HHV-6 encephalitis may complicate the early phase after allogeneic hematopoietic stem cell transplantation: Detection by qualitative multiplex PCR and subsequent quantitative real-time PCR
HHV-6 encephalitis may complicate the early phase after allogeneic hematopoietic stem cell transplantation: Detection by qualitative multiplex PCR and subsequent quantitative real-time PCR
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DOI：
10.1002/jmv.24340
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发表时间：
2016-02-01
影响因子：
12.7
通讯作者：
Tsutsumi, Hiroyuki
中科院分区：
文献类型：
--
作者：
Inazawa, Natsuko;Hori, Tsukasa;Tsutsumi, Hiroyuki
造血干细胞移植（HSCT）后病毒再激活可引起多种并发症，尤其是病毒性脑炎.在这项前瞻性研究中，我们研究了HSCT后血液中病毒再活化与CNS功能障碍的相关性。我们采用多重PCR检测13种病毒作为一线筛选试验和实时PCR进行后续定量评价。从HSCT前至HSCT后42天收集了105例患者的591份全血样本。7例患者出现CNS功能障碍，如意识改变。在七个中的六个中，多重PCR测试在至少一个样本中检测到HHV-6 DNA。相反，在整个研究期间，在7名患者中从未检测到来自其他病毒的DNA，如CMV、EBV、HHV-7、腺病毒和HBV。全血HHV-6 DNA水平的定量测量表明，在CNS功能障碍期间，6个HHV-6 DNA载量中的4个在连续时间点升高。此外，病毒DNA峰与CNS功能障碍的发展存在时间相关性。在四名患者中的两名中进行了CSF检测，并在两名患者中证实了与全血中的HHV-6 DNA水平相当的高水平。因此，这四名患者疑似患有HHV-6脑炎，在研究人群中的发病率为3.8%。我们的研究结果表明，早期诊断可能的HHV-6脑炎，可以提高确认高HHV-6 DNA载量的血液。(c)2015 Wiley Periodicals，Inc.
Viral reactivation following hematopoietic stem cell transplantation (HSCT) can cause various complications especially viral encephalitis. In this prospective study, we investigated the correlation of post-HSCT viral reactivation in blood with CNS dysfunction. We employed a multiplex PCR that detects 13 kinds of viruses as a first-line screening test and real-time PCR for subsequent quantitative evaluation. Five hundred ninety-one whole blood samples were collected from 105 patients from before until 42 days after HSCT. Seven patients developed CNS dysfunction such as altered consciousness. In six of the seven, the multiplex PCR test detected HHV-6 DNA in at least one sample. In contrast, DNA from other viruses, such as CMV, EBV, HHV-7, adenovirus, and HBV was never detected in any of the seven patients throughout the study period. Quantitative measurement of whole blood HHV-6 DNA levels demonstrated four of the six HHV-6 DNA loads were elevated at successive time points during the CNS dysfunction. In addition, the virus DNA peaks were temporally associated with the development of CNS dysfunction. CSF was tested in two of the four patients and high HHV-6 DNA levels comparable to those in whole blood were confirmed in both. These four patients were, thus, suspected to have developed HHV-6 encephalitis, a rate of 3.8% in the study population. Our results suggest that early diagnosis of probable HHV-6 encephalitis can be improved by confirming high HHV-6 DNA load in blood. (c) 2015 Wiley Periodicals, Inc.