异基因造血干细胞移植患者人类疱疹病毒7型感染

目的：了解人类疱疹病毒7型（HHV-7）在异基因造血干细胞移植（allo-HSCT）患者的感染现状。方法：采集72例allo-HSCT患者外周血标本680份以及53例供者标本。采用巢式聚合酶链反应检测供者以及移植前、后患者HHV-7 DNA血症。结果：72例患者中有62例（86．1％）移植后至少1次检出HHV-7 DNA血症,中位时间为15．6（7～56）d。29例（40．3％）移植后出现持续性HHV-7 DNA血症。47例接受含抗胸腺细胞球蛋白（ATG）预处理方案的人类白细胞抗原（HLA）配型不合移植或配型相合的非血缘移植患者中持续性HHV-7血症的发生率为48．9％（23／47）,显著高于接受不含ATG预处理方案的配型相合移植患者[24％（6／25）,P=0．040]。应用糖皮质激素治疗的患者移植后持续性HHV-7 DNA血症的发生率为44．6％（39／65）,显著高于未接受糖皮质激素治疗的患者[0％（0／7）,P=0．037]。HHV-7 血症与急性移植物抗宿主病、出血性膀胱炎、巨细胞病毒和人类疱疹病毒6型感染无显著相关性。结论：HHV-7感染在allo-HSCT后患者中很常见,且其持续感染与预处理方案中ATG和移植后糖皮质激素的应用密切相关。

Human herpesvirus 7 infection in patients after allogeneic hematopoietic stem cell transplantation

OBJECTIVE: To study the prevalence of human herpesvirus 7 (HHV-7) infection in recipients following allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS: Peripheral blood samples were collected before and weekly after allo-HSCT from 72 consecutive recipients and 53 donors. Nested polymerase chain reaction (nPCR) was used to monitor HHV-7 DNAemia. RESULTS: HHV-7 DNAemia was detected at least once in 86.1% (62/72) of the 72 patients on the median day 15.6 (7 approximately 56 days) after allo-HSCT. Continuing HHV-7 DNAemia (HHV-7 DNAemia maintained at least 4 weeks) was evidenced in 40.3% (29/72) of the patients after allo-HSCT. The prevalence of continuing HHV-7 DNAemia in the patients receiving HLA mismatched or HLA matched unrelated allo-HSCT who underwent conditioning with anti-thymocyte globulin (ATG) was 48.9% (23/47), significantly higher than that in the patients receiving HLA matched related allo-HSCT with conditioning without ATG [24% (6/25), P = 0.040]. Enhanced incidence the prevalence of HHV-7 DNAemia in the patients receiving corticosteroid after allo-HSCT was 44.6% (39/65), significantly higher than that in the patients who did not receive corticosteroid [0% (0/7), P = 0.037]. No relationship was observed between HHV-7 infection and transplant-related complications including acute graft versus host disease, hemorrhagic cystitis, cytomegalovirus and HHV-6 infection. CONCLUSION: Common in allo-HSCT recipients, HHV-7 DNAemia is closely associated with conditioning with ATG and application of corticosteroid after allo-HSCT.