enabling rapid assessment of the efficacy of antiviral treatment strategies.
We estimated the frequency of alphaherpesviral DNAemia and the viral load during early post-transplantation period after alloHSCT; we also analyzed association of the DNAemia and chosen parameters of the patients.
A cohort of 190 alloHSCT recipients from two hospitals in Warsaw, Poland, was examined weekly during 100-day early post-transplantation period using quantitative real time PCR assays. A total of 2475 sera samples were evaluated for the presence of α-herpesviral DNA in patients, of whom 117 (62%) received unrelated grafts, while the remaining 73 (38%) received grafts from sibling donors. All patients received standard antiviral prophylaxis with acyclovir. In the examined group, anti-HSV-1, anti-HSV-2 and anti-VZV IgGs were examined prior to transplantation, RESULTS: Within the study period, DNA of α-herpesviruses was detected in 44 patients (23.2%). Most patients tested positive for HSV-1 DNA (43 patients, 22.6%), single patient for HSV-2, and no patient positive for VZV. Clinical symptoms such as pneumonia, skin changes, elevated levels of aminotransferases were observed in five patients, four of these patients presented symptoms of GvHD at the same time. (2,6%). Statistics shows that GvHD (P<0.001) and matched unrelated donor as a source of HSCT (P=0.048) are associated with the development of HSV-1 DNAemia.
Although our data demonstrate frequent reactivation of HSV-1 in the early post-transplant period, the rate of symptomatic infections was low. We did not find association between HSV-1 viremia and mortality, but significant association with GvHD and donor source was observed.
人类α-疱疹病毒引起的感染通常病程良性且会复发。然而，在免疫功能低下的宿主中，它们可能变得危险。在这种情况下，分子方法是一种可靠的诊断工具，能够快速评估抗病毒治疗策略的疗效。
我们估计了异基因造血干细胞移植（alloHSCT）后移植早期α-疱疹病毒血症的频率和病毒载量；我们还分析了病毒血症与患者选定参数之间的关联。
对来自波兰华沙两家医院的190名alloHSCT受者队列在移植后100天的早期每周进行检查，采用定量实时PCR检测。共评估了2475份患者血清样本中α-疱疹病毒DNA的存在情况，其中117名（62%）接受了无关供体的移植物，其余73名（38%）接受了同胞供体的移植物。所有患者均接受阿昔洛韦标准抗病毒预防。在研究组中，移植前检测了抗HSV-1、抗HSV-2和抗VZV IgG。
在研究期间，44名患者（23.2%）检测到α-疱疹病毒DNA。大多数患者HSV-1 DNA检测呈阳性（43名患者，22.6%），1名患者HSV-2呈阳性，无患者VZV呈阳性。5名患者出现了如肺炎、皮肤改变、转氨酶水平升高等临床症状，其中4名患者同时出现移植物抗宿主病（GvHD）症状（2.6%）。统计显示，GvHD（P<0.001）和作为HSCT来源的匹配无关供体（P=0.048）与HSV-1病毒血症的发生有关。
尽管我们的数据表明移植后早期HSV-1频繁重新激活，但有症状感染的发生率较低。我们未发现HSV-1病毒血症与死亡率之间的关联，但观察到与GvHD和供体来源有显著关联。
