Osman H K, Peiris J S, Taylor C E, Warwicker P, Jarrett R F, Madeley C R
Department of Virology, Royal Victoria Infirmary, Newcastle upon Tyne, England.
J Med Virol. 1996 Apr;48(4):295-301. doi: 10.1002/(SICI)1096-9071(199604)48:4<295::AID-JMV1>3.0.CO;2-2.
Fifty-six renal allograft recipients were studied prospectively for 3 months or longer after transplant. The polymerase chain reaction (PCR) was used to screen peripheral blood leucocyte (PBL) specimens for CMV, human herpesvirus 6 (HHV6) and human herpesvirus 7 (HHV7) DNA (DNAemia) in 67 healthy controls and in serial (fortnightly) PBL specimens from the 56 allograft recipients. None of the healthy controls had detectable CMV DNAemia, although HHV6 and HHV7 DNAemia was found in 7% and 9% of individuals respectively. In contrast, DNAemia due to CMV, HHV6 and HHV7 was found in 50%, 36% and 39% of patients respectively, at some time during the post-transplant period. Of the 28 patients who had CMV DNAemia, eight developed "CMV disease". The risk of progression to "CMV disease" was increased in patients with concurrent DNAemia to all three viruses (relative risk 3.7; 95% CI 1.3-10.5). The relative risk of "CMV disease" for patients with concurrent CMV and HHV7 was also increased (RR = 3.5; 95% CI = 1.1-11.6), while the association between CMV and HHV6 was inconclusive (RR = v2.1; 95% CI = 0.7-6.6). The first 26 patients recruited to the study also had serial serum samples tested for antibody responses to the three viruses. "CMV disease" was associated with rising antibody titres to HHV7 (Fisher's exact test, P = 0.02), and weakly so with HHV6 (P = 0.07). It is concluded that in patients with CMV DNAemia, concurrent infection/reactivation HHV7 (and possibly HHV6) is associated with an increased risk of progression to "CMV disease".
对56例肾移植受者进行了前瞻性研究，观察移植后3个月或更长时间的情况。采用聚合酶链反应（PCR）检测67例健康对照者外周血白细胞（PBL）标本以及56例移植受者的系列（每两周一次）PBL标本中的巨细胞病毒（CMV）、人类疱疹病毒6型（HHV6）和人类疱疹病毒7型（HHV7）DNA（病毒血症）。所有健康对照者均未检测到CMV病毒血症，不过分别在7%和9%的个体中发现了HHV6和HHV7病毒血症。相比之下，在移植后的某个时间段，分别有50%、36%和39%的患者出现了由CMV、HHV6和HHV7引起的病毒血症。在28例出现CMV病毒血症的患者中，有8例发生了“CMV疾病”。同时感染这三种病毒的患者进展为“CMV疾病”的风险增加（相对风险3.7；95%可信区间1.3 - 10.5）。同时感染CMV和HHV7的患者发生“CMV疾病”的相对风险也增加（RR = 3.5；95%可信区间 = 1.1 - 11.6），而CMV与HHV6之间的关联尚无定论（RR = 2.1；95%可信区间 = 0.7 - 6.6）。纳入该研究的前26例患者还对三种病毒的抗体反应进行了系列血清样本检测。“CMV疾病”与HHV7抗体滴度升高相关（Fisher精确检验，P = 0.02），与HHV6的相关性较弱（P = 0.07）。研究得出结论，在出现CMV病毒血症的患者中，同时感染/再激活HHV7（可能还有HHV6）与进展为“CMV疾病”的风险增加有关。
