Viral load and humoral immune response in association with disease severity in Puumala hantavirus-infected patients--implications for treatment.
Viral load and humoral immune response in association with disease severity in Puumala hantavirus-infected patients--implications for treatment.
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DOI：
10.1111/1469-0691.12259
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发表时间：
2014-03
期刊：
影响因子：
--
通讯作者：
Ahlm C
中科院分区：
文献类型：
--
作者：
Pettersson L;Thunberg T;Rocklöv J;Klingström J;Evander M;Ahlm C
汉坦病毒是欧亚大陆肾综合征出血热（HFRS）和美洲汉坦病毒心肺综合征（HCPS）的病原体。不同汉坦病毒的病死率不同，可高达40%。目前尚无特效治疗方法。汉坦病毒的发病机制还不清楚，但最有可能的是，病毒介导和宿主介导的机制都参与其中。本研究的目的是探讨肾综合征出血热（HFRS）患者的普马拉汉坦病毒（PUUV）RNA载量、体液免疫应答和疾病严重程度之间的关系。我们对105例PUUV感染患者进行了研究，这些患者在疾病的急性期和1-3个月后进行了随访。105例患者中有15例（14%）被归类为中度/重度疾病。低PUUV特异性IgG应答（p <0.05）和高白色血细胞计数（p <0.001）与更严重的疾病显著相关。在疾病发作后9天内，在大多数患者血浆样本中检测到PUUV RNA;然而，PUUV RNA载量或病毒血症的寿命与疾病严重程度无关。我们的结论是，低特异性IgG反应与HFRS患者的疾病严重程度相关，而PUUV RNA载量似乎并不影响HFRS的严重程度。我们的研究结果提高了被动免疫疗法作为汉坦病毒感染患者有效治疗的可能性。
Hantaviruses are the causative agents of haemorrhagic fever with renal syndrome (HFRS) in Eurasia and of hantavirus cardiopulmonary syndrome (HCPS) in the Americas. The case fatality rate varies between different hantaviruses and can be up to 40%. At present, there is no specific treatment available. The hantavirus pathogenesis is not well understood, but most likely, both virus-mediated and host-mediated mechanisms are involved. The aim of the present study was to investigate the association among Puumala hantavirus (PUUV) viral RNA load, humoral immune response and disease severity in patients with HFRS. We performed a study of 105 PUUV-infected patients that were followed during the acute phase of disease and for up to 1–3 months later. Fifteen of the 105 patients (14%) were classified as having moderate/severe disease. A low PUUV-specific IgG response (p <0.05) and also a higher white blood cell count (p <0.001) were significantly associated with more severe disease. The PUUV RNA was detected in a majority of patient plasma samples up to 9 days after disease onset; however, PUUV RNA load or longevity of viraemia were not significantly associated with disease severity. We conclude that a low specific IgG response was associated with disease severity in patients with HFRS, whereas PUUV RNA load did not seem to affect the severity of HFRS. Our results raise the possibility of passive immunotherapy as a useful treatment for hantavirus-infected patients.
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