Human Herpesvirus 6 Reactivation Evaluated by Digital Polymerase Chain Reaction and Its Association With Dynamics of CD134-Positive T Cells After Allogeneic Hematopoietic Stem Cell Transplantation
Human Herpesvirus 6 Reactivation Evaluated by Digital Polymerase Chain Reaction and Its Association With Dynamics of CD134-Positive T Cells After Allogeneic Hematopoietic Stem Cell Transplantation
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DOI：
10.1093/infdis/jiz237
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发表时间：
2019-09-15
影响因子：
6.4
通讯作者：
Mori, Takehiko
中科院分区：
文献类型：
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作者：
Nakayama, Hitomi;Yamazaki, Rie;Mori, Takehiko
背景。人类疱疹病毒6 （HHV-6）在异基因造血干细胞移植（alloo - hsct）后引起危及生命的中枢神经系统疾病。最近的研究表明CD134是HHV-6B的特异性受体，并证明其在同种异体造血干细胞移植后cd4阳性T细胞中的表达水平可能与HHV-6的再激活有关。我们前瞻性地评估了同种异体造血干细胞受体中HHV-6再激活与CD134(+) T细胞之间的关系。采用数字聚合酶链反应定量测定34例患者同种异体造血干细胞移植后每周血浆中HHV-6病毒载量。用流式细胞术连续测定移植前后CD4 + T细胞中CD134的比值（CD134/CD4比值）。在23例（68%）患者中检测到HHV-6再激活。HHV-6再激活患者调节前CD134/CD4比值显著高于未激活患者（中位数，3.8% vs 1.5%, P < 0.01）。在多因素分析中，调节前较高的CD134/CD4比值与HHV-6再激活发生率显著相关（优势比为10.5[95%可信区间，1.3-85.1],P = .03）。预处理前较高的CD134/CD4比值与较高的HHV-6再激活风险相关，提示该比值可能是预测同种异体造血干细胞移植后HHV-6再激活的一个有希望的指标。
Background. Human herpesvirus 6 (HHV-6) causes life-threatening central nervous system disorders after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Recent studies implicated CD134 as a specific receptor of HHV-6B and demonstrated that its expression levels in CD4-positive T cells after allo-HSCT could be related to the reactivation of HHV-6. We prospectively evaluated the relationship between HHV-6 reactivation and CD134(+) T cells in the recipients of allo-HSCT.Methods. HHV-6 viral load in plasma was quantitatively measured weekly after allo-HSCT by digital polymerase chain reaction in 34 patients. The ratio of CD134 in CD4(+) T cells (CD134/CD4 ratio) was serially measured by flow cytometry before and after transplantation.Results. HHV-6 reactivation was detected in 23 patients (68%). The CD134/CD4 ratio before conditioning was significantly higher in patients with HHV-6 reactivation than in those without (median, 3.8% vs 1.5%, P < .01). In multivariate analysis, a higher CD134/CD4 ratio before conditioning was significantly associated with the incidence of HHV-6 reactivation (odds ratio, 10.5 [95% confidence interval, 1.3-85.1], P = .03).Conclusions. A higher CD134/CD4 ratio before conditioning was associated with a higher risk of HHV-6 reactivation, suggesting that the rate may be a promising marker for predicting HHV-6 reactivation after allo-HSCT.