异基因造血干细胞移植后人类疱疹病毒6型感染及其与巨细胞病毒感染的相关性  

Prevalence of Human Herpesvirus-6 in Allogeneic Hematopoietic Stem Cell Transplant Recipients in Correlation with Cytomegalovirus Infection

作　　者：王立茹[1] 董陆佳[1] 陆道培[1] 

机构地区：[1]北京大学血液病研究所,北京大学人民医院,北京100044

出　　处：《中国实验血液学杂志》2006年第6期1204-1209,共6页Journal of Experimental Hematology

基　　金：北京市科技项目基金资助;编号9550213100

摘　　要：为了解人类疱疹病毒6型(humanherpesvirus6,HHV-6)在中国接受异基因造血干细胞移植(hematopoiet-icstemcelltransplantation,HSCT)的人群中感染现状及其与巨细胞病毒(cytomegalovirus,CMV)感染的相关性,对72例接受HSCT的患者HHV-6DNA血症进行连续监测。收集HSCT患者移植前和移植后1-12周EDTA抗凝的外周血标本共680份,采用巢式聚合酶链反应检测外周血单个核细胞中HHV-6DNA,并利用HindⅢ限制性内切酶对HHV-6进行基因分型,同时采用免疫荧光法检测CMV抗原血症。结果显示,HSCT后62.5%(45/72)的患者至少1次出现HHV-6DNA血症,首次检出的中位时间为14(7-63)天;除1例患者检出HHV-6A型以外,其余所有HHV-6阳性患者均为HHV-6B型感染。65.3%(47/72)的移植后患者至少1次发生CMV抗原血症,首次检出的中位时间为43(14-105)天。HHV-6与CMV共感染(CMV+/HHV-6+)的发生率为52.8%(38/72)。HHV-6DNA血症的首次检出时间早于CMV抗原血症(P<0.0001)。HHV-6DNA血症阳性患者CMV抗原血症检出率显著高于HHV-6血症阴性患者[84.4%(38/45)vs33.3%(9/27),P=0.0001]。HSCT后的疱疹病毒感染相关疾病中出血性膀胱炎(HC)发生率较高[23.6%(17/72)],其中88.2%(15/17)的HC发生于HHV-6血症阳性患者,82.3%(14/17)发生于CMV+/HHV-6+患者。结论HSCT后HHV-6感染以及HHV-6与CMV共感染状态普遍存在,且发生于移植后早期的HHV-6感染与发生时间相对较晚的CMV感染之间可能存在相关性。In order to study the prevalence of human herpesvirus 6 （HHV-6） in allogeneic hematopoietic stem cell transplant （allo-HSCT） recipients in China and to analyze the relationship between HHV-6 and cytomegalovirus （ CMV ） infection in post-HSCT patients, nested polymerase chain reaction （PCR） was used to monitor HHV-6 DNAemia in 72 consecutive allo-HSCT recipients. 680 EDTA anticoagulated peripheral blood specimens were gathered before HSCT or weekly until 12 weeks after allo-HSCT. The variants of HHV-6 were identified by Hind IU restriction analysis. CMV-pp65 antigenemia was detected by immunofluresence stain. The results showed that HHV-6 DNAemia was detected at least once in 62.5% （45/72） of the patients on the median day 14 （range, 7 -63 days） after allo-HSCT, and HHV-6B was the predominant variant. CMV antigenemia was detected at least once in 65.3% （47/72） of the patients on the median day 43 （range, 14- 105 days） after allo-HSCT. Co-infection of HHV-6 and CMV （HHV-6^＋/CMV^＋） occurred in 52.8% （38/72） recipients. The onset of HHV-6 DNAemia was earlier than that of CMV antigenemia （P 〈 0.0001 ）. Patients with HHV-6 DNAemia positive were more likely to have concurrent CMV antigenemia than HHV-6 DNAemia negative patients （84.4% vs 33.3%, P = 0. 0001 ） after allo-HSCT. Among the herpesvirus related disease, the relatively high incidence of hemorrhage cystitis （HC） occurred in 23.6% （17/72） of post-HSCT patients. 88.2% （15/17） of HC developed in HHV-6 positive patients,and 82.3% （14/17） occurred in CMV^＋/HHV-6^＋ patients. It is concluded that infection of HHV-6, co-infection of HHV-6 and CMV, commonly occurred in post-HSCT patients in China, HHV-6 infection closely related to CMV antigenemia.

关 键 词：造血干细胞移植 人类疱疹病毒6型 巨细胞病毒 

分 类 号：R373.11[医药卫生—病原生物学] R457.7[医药卫生—基础医学]