Monitoring of cytomegalovirus, Epstein-Barr virus and adenovirus infections in hematopoietic stem cell transplant recipients

Authors : Buket ŞEFLEK, Hale GÜMÜŞ, Mehmet ÇİMENTEPE, Serhan KÜPELİ, Fügen YARKIN

Pages : 432-440

Doi:10.17826/cumj.1239938

View : 63 | Download : 218

Publication Date : 2023-07-02

Article Type : Research Paper

Abstract :Purpose: Haematopoietic stem cell transplant insert ignore into journalissuearticles values(HSCT); recipients with iatrogenic immunosuppression are high-risk patients for viral infections. The aim of this study was to investigate the incidence of cytomegalovirus insert ignore into journalissuearticles values(CMV);, Epstein-Barr virus insert ignore into journalissuearticles values(EBV);, and adenovirus insert ignore into journalissuearticles values(ADV); infections in HSCT recipients. Materials and Methods: We prospectively monitored 35 patients aged 0-17 years who had allogeneic insert ignore into journalissuearticles values(n=30); and autologous insert ignore into journalissuearticles values(n=5); HSCT by quantitative real-time polymerase chain reaction tests for CMV, EBV, and ADV. The monitoring was performed one week before HSCT and weekly for the first 100 days, once a month up to one year after HSCT. In addition, seropositivity for viruses was analysed by Enzyme-Linked Immuno Sorbent Assay a week before transplantation. Results: Before transplantation, all 35 insert ignore into journalissuearticles values(100%); patients who underwent HSCT were CMV IgG positive, 30 insert ignore into journalissuearticles values(85.7% - 95% CI: 74.1%-97.3%); HSCT recipients were found to be EBV IgG positive. CMV infection was found in 24 insert ignore into journalissuearticles values(80% - 95% CI: 65.7%-94.3%);, ADV infection in 11 insert ignore into journalissuearticles values(36.7% - 95% CI: 19.4%-53.9%); and EBV infection in 8 insert ignore into journalissuearticles values(26.7% - 95% CI: 10.8%-42.5%); allogeneic HSCT patients. In this group, CMV DNA viral load in 8 insert ignore into journalissuearticles values(26.7%); patients, of which one insert ignore into journalissuearticles values(3.3%); coinfected with EBV DNA and one insert ignore into journalissuearticles values(3.3%); with ADV DNA, was higher than 1000 copies/mL which was required for pre-emptive treatment. Among 5 autologous HSCT recipients, CMV DNA was detected in 2 patients, EBV DNA in 5 and ADV DNA in 2. Pre-emptive treatment was given to 11 insert ignore into journalissuearticles values(%31.4 - 95% CI: 16%-46.8%; 6 CMV, 2 EBV, 1 ADV, 1 CMV-EBV and 1 CMV-ADV infection); of 35 patients. Thus, the development of viral disease was prevented in 7 insert ignore into journalissuearticles values(63.6% - 95% CI: 35.2%-92.1%);. Of the total 35 patients, only 2 insert ignore into journalissuearticles values(5.7% - 95% CI: 0.0%-13.4%); died due to viral infection. Conclusion: Early diagnosis of viral infections by prospective monitoring of viral loads in HSCT patients would be effective in preventing morbidity and mortality by ensuring timely initiation of pre-emptive therapy.
Keywords : CMV, EBV, ADV, hematopoetik kök hücre transplantasyonu