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Objective To compare the prophylactic efficacy of combination of ganciclovir and acy- clovir or acyclovir alone against cytomegalovirus pneumonia in renal transplant recipients.Methods A to- tal of 217 renal transplant recipient(124 men and 93 women;mean age,32 years;age range,16-72 years) were divided into 3 groups randomly.In 51 cases,acyclovir was taken orally at a dose of 400 mg,3/d,from the third d to 3 months after transplantation.In 74 cases,ganciclovir was administered at a dose of 250 mg/d intravenously from the 21st d to 27th d to replace Acyclovir.In 92 cases,no prophylaxis against eytomegalov- irus pneumonia was performed.All patients were followed 3 months after transplantation.Comparison of the incidence rates of cytomegalovirus pneumonia among the 3 groups was performed using Fisher's exact test. Results Cytomegalovirus pneumonia developed in 20 cases in the 3 groups,including 4 cases(5.4%) in combined use group,2 cases(3.9%)in acyclovir alone group,and 14 cases(15.2%)in control group. Significant difference existed between the 2 experimental and control groups(P＜0.05).However,no signifi- cant difference existed between the 2 experimental groups(P＞0.05).Of the 20 cases,17(85.0%)were cured,and 3 died of respiratory failure.Conclusions Ganciclovir and acyclovir have prophylactic effect a- gainst cytomegalovirus pneumonia in renal transplant recipients.These 2 medications are inexpensive,and the patients have good compliance.
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Objective To explore the correlation between cytomegalovirus pneumonia (CMV-IP) and viral load in renal transplant recipients and to find out the threshold value of viral load for predicting CMV-IP. Methods The blood samples of 56 renal transplant recipients were taken weekly for the first 2 months and every 2 weeks for 2-6 months after transplantation.Real-time PCR were used to quantify the plasma CMV DNA.The mean viral loads of CMV-IP group and non-CMV-IP group in each time were compared using Wilcoxon test.Different cut-off values were tested to find the suitable values to predict the CMV-IP. Results Of the 56 recipients,8 (14.3%) developed CMV-IP.The viral loads were near zero in the first 4 weeks in both groups;from week 5 the viral load of CMV-IP group increased gradually and reached the climax at week 8 and then declined,but the load of non-CMV-IP group fluctuated at a low level.During weeks 5-11,the viral loads of CMV-IP group were higher than those of non-VMV-IP group.At 5,7 and 9 weeks,the differences of the viral loads between the 2 groups were significant (P
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AIM: To investigate whether human cytomegalovirus(HCMV) regulate human embryonic lung fibroblast(HEL) cell proliferation and apoptosis by activating NF-?B. METHODS: Immunohistochemistry and Western blot analysis were used to detect the NF-?B translocation and/or Bcl-2 and the levels of I-?B? during HCMV infection. Apoptotic cell were examined by flow cytometry, and the HEL cell proliferation was determined by MTT. RESULTS: The levels of NF-?B in the nucleus reached highly 48 h postinfection, and the levels of I-?B? were low 24 h postinfection. The activity of NF-?B was inhibited 120 h postinfection. The levels of bcl-2 was accorded with the activity of NF-?B. HCMV promoted HEL cells to proliferate before 72 h postinfection and induced apoptosis 120 h postinfection. CONCLUSION: NF-?B plays a role in HEL cell proliferation and apoptosis during HCMV infection, and it involves in the pathological mechanisms of diseases associated with HCMV infection.
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Objective To study the therapeutic effects and side effects of foscarnet in the treatment of active(IgG+,IgM+)and inactive(IgC+,IgM-)cytomegalovirus(CMV)infection after cadaver renal transplantation.Methods Forty-one cases of active cytomegalovirus infection and 22 of inactive cytomegalovirus were selected to receive foscarnet treatment.Besides,10 cases of inactive cytomegalovirus infection served as control group without receiving foscarnet.The usage of foscarnet was 40 mg/kg,iv.,2 ～3 weeks in the active stage,50 mg/kg,iv.,3～4 weeks in the inactive stage.Results Clinical symptoms of patients in the active stage were controlled,and serologic CMV IgG turned negative.Moreover,no positive infection was found after 3-month follow-up for those who received foscarnet.At the same time, 3 patients in the control group turned into active infection. Only one receiving foscarnet appeared urine volume cutting down temporarily,and the renal function had a reversible change;2 patients had skin red reaction.Conclusion Foscarnet could control CMV active infection quickly,markedly and firmly.and no recurrence was found during a 3-month follow-up.Foscarnet may protect the inactive patients from turning positive.And foscarnet had no obvious damage to the renal graft function and didn't interfere with the metabolism of blood calcium and cyclosporine A.Foscarnet is a safe and effective drug to treat CMV infection.
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AIM: To study effects of tumour necrosis factor alpha(TNF?) and interleukin-10(IL-10) on human cytomegalovirus AD169 (HCMV AD169) infection in human embryonic lung fibroblasts (HEL),and the ability of the infected HEL to produce TNF?. We have attempted to understand the effect of cytokines in the immune of HCMV infection. METHODS: TNF??IL-10 were added separately with different concentrations before 24 h HCMV infection of HEL to study the effect of TNF? and IL-10 on multiplication of HCMV. HCMV was incubated with HEL, TNF? in culture supernatants were measured at 4, 24, 48, 72, 96 h postinfection. The level of TNF? was measured by enzyme-linked immunosorbent assay( ELISA). RESULTS: The addition of TNF? with the concentration of 10-100 ?g/L or IL-10 with the concentration of 1-10 ?g/L before 24 h HCMV infection of HEL could remarkably inhibited the multiplication of HCMV in HEL. Level of TNF? didn't increase in infected cell supernatants. CONCLUSION: TNF? and IL-10 play an important role in the immune of HCMV infection.
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During the past few years, it was found that hemophiliacs suffered from AIDS increasingly from year to year. The first case of hemophilia with AIDS was found in the fourth quater of 1981. Eight cases of hemophilia occurred in 1982, and 12 cases of AIDS were found in the hemophiliacs in 1983. The goal of this paper was to test the titer of CMV, EBV, HTLV and EA in the blood stream of hemophiliacs. Hemophiliacs had much higher sensitivity to CMV and EBV than the healthy control. There was a significant difference between these hemophiliacs without any symptoms of AIDS and healthy man. The relationship between hemophilia and AIDS and the cause that the hemophiliac suffers from AIDS are discussed.