Analysis of lymphocyte subgroups in Crimean-Congo hemorrhagic fever.
OBJECTIVE
This study examined the association between lymphocyte subgroups and mortality in patients with Crimean-Congo hemorrhagic fever (CCHF) in Turkey.


METHODS
During the spring and summer of 2007, peripheral blood was collected from hospitalized patients with suspected CCHF. Lymphocyte subgroups were characterized by fluorescence-activated cell sorting. CCHF cases were confirmed by detecting viral RNA by PCR and/or IgM antibodies by ELISA. Lymphocyte subgroups were compared between fatal and non-fatal cases. The correlation between lymphocyte subgroups and viral loads was also investigated.


RESULTS
Seventy-seven confirmed cases of CCHF were included in this study (five cases were fatal (6.5 %)). No differences in lymphocyte subgroups were found between fatal and non-fatal cases, except for significantly higher CD3+CD8+ T cells in the fatal cases (p=0.017). A positive correlation between viral load and CD3+CD8+ T cells was also detected (p=0.044). There was no correlation between other lymphocyte subgroups and viral load.


CONCLUSIONS
Higher levels of CD3+CD8+ T lymphocytes were detected in fatal compared to non-fatal CCHF cases. Despite this cytotoxic immune activation, a fatal outcome could not be prevented. We hypothesize that high viral load and other factors may influence this outcome, although more studies are required to explain the pathogenesis of CCHF.
Akinci
Esragül
E
Clinic of Infectious Diseases and Clinical Microbiology, Ankara Numune Education and Research Hospital, Samanpazari, Ankara, Turkey. esragulakinci@yahoo.com
Yilmaz
Mesude
M
Bodur
Hürrem
H
Ongürü
Pinar
P
Bayazit
Fatma Nurhayat
FN
Erbay
Ayşe
A
Ozet
Gülsüm
G
D000293:Adolescent; D000328:Adult; D017252:CD3 Complex / Q000378:metabolism; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D003225:Hemorrhagic Fever Virus, Crimean-Congo / Q000276:immunology*; D006479:Hemorrhagic Fever, Crimean / Q000276:immunology* / Q000401:mortality* / Q000503:physiopathology / Q000821:virology; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D016131:Lymphocyte Subsets / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D014421:Turkey / Q000453:epidemiology; D019562:Viral Load; D055815:Young Adult
D017252:CD3 Complex; D007075:Immunoglobulin M; D012367:RNA, Viral