Relationship between beta-herpesviruses reactivation and development of complications after autologous peripheral blood stem cell transplantation.
The relationship between beta-herpesviruses reactivation and the development of complications after autologous peripheral blood stem cell transplantation was investigated. Viral genomic sequences were detected by the polymerase chain reaction, virus-specific antibodies by ELISA, and human herpesvirus (HHV)-6 variants by restriction endonuclease analysis. Virus reactivation, serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, soluble IL-2 receptor (sIL-2R), IL-2, and IL-4 were compared with clinical features in 44 patients before and after transplantation. Anti-CMV and anti-HHV-6 antibodies were found in 70.5% and 81.8% of patients, respectively. The frequency of plasma viremia was significantly higher in patients after transplantation (41% vs. 11.4%). Reactivation of more than one virus was identified in 55.6% of patients and reactivation of HHV-7 alone in 44.4%. In cases of concurrent infection, HHV-7 was reactivated before HHV-6, and both HHV-6 and HHV-7 were reactivated before CMV. There was a significant increase in HHV-6 load in peripheral blood leukocytes DNA during viremia. In all cases HHV-6B variant was detected. Complications after transplantation occurred in 27.3% of patients and virus reactivation was detected in all patients with complications. The significant increases in the rate of HHV-6 and HHV-7 reactivation and in serum levels of TNF-α, IL-1β, and sIL-2R, as well as aggravated immunosuppression, suggest that both viruses were involved in the complications after autologous peripheral blood stem cell transplantation, via their immunomodulatory activity. The kinetics of reactivation suggests a potential role of HHV-7 as a co-factor of HHV-6 reactivation, and of both HHV-6 and HHV-7 as co-factors of CMV reactivation.
August Kirchenstein Institute of Microbiology and Virology, Riga Stradins University, Riga, Latvia. scapenko@latnet.lv
Svetlana
S
Chapenko
Ilze
I
Trociukas
Simona
S
Donina
Maksim
M
Chistyakov
Alina
A
Sultanova
Sabine
S
Gravelsina
Sandra
S
Lejniece
Modra
M
Murovska
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D003587:Cytomegalovirus / Q000302:isolation & purification / Q000472:pathogenicity*; D003586:Cytomegalovirus Infections / Q000276:immunology / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006566:Herpesviridae Infections / Q000276:immunology / Q000821:virology; D015654:Herpesvirus 6, Human / Q000472:pathogenicity* / Q000502:physiology; D016199:Herpesvirus 7, Human / Q000472:pathogenicity* / Q000502:physiology; D006801:Humans; D053583:Interleukin-1beta / Q000097:blood; D007376:Interleukin-2 / Q000097:blood; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications / Q000276:immunology / Q000821:virology*; D060888:Real-Time Polymerase Chain Reaction; D015375:Receptors, Interleukin-2 / Q000097:blood; D012189:Retrospective Studies; D014182:Transplantation, Autologous / Q000009:adverse effects; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D019562:Viral Load; D014766:Viremia / Q000473:pathology / Q000821:virology; D014775:Virus Activation; D055815:Young Adult
D000914:Antibodies, Viral; D004279:DNA, Viral; C508594:IL2 protein, human; D053583:Interleukin-1beta; D007376:Interleukin-2; D015375:Receptors, Interleukin-2; D014409:Tumor Necrosis Factor-alpha