The prospective evaluation of viral loads in patients with severe fever with thrombocytopenia syndrome
The prospective evaluation of viral loads in patients with severe fever with thrombocytopenia syndrome
复制标题
DOI：
10.1016/j.jcv.2016.03.017
复制
发表时间：
2016-05-01
影响因子：
8.8
通讯作者：
Cao, Wu-Chun
中科院分区：
文献类型：
--
作者：
Yang, Zhen-Dong;Hu, Jian-Gong;Cao, Wu-Chun
背景：由新型布尼亚病毒（SFTSV）引起的严重发热伴血小板减少综合征（SFTS）是在中国首次发现的一种潜在致命疾病。通过血液或体液接触进行人际传播被认为是重要的感染途径。目的：本研究旨在调查SFTSV感染后的纵向病毒载量，并确定影响SFTS患者病毒排毒的因素。方法：对河南省信阳市208例实验室确诊的SFTSV感染患者进行前瞻性观察性研究。入院时和住院期间连续采集血清样本，通过实时 RT-PCR 定量 SFTSV RNA。结果：55.6% 的患者入院时病毒 RNA 检测不到，大多数病例直到三天后才可检测到，并在发病后六天达到最高水平。此后明显下降，但在 20 多天内保持可检测到。在整个住院期间，病毒载量可以独立预测严重疾病的结果。病毒载量>10(7)拷贝/mL可预测致命结果。血清PLT、WBC、LDH、AST和CK水平与病毒载量水平显着相关。结论：基于PCR检测的SFTSV感染诊断应在发病后至少3天进行。病毒载量在发病后六天左右达到峰值，人际传播的风险最高。 (C) 2016 Elsevier B.V. 保留所有权利。
Background: Severe fever with thrombocytopenia syndrome (SFTS), caused by novel bunyavirus (SFTSV) is a potentially fatal disease that was first identified in China. Person to person transmission through contact with blood or body fluids was considered as an important infection route.Objectives: The study is designed to investigate the longitudinal viral loads following SFTSV infection and to identify factors affecting viral shedding in SFTS patients.Methods: A prospective, observational study was performed on 208 laboratory-confirmed SFTSV infected patients in Xinyang, Henan Province. Sequential serum samples were collected on admission and during the hospitalization for quantification of SFTSV RNA by real-time RT-PCR.Results: The viral RNA was undetectable in 55.6% of the patients on admission into the hospital, becoming detectable in most cases until three days and attained maximum level on six days after disease onset. This was followed by an obvious decrease thereafter, but maintained detectable for over 20 days. Viral load was independently predictable of severe disease outcome throughout the hospitalization. Viral load of >10(7) copies/mL was predictable of fatal outcome. The serum levels of PLT, WBC, LDH, AST and CK were significantly associated with viral loads level.Conclusions: The diagnosis of SFTSV infection based on PCR test should be performed at least three days after disease onset. Peaking viral loads were attained around six days after disease, posing a highest risk of human-to-human transmission. (C) 2016 Elsevier B.V. All rights reserved.