From the Faculty of Medicine, University of Belgrade, Serbia.
From the Department of Virology, Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Serbia.
Exp Clin Transplant. 2021 Nov;19(11):1156-1162. doi: 10.6002/ect.2021.0282.
The human cytomegalovirus is a notorious pathogen in the pediatric transplant setting. Although studies on factors in complicity with cytomegalovirus infection abound, the roles of age, sex, allogeneic hematopoietic stem cell transplant modality, and type of underlying disease (malignant vs nonmalignant) with regard to cytomegalovirus infection and viral load in children are seldom explored. Our aim was to examine the significance of these factors on cytomegalovirus infection and viral load in Serbian pediatric recipients of allogeneic hematopoietic stem cell transplant.
Thirty-two pediatric recipients of allogeneic hematopoietic stem cell transplant to treat various malignant and nonmalignant disorders were prospectively monitored for cytomegalovirus infection. The real-time quantitative polymerase chain reaction was used for pathogen detection and quantitation. Demographic and virologic parameters were statistically analyzed with SPSS statistics software (version 20).
Cytomegalovirus DNA was detected in 23 patients (71.9%). Infection occurred significantly more often (P = .015) in patients with haploidentical donors. The opposite was noted for matched sibling grafts (P = .006). Viral load was higher in female patients (P = .041) and children with malignant diseases (P = .019).There was no significant relationship between viral infection or load and medical complications.
Transplant recipients presented with a high incidence of cytomegalovirus viremia. The modality of allogeneic hematopoietic stem cell transplant was associated with the frequency of cytomegalovirus infection. Age, sex, type of underlying disease, and medically relevant events were not conducive to occurrences of viremia. Notably, we observed substantial viral loads in female patients and patients with neoplastic diseases. Studies comprising larger populations are needed to better understand these results.
人巨细胞病毒是儿科移植环境中臭名昭著的病原体。尽管关于细胞巨化病毒感染协同因素的研究很多，但年龄、性别、异基因造血干细胞移植方式以及基础疾病（恶性与非恶性）类型与儿童细胞巨化病毒感染和病毒载量的关系很少被探索。我们的目的是研究这些因素在塞尔维亚儿科异基因造血干细胞移植受者细胞巨化病毒感染和病毒载量中的意义。
32 名接受异基因造血干细胞移植以治疗各种恶性和非恶性疾病的儿科患者被前瞻性监测细胞巨化病毒感染。使用实时定量聚合酶链反应检测病原体并定量。使用 SPSS 统计软件（版本 20）对人口统计学和病毒学参数进行统计分析。
23 例患者（71.9%）检测到细胞巨化病毒 DNA。与匹配的同胞供体相比，单倍体供体的感染发生率显著更高（P =.015）。相反，对于匹配的同胞供体，感染发生率显著更低（P =.006）。女性患者的病毒载量更高（P =.041），恶性疾病患者的病毒载量更高（P =.019）。病毒感染或载量与医疗并发症之间无显著关系。
移植受者呈现高发生率的细胞巨化病毒血症。异基因造血干细胞移植方式与细胞巨化病毒感染的频率相关。年龄、性别、基础疾病类型和医学相关事件不利于病毒血症的发生。值得注意的是，我们观察到女性患者和患有肿瘤性疾病的患者存在大量病毒载量。需要更大的人群研究来更好地理解这些结果。
