Monitoring of human cytomegalovirus infections and ganciclovir treatment in heart transplant recipients by determination of viremia, antigenemia, and DNAemia.
Monitoring of human cytomegalovirus infections and ganciclovir treatment in heart transplant recipients by determination of viremia, antigenemia, and DNAemia.
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通过测定病毒血症、抗原血症和 DNA 血症来监测心脏移植受者的人类巨细胞病毒感染和更昔洛韦治疗。
DOI：
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发表时间：
1991
影响因子：
6.4
通讯作者：
G. Milanesi
中科院分区：
文献类型：
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作者：
G. Gerna;D. Zipeto;M. Parea;M. Revello;E. Silini;E. Percivalle;M. Zavattoni;P. Grossi;G. Milanesi
根据外周血多形核白细胞（PMNL）中抗原血症、病毒血症和DNA血症（聚合酶链反应[PCR]）的测定，监测14例心脏移植受者的人巨细胞病毒（HCMV）感染。3例患者有症状的原发性，10例复发（3例无症状），1例（血清阴性）无HCMV感染。当病毒血症/抗原血症水平大于50个感染的PMNL/2 x 10（5）个检查细胞时，出现严重的临床症状。在检查的200份血液样本中，93份（46.5%）为病毒血症/抗原血症和DNA血症阳性，而48份（24.0%）仅为DNA血症阳性; 59份（29.5%）在所有检测中均为阴性。心脏移植受者HCMV感染的随访显示，PCR可以比抗原血症/病毒血症检测早7-10天检测到血液中的病毒出现。另一方面，通过PCR评估，病毒从血液中消失的时间比其他检测方法晚数周或数月。仅通过PCR检测病毒从未与明显的HCMV相关临床症状相关。在接受更昔洛韦治疗的8例有症状的患者中，2例在治疗结束时PCR阴性，1例在随后的几周内从血液中清除病毒，而5例显示持续或复发感染。
Fourteen heart transplant recipients were monitored for human cytomegalovirus (HCMV) infection based on determination of antigenemia, viremia, and DNAemia (by polymerase chain reaction [PCR]) in peripheral blood polymorphonuclear leukocytes (PMNL). Three patients had symptomatic primary, 10 had recurrent (3 asymptomatic), and 1 (seronegative) had no HCMV infection. Severe clinical symptoms appeared when levels of viremia/antigenemia were greater than 50 infected PMNL/2 x 10(5) cells examined. Of 200 blood samples examined, 93 (46.5%) were positive for viremia/antigenemia and DNAemia, whereas 48 (24.0%) were positive for DNAemia only; 59 (29.5%) were negative in all assays. Follow-up of HCMV infections in heart transplant recipients showed that PCR can detect viral appearance in blood 7-10 days earlier than assays for antigenemia/viremia. On the other hand, viral disappearance from blood, as assessed by PCR, occurred weeks or months later than revealed by other assays. Detection of virus by PCR only was never associated with overt HCMV-related clinical symptoms. Of the 8 symptomatic patients treated with ganiclovir, 2 became PCR-negative at the end of treatment and 1 cleared virus from blood in the following weeks, whereas 5 showed persistent or recurrent infection.