Herpesvirus humano 5,6 e 7 (HHV-5, HHV-6 e HHV-7) em receptores de transplantes de medula ossea / Human herpesvirus (cytomegalovirus, HHV-6 and HHV-7) in bone marrow transplatation patients

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

The prototype member of the Betaherpesvirus subfamily, human cytomegalovirus (HCMV), is the most important infectious pathogen in transplant recipients, including those receiving bone marrow (BM) or stem cell (SC) grafts. Rapid diagnostic tests to identify active CMV infection, and pre-emptive therapy are significant improvements in the management of CMV. Two newly identified betaherpesviruses, human herpesvirus-6 (HHV-6) and human betaherpesvirus-7 (HHV-7), are genetically more closely related to each other than to CMV. Both are highly prevalent in the general population. These viruses are not as pathogenic as CMV but HHV-6 can cause disease such as encephalitis, hepatitis and bone marrow suppression. The aim of this study was to evaluate the clinical impact of these three viruses in bone marrow and stem cell transplantation patients. Monitorization with Nested-PCR is important in the control of active CMV infection or disease. Nested polymerase chain reaction (N-PCR) was used prospectively to monitor 43 patients for evidence of active infections and diseases caused by HCMV, HHV-6 and HHV-7 for up to 150 days after transplant. Forty-one adult recipients of BM or SC graft with malignant diseases and two patients with non-malignant diseases, and with a risk for CMV disease (D+/R+; D+/R-) were enrolled in this study. Aciclovir was used before the transplant at low doses, as prophylactic therapy for HHV-1. Patients with active CMV infections received pre-emptive therapy with ganciclovir. The incidence of positive active HCMV in blood, HHV-6 and HHV-7 in serum detected by Nested-PCR was 72%, 4.6% and 13.9%, respectively. HCMV disease occurred in 8/43 patients (18.6%), in the gastrointestinal tract and all presented positive N-PCR for active HCMV infection and one presented active infection by HHV-6 detected in serum. None of the patients presented active HHV-7 infection. Co-infection by HHV-6 and HHV-7 was low. CMV disease remains the most important disease after BMT. Future studies can be made to a better understanding in relationship between HCMV, HHV-6 and HHV-7 in BM or SC transplantation recipients

ASSUNTO(S)

infection cytomegalovirus infections bone marrow transplatation transplante de medula ossea human herpesvirus 6 infeções por citomegalovirus infecção humano herpesvirus 6 human herpesvirus 7 humano herpesvirus 7

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