Laboratory of Molecular Virology, Oswaldo Cruz Institute / Fiocruz, Rio de Janeiro, Brazil.
Laboratory of Technological Development in Virology, Oswaldo Cruz Institute / Fiocruz, Rio de Janeiro, Brazil.
BMC Infect Dis. 2019 Sep 4;19(1):773. doi: 10.1186/s12879-019-4309-4.
The etiology of acute liver failure (ALF) is often unknown and reported to be associated with herpesviruses in a number of cases. In this study, we examined for betaherpesviruses infections in patients with ALF of unknown etiology using a multiplex qPCR to Betaherpesviruses subfamily.
Liver explant and serum samples from 27 patients with ALF of unknown etiology were analyzed with the aid of multiplex qPCR to identify betaherpesviruses. All positive samples were sequenced to confirm herpes infection and liver enzyme levels evaluated.
Betaherpesviruses infection was effectively detected using multiplex qPCR. Six (22%) HHV-6, one (3%) HCMV and two (7%) dual infections (one with HHV-7/HHV-6, and the other with HHV-7/ HCMV). Interestingly, HHV-7 was only detected in the presence of other betaherpesviruses. Sequencing information confirmed betaherpesviruses infection. High hepatic enzyme levels and INR values> 1.5 were determined in all betaherpesvirus-positive patients.
Multiplex qPCR facilitated efficient quantification, indicating that differentiation between betaherpesviruses is possible with the sole use of real-time PCR. Liver explant and serum samples were positive for some betaherpesviruses, and coinfection of HHV-7 with HHV-6 and HCMV was additionally detected. Based on these results, we propose that ALF patients should be screened for the presence of betaherpesviruses.
急性肝衰竭（ALF）的病因通常未知，并报告在许多情况下与疱疹病毒有关。在这项研究中，我们使用多重 qPCR 对亚科β疱疹病毒检测了原因不明的 ALF 患者中的β疱疹病毒感染。
利用多重 qPCR 分析了 27 例原因不明的 ALF 患者的肝组织和血清样本，以鉴定β疱疹病毒。所有阳性样本均进行测序以确认疱疹感染，并评估肝酶水平。
使用多重 qPCR 有效检测到β疱疹病毒感染。6 例（22%）HHV-6、1 例（3%）HCMV 和 2 例（7%）双重感染（1 例为 HHV-7/ HHV-6，另 1 例为 HHV-7/HCMV）。有趣的是，仅在存在其他β疱疹病毒的情况下才检测到 HHV-7。测序信息证实了β疱疹病毒感染。所有β疱疹病毒阳性患者的肝酶水平和 INR 值均较高（均>1.5）。
多重 qPCR 促进了高效定量，表明仅使用实时 PCR 就可以区分β疱疹病毒。肝组织和血清样本对某些β疱疹病毒呈阳性，并且还检测到 HHV-7 与 HHV-6 和 HCMV 的合并感染。基于这些结果，我们建议应筛查 ALF 患者是否存在β疱疹病毒。
