Clinical characteristics, outcome and the role of viral load in nontransplant patients with Epstein-Barr viraemia.
Epstein-Barr virus (EBV) is important in the development of post-transplant lymphoproliferative disease in allogeneic stem cell and solid organ transplant recipients. We have studied the clinical significance of EBV DNAaemia among nontransplant patients in a tertiary referral hospital. We retrospectively reviewed the medical records for main diagnosis, outcome, immunosuppressive/cytotoxic chemotherapy and other opportunistic infections of the patients who were found positive in quantitative real-time PCR assay for EBV (EBV-qPCR) between the years 2000 and 2007. Allogeneic stem cell and solid organ transplant recipients were excluded, and all patients in nonsurgical adult wards were included. Altogether, 62 patients had at least one plasma sample positive with an EBV-qPCR. Fifteen were immunocompetent, most had primary EBV infection, and the outcome was good. On the other hand, 36 had malignant disease, seven had HIV infection and seven had immunosuppressive conditions of an other aetiology. All but one of the malignancies were of lymphoid origin, and most of these patients had a history of multiple cytotoxic treatments. Immunosuppressed patients had higher viral loads. EBV viraemia is associated with severe immunosuppression and lymphoid malignancies.
Martelius
T
T
Department of Medicine, Divisions of Infectious Diseases, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland. timi.martelius@helsinki.fi
Lappalainen
M
M
Aalto
S M
SM
Nihtinen
A
A
Hedman
K
K
Anttila
V-J
VJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002051:Burkitt Lymphoma / Q000821:virology; D004279:DNA, Viral / Q000097:blood; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000473:pathology* / Q000821:virology*; D005260:Female; D015658:HIV Infections / Q000150:complications; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D019562:Viral Load; D014766:Viremia; D014773:Virology / Q000379:methods
D004279:DNA, Viral; D007166:Immunosuppressive Agents