Yadav S, Chattopadhya D, Prakash C, Kumari S, Vergheese T
Department of Paediatrics, Kalawati Saran Children's Hospital, Delhi, India.
J Trop Pediatr. 1993 Aug;39(4):243-50. doi: 10.1093/tropej/39.4.243.
A total of 74 multitransfused (MT) children of beta thalassaemia major were analysed for prevalent viral markers transmitted through transfusion. A higher incidence of serological markers for Hepatitis B virus (HBV), cytomegalovirus (CMV) could be observed in the group of MT children compared to control group. There was a significant trend (chi 2 = 33.4; P < 0.001) in the increase in prevalence of viral markers along with the increase in the number of transfusions. MT children receiving more than 50 transfusions were found to have evidence for at least one or multiple viral infections transmitted through blood. Children receiving more than 50 transfusions were characterized by marked alteration of T3, T8, and B cells while T4/T8 ratio was found to be significantly decreased (P < 0.001) only in the group of children receiving more than 100 transfusions. Relative assessment of the alteration of lymphocyte subsets in various groups of viral infection showed that cases with CMV IgM to have more marked influence on the alteration of T8 cells, T4/T8 ratio, and B cells compared to other groups of viral infections. Reassessment of the lymphocyte subset profile in MT children in the light of CMV IgM positive cases revealed that in children receiving more than 50 transfusions significant alterations of lymphocyte subjects were influenced by the presence of CMV IgM positive cases in these groups. Our study points out that the correlation between the alteration of lymphocyte subset profile and number of transfusion in MT children need to be reassessed in the light of acute CMV infection in the form of CMV IgM.
对74例重型β地中海贫血多次输血(MT)患儿进行分析,以检测通过输血传播的常见病毒标志物。与对照组相比,MT患儿组中乙型肝炎病毒(HBV)、巨细胞病毒(CMV)血清学标志物的发生率更高。随着输血次数的增加,病毒标志物的流行率呈显著上升趋势(χ2 = 33.4;P < 0.001)。发现接受超过50次输血的MT患儿有证据表明存在至少一种或多种通过血液传播的病毒感染。接受超过50次输血的患儿的特征是T3、T8和B细胞有明显改变,而仅在接受超过100次输血的患儿组中发现T4/T8比值显著降低(P < 0.001)。对不同病毒感染组淋巴细胞亚群改变的相对评估表明,与其他病毒感染组相比,CMV IgM阳性病例对T8细胞、T4/T8比值和B细胞的改变影响更大。根据CMV IgM阳性病例重新评估MT患儿的淋巴细胞亚群谱,发现在接受超过50次输血的患儿中,淋巴细胞亚群的显著改变受这些组中CMV IgM阳性病例的影响。我们的研究指出,需要根据CMV IgM形式的急性CMV感染重新评估MT患儿淋巴细胞亚群谱改变与输血次数之间的相关性。