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2.
Rev. Soc. Bras. Med. Trop ; 52: e20180386, 2019. graf
Article in English | LILACS | ID: biblio-990436

ABSTRACT

Abstract Hepatitis B infection is a global health issue. When considering patients with rheumatic diseases, this is no different. By using immunosuppressant drugs, such as DMARDs and biologics, viral reactivation is possible, leading to serious consequences on the patient. We report 3 cases of association between ankylosing spondylitis and hepatitis B with the use of immunosuppressant drugs. Case 1 was a patient with previous HBV infection using DMARD. Cases 2 and 3 were patients chronically infected by HBV during immunosuppressant therapy. The management of HBV infection during immunosuppressant therapy is challenging and needs multidisciplinary support.


Subject(s)
Humans , Female , Pregnancy , Spondylitis, Ankylosing , Virus Activation/drug effects , Antirheumatic Agents/adverse effects , Hepatitis B/immunology , Immunosuppressive Agents/adverse effects , Antirheumatic Agents/therapeutic use , Endemic Diseases , Immunosuppressive Agents
3.
Article in Chinese | WPRIM | ID: wpr-775249

ABSTRACT

Herpes simplex virus (HSV), including HSV-1 and HSV-2, is an important pathogen that can cause many diseases. Usually these diseases are recurrent and incurable. After lytic infection on the surface of peripheral mucosa, HSV can enter sensory neurons and establish latent infection during which viral replication ceases. Moreover, latent virus can re-enter the replication cycle by reactivation and return to peripheral tissues to start recurrent infection. This ability to escape host immune surveillance during latent infection and to spread during reactivation is a viral survival strategy and the fundamental reason why no drug can completely eradicate the virus at present. Although there are many studies on latency and reactivation of HSV, and much progress has been made, many specific mechanisms of the process remain obscure or even controversial due to the complexity of this process and the limitations of research models. This paper reviews the major results of research on HSV latency and reactivation, and discusses future research directions in this field.


Subject(s)
Herpes Simplex , Virology , Herpesvirus 1, Human , Physiology , Humans , Virus Activation , Physiology , Virus Latency , Physiology , Virus Replication
4.
Article in English | WPRIM | ID: wpr-785653

ABSTRACT

BACKGROUND/AIMS: Hepatitis B virus reactivation (HBVr) following chemotherapy (CMT) is well-known among hematologic malignancies, and screening recommendations are established. However, HBVr data in solid organ malignancy (SOM) patients are limited. This study aims to determine hepatitis B surface antigen (HBsAg) screening rates, HBV prevalence, and the rate of significant hepatitis caused by HBVr in SOM patients undergoing CMT.METHODS: Based on the Oncology unit’s registration database from 2009–2013, we retrospectively reviewed records of all SOM patients ≥18 years undergoing CMT at Songklanagarind Hospital who were followed until death or ≥6 months after CMT sessions. Exclusion criteria included patients without baseline liver function tests (LFTs) and who underwent CMT before the study period. We obtained and analyzed baseline clinical characteristics, HBsAg screening, and LFT data during follow-up.RESULTS: Of 3,231 cases in the database, 810 were eligible. The overall HBsAg screening rate in the 5-year period was 27.7%. Screening rates were low from 2009–2012 (7.8–21%) and increased in 2013 to 82.9%. The prevalence of HBV among screened patients was 7.1%. Of those, 75% underwent prophylactic antiviral therapy. During the 6-month follow-up period, there were three cases of significant hepatitis caused by HBVr (4.2% of all significant hepatitis cases); all were in the unscreened group.CONCLUSIONS: The prevalence of HBV in SOM patients undergoing CMT in our study was similar to the estimated prevalence in general Thai population, but the screening rate was quite low. Cases of HBVr causing significant hepatitis occurred in the unscreened group; therefore, HBV screening and treatment in SOM patients should be considered in HBV-endemic areas.


Subject(s)
Asian Continental Ancestry Group , Drug Therapy , Drug-Related Side Effects and Adverse Reactions , Follow-Up Studies , Hematologic Neoplasms , Hepatitis B Surface Antigens , Hepatitis B virus , Hepatitis B , Hepatitis B, Chronic , Hepatitis , Humans , Liver Function Tests , Mass Screening , Prevalence , Retrospective Studies , Thailand , Virus Activation
6.
Clinics ; 73(supl.1): e558s, 2018. tab, graf
Article in English | LILACS | ID: biblio-974945

ABSTRACT

The name of the family Polyomaviridae, derives from the early observation that cells infected with murine polyomavirus induced multiple (poly) tumors (omas) in immunocompromised mice. Subsequent studies showed that many members of this family exhibit the capacity of mediating cell transformation and tumorigenesis in different experimental models. The transformation process mediated by these viruses is driven by viral pleiotropic regulatory proteins called T (tumor) antigens. Similar to other viral oncoproteins T antigens target cellular regulatory factors to favor cell proliferation, immune evasion and downregulation of apoptosis. The first two human polyomaviruses were isolated over 45 years ago. However, recent advances in the DNA sequencing technologies led to the rapid identification of additional twelve new polyomaviruses in different human samples. Many of these viruses establish chronic infections and have been associated with conditions in immunosuppressed individuals, particularly in organ transplant recipients. This has been associated to viral reactivation due to the immunosuppressant therapy applied to these patients. Four polyomaviruses namely, Merkel cell polyomavirus (MCPyV), Trichodysplasia spinulosa polyomavirus (TSPyV), John Cunningham Polyomavirus (JCPyV) and BK polyomavirus (BKPyV) have been associated with the development of specific malignant tumors. However, present evidence only supports the role of MCPyV as a carcinogen to humans. In the present review we present a summarized discussion on the current knowledge concerning the role of MCPyV, TSPyV, JCPyV and BKPyV in human cancers.


Subject(s)
Humans , Tumor Virus Infections/virology , Polyomavirus/pathogenicity , Polyomavirus Infections/virology , Neoplasms/virology , Virus Activation , Cell Transformation, Viral , Polyomavirus/classification , Polyomavirus/physiology
7.
Ann. hepatol ; 16(2): 198-206, Mar.-Apr. 2017. tab
Article in English | LILACS | ID: biblio-887223

ABSTRACT

ABSTRACT HBV and HCV reactivation has been widely reported in patients undergoing immunosuppressive therapy for oncohaematological diseases. We aimed to evaluate the HBV and HCV reactivation events in patients with non-Hodgkin lymphoma (NHL) or Hodgkin lymphoma (HL) underwent cytotoxic chemotherapy containing or not rituximab. This is a retrospective observational study, including all patients with NHL and HL attending an Italian tertiary referral hospital, the University of Naples "Federico II". A total of 322 patients were enrolled. We evaluated serum HBV and HCV markers. A total of 47 (38%) patients with occult HBV infection were enrolled. Seven/47 were treated with therapeutic cytotoxic schedule containing rituximab. Of them, 6/7 received prophylaxis with lamivudine. HBV reactivation was observed in two patients treated with rituximab. A reactivation was observed in the only patient (HBcAb+/HBsAb+) not receiving lamivudine prophylaxis, and the other one was observed in 1 patient with isolated HBcAb positivity during lamivudine prophylaxis. Moreover, 8 patients with HCV-Ab positivity were enrolled. No viral reactivation was observed in these patients. In conclusion, patients with occult HBV infection receiving chemotherapy containing rituximab for lymphoma without antiviral prophylaxis are at risk of viral reactivation. On the contrary, there is no risk of reactivation in patients undergoing rituximab-free schedule. Our findings suggest that there is also very low risk of HCV reactivation. This preliminary report underlines the concept that HBV reactivation is strongly related to the type of immunosuppressive therapy administered and that antiviral prophylaxis needs to be tailored.


Subject(s)
Humans , Adult , Middle Aged , Virus Activation , Lymphoma, Non-Hodgkin/drug therapy , Hodgkin Disease/drug therapy , Hepatitis B virus/pathogenicity , Immunocompromised Host , Hepatitis C/virology , Hepacivirus/pathogenicity , Hepatitis C Antibodies/blood , Rituximab/adverse effects , Hepatitis B/virology , Antineoplastic Agents/adverse effects , Antiviral Agents/administration & dosage , Lymphoma, Non-Hodgkin/immunology , Hodgkin Disease/immunology , Biomarkers/blood , Hepatitis B virus/immunology , Retrospective Studies , Hepatitis C/diagnosis , Hepatitis C/immunology , Hepatitis C/prevention & control , Hepacivirus/immunology , Tertiary Care Centers , Hepatitis B/diagnosis , Hepatitis B/immunology , Hepatitis B/prevention & control , Italy
8.
Ann. hepatol ; 16(1): 86-93, Jan.-Feb. 2017. graf
Article in English | LILACS | ID: biblio-838090

ABSTRACT

Abstract: Background and aims. Pegylated interferon (Peg-INF) and ribavirin (RBV) based therapy is suboptimal and poorly tolerated. We evaluated the safety, tolerability and efficacy of a 24-week course of sofosbuvir plus daclatasvir without ribavirin for the treatment of hepatitis C virus (HCV) recurrence after liver transplantation (LT) in both HCV-monoinfected and human immunodeficiency virus (HIV)-HCV coinfected patients. Material and methods. We retrospectively evaluated 22 consecutive adult LT recipients (16 monoinfected and 6 coinfected with HIV) who received a 24-week course of sofosbuvir plus daclatasvir treatment under an international compassionate access program. Results. Most patients were male (86%), with a median age of 58 years (r:58-81y). Median time from LT to treatment onset was 70 months (r: 20-116 m). HCV genotype 1b was the most frequent (45%), 55% had not responded to previous treatment with Peg-INF and RBV and 14% to regiments including first generation protease inhibitors. Fifty-six percent of the patients had histologically proven cirrhosis and 6 had ascites at baseline. All patients completed the 24-week treatment course without significant side effects except for one episode of severe bradicardya, with only minor adjustments in immunosuppressive treatment in some cases. Viral suppression was very rapid with undetectable HCV-RNA in all patients at 12 weeks. All 22 patients achieved a sustained virological response 12 weeks after treatment completion. Conclusion. The combination of sofosbuvir plus daclatasvir without ribavirin is a safe and effective treatment of HCV recurrence after LT in both monoinfected and HIV-coinfected patients, including those with decompensated cirrhosis.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Antiviral Agents/administration & dosage , HIV Infections/virology , Liver Transplantation/adverse effects , Hepatitis C/drug therapy , Hepacivirus/drug effects , End Stage Liver Disease/surgery , Coinfection , Sofosbuvir/administration & dosage , Imidazoles/administration & dosage , Liver Cirrhosis/drug therapy , Antiviral Agents/adverse effects , Recurrence , Time Factors , Virus Activation , RNA, Viral/genetics , Drug Administration Schedule , HIV Infections/diagnosis , Retrospective Studies , Treatment Outcome , Hepatitis C/diagnosis , Hepatitis C/virology , Hepacivirus/genetics , Hepacivirus/pathogenicity , Viral Load , Drug Therapy, Combination , Compassionate Use Trials , End Stage Liver Disease/diagnosis , End Stage Liver Disease/virology , Sofosbuvir/adverse effects , Imidazoles/adverse effects , Immunosuppressive Agents/administration & dosage , Liver Cirrhosis/diagnosis , Liver Cirrhosis/virology
9.
Braz. j. med. biol. res ; 50(2): e5566, 2017. tab, graf
Article in English | LILACS | ID: biblio-839257

ABSTRACT

Acute graft-versus-host disease (aGVHD) and cytomegalovirus reactivation are important complications after allogeneic stem cell transplantation (alloHSCT). Here, we evaluated the impact of treatment with alemtuzumab on the occurrence of aGVHD, cytomegalovirus reactivation and survival after alloHSCT. This was a prospective cohort study conducted at the allo-HSCT unit of Hospital das Clínicas, Universidade Federal de Minas Gerais, Brazil, from January 2009 to December 2011. Fifty-seven patients who underwent alloHSCT were included. Forty-five (79%) patients had a malignant disease. Alemtuzumab was administered before the conditioning regimen at a dose of 1 mg/kg in children and 30 mg/day for 2 days in adults or children weighing more than 40 kg (a total dose of 60 mg) with a non-malignant disease or patients with a malignant disease and high-risk for GVHD mortality. Alemtuzumab was used in 23 (40%) patients, of whom 17 received a reduced-intensity conditioning. Eleven patients presented aGVHD (grade 2–4) and only 1 of them received alemtuzumab. Cumulative incidence of aGVHD (grade 2–4) at day 100 after transplantation (D+100) was 4 for patients receiving alemtuzumab and 29% for patients not receiving alemtuzumab. Cumulative incidence of cytomegalovirus reactivation for patients receiving or not alemtuzumab was 62 and 38%, respectively. Sixteen patients died in the first 100 days after alloHSCT, most of them due to bacterial sepsis. Only 2 patients died of aGVHD until D+100. Overall survival was 50% without any impact of alemtuzumab. Alemtuzumab effectively controlled aGVHD but increased the risk of cytomegalovirus reactivation without improving survival.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Young Adult , Antibodies, Monoclonal, Humanized/therapeutic use , Cytomegalovirus Infections/prevention & control , Graft vs Host Disease/prevention & control , Hematopoietic Stem Cell Transplantation/methods , Alemtuzumab , Cytomegalovirus/physiology , Disease-Free Survival , Graft vs Host Disease/virology , Hematopoietic Stem Cell Transplantation/adverse effects , Prospective Studies , Risk Factors , Transplantation, Homologous , Virus Activation/drug effects
10.
Rev. chil. infectol ; 33(3): 340-345, jun. 2016. ilus, mapas
Article in Spanish | LILACS | ID: lil-791029

ABSTRACT

El síndrome DRESS (drug reaction with eosinophilia and systemic symptoms) constituye una reacción adversa a fármacos, potencialmente mortal, caracterizada por una erupción cutánea polimorfa asociada a fiebre, linfadeno-patías y compromiso multiorgánico con eosinofilia. Presentamos el caso clínico de un hombre inmunocompetente con un síndrome DRESS secundario a carbamazepina que cursó concomitantemente con una meningoencefalitis por virus herpes humano 6 (VHH-6). El rol patogénico del VHH-6 en el síndrome DRESS sigue siendo controversial; sin embargo, dada la importancia diagnóstica y eventualmente pronóstica de la infección por VHH-6, su tamizaje sería recomendable dentro del estudio de estos pacientes.


DRESS syndrome (drug reaction with eosinophilia and systemic symptoms) is an adverse life-threatening drug reaction characterized by a polymorphous rash associated with fever, lymphadenopathy and multiorgan involvement with eosinophilia. We present the case of an immunocompetent man with DRESS syndrome secondary to carbamazepine, that developed concomitantly meningoencephalitis caused by human herpes virus 6 (HHV-6), and a review of literature. The pathogenic role of HHV-6 in DRESS syndrome remains controversial. Given the diagnostic and possibly prognostic significance of HHV-6, the screening seems to be a good measure to use in the clinical management of these patients.


Subject(s)
Humans , Male , Adult , Carbamazepine/adverse effects , Herpesvirus 6, Human/physiology , Drug Hypersensitivity Syndrome/etiology , Immunocompetence , Meningoencephalitis/virology , Anticonvulsants/adverse effects , Antiviral Agents/therapeutic use , Virus Activation , Polymerase Chain Reaction , Drug Hypersensitivity Syndrome/drug therapy , Meningoencephalitis/immunology , Meningoencephalitis/drug therapy
11.
Article in Chinese | WPRIM | ID: wpr-360104

ABSTRACT

The incidence of HBV infection in lymphoma patients is much higher than that in the general normal population. HBV reactivation caused by treatment is one of the common complications in considerable amount of lymphoma patients, which can induce fatal fulminating hepatitis in severe cases. The HBV reactivation in lymphoma patients is related to multiple factors, such as age, sex, HBV infectious state, HBV genotypes and gene mutations, and antitumor drugs. It's necessary to strengthen monitoring, prevention and treatment to HBV reactivation in the process of dealing with lymphoma. This review focuses on the epidemiological characteristics of lymphoma and HBV, as well as the risk factors, morbidity, pathogenesis, clinical feature, suggestion on prevention and treatment of HBV reactivation.


Subject(s)
Antineoplastic Agents , Therapeutic Uses , Hepatitis B , Drug Therapy , Hepatitis B Surface Antigens , Hepatitis B virus , Physiology , Humans , Lymphoma , Drug Therapy , Virology , Risk Factors , Virus Activation
12.
Article in English | WPRIM | ID: wpr-138553

ABSTRACT

Advances in the treatment of malignant and inflammatory diseases have developed over time, with increasing use of chemotherapeutic and immunosuppressive agents of a range of drug classes with varying mechanism and potency in their effects on the immune system. These advances have been met with the challenge of increased risk of hepatitis B virus (HBV) reactivation in susceptible individuals. The magnitude of risk of HBV reactivation is associated with the individual's HBV serological status and the potency and duration of immunosuppression. Individuals with chronic hepatitis B (CHB) and previously infected but serologically cleared HBV infection are both susceptible to HBV reactivation. HBV reactivation in the setting of immunosuppression is a potentially life threatening condition leading to liver failure and death in extreme cases. It is important to recognize that HBV reactivation in the setting of immunosuppression is potentially preventable. Therefore, identification of patients at risk of HBV reactivation and institution of prophylactic antiviral therapy prior to initiation of immunosuppression is essential.


Subject(s)
Antiviral Agents/therapeutic use , Autoimmune Diseases/complications , Hematopoietic Stem Cell Transplantation , Hepatitis B/complications , Hepatitis B Core Antigens/blood , Hepatitis B Surface Antigens/blood , Hepatitis B virus/physiology , Humans , Immunosuppressive Agents/therapeutic use , Organ Transplantation , Virus Activation/physiology
13.
Article in English | WPRIM | ID: wpr-138552

ABSTRACT

Advances in the treatment of malignant and inflammatory diseases have developed over time, with increasing use of chemotherapeutic and immunosuppressive agents of a range of drug classes with varying mechanism and potency in their effects on the immune system. These advances have been met with the challenge of increased risk of hepatitis B virus (HBV) reactivation in susceptible individuals. The magnitude of risk of HBV reactivation is associated with the individual's HBV serological status and the potency and duration of immunosuppression. Individuals with chronic hepatitis B (CHB) and previously infected but serologically cleared HBV infection are both susceptible to HBV reactivation. HBV reactivation in the setting of immunosuppression is a potentially life threatening condition leading to liver failure and death in extreme cases. It is important to recognize that HBV reactivation in the setting of immunosuppression is potentially preventable. Therefore, identification of patients at risk of HBV reactivation and institution of prophylactic antiviral therapy prior to initiation of immunosuppression is essential.


Subject(s)
Antiviral Agents/therapeutic use , Autoimmune Diseases/complications , Hematopoietic Stem Cell Transplantation , Hepatitis B/complications , Hepatitis B Core Antigens/blood , Hepatitis B Surface Antigens/blood , Hepatitis B virus/physiology , Humans , Immunosuppressive Agents/therapeutic use , Organ Transplantation , Virus Activation/physiology
14.
Chinese Journal of Hematology ; (12): 138-143, 2016.
Article in Chinese | WPRIM | ID: wpr-234016

ABSTRACT

<p><b>OBJECTIVE</b>To analyze the prevalence of Epstein Barr Virus (EBV) infection in patients following allogeneic hematopoietic stem cell transplantation (allo-HSCT).</p><p><b>METHODS</b>The occurrence of EBV viremia, EBV disease and post-transplant lymphoproliferative disease (PTLD) were retrospectively analyzed in 736 patients received allo-HSCT in single-center from 1st January 2012 through July 31th, 2014.</p><p><b>RESULTS</b>Of 736 patients (302 male and 434 females) with a median age of 31 (2 to 62) years old, EBV infection occurred in 181 patients, the total incidence of EBV infection was 27.6%, with a median time of 57 (16 to 829) days. The cumulative incidences of probable EBV disease and PTLD were 7.2% (13/181) and 2.8% (5/181). Viral load higher than 1.0×10(4) copies/ml occurs in 130 patients, of which 67 patients received rituximab as pre-empty prophylaxis and significantly reduced the incidences of probable EBV disease and PTLD (6.0% vs 22.2%, P=0.009). The mortality was 27.6% in all patients with EBV infection: 24.5% in EBV viremia, 53.8% in probable EBV disease, and 60.6% in PTLD. By univariate and multivariate analysis, the use of anti-thymocyte globulin (ATG), HLA-mismatch HSCT, cGVHD and CMV reactivation were independent risk factors for EBV infection. The time of first EBV reactivation was closely related with cGVHD(OR=0.620, 95%CI 0.453-0.849, P=0.003) and bone marrow or cord blood (OR=1.156, 95%CI 1.022-2.250, P=0.039) as source of stem cells for transplantation.</p><p><b>CONCLUSION</b>EBV reactivation is a common complication in patients with allo-HSCT, especially high mortality in PTLD and probable EBV disease. The use of ATG, HLA-mismatch HSCT, cGVHD and CMV reactivation were independent risk factors for EBV infection. The usage of rituximab as pre-empty prophylaxis may reduce the incidences of probable EBV disease and PTLD.</p>


Subject(s)
Adolescent , Adult , Antilymphocyte Serum , Therapeutic Uses , Child , Child, Preschool , Epstein-Barr Virus Infections , Female , Hematopoietic Stem Cell Transplantation , Herpesvirus 4, Human , Humans , Incidence , Lymphoproliferative Disorders , Virology , Male , Middle Aged , Multivariate Analysis , Retrospective Studies , Risk Factors , Rituximab , Therapeutic Uses , Transplantation, Homologous , Viral Load , Virus Activation , Young Adult
15.
Einstein (Säo Paulo) ; 13(1): 142-148, Jan-Mar/2015. tab, graf
Article in English | LILACS | ID: lil-745879

ABSTRACT

Cytomegalovirus infection is one of most frequent infectious complications after renal transplantation, and can be classified as primo-infection, when the transmission occurs through the graft, or reactivation, when the recipient is cytomegalovirus seropositive. After transplantation, cytomegalovirus can appear as an infection, when the patient presents with evidence of viral replication without symptoms or disease, which has two clinical spectra: typical viral syndrome or invasive disease, which is a less common form. Their effects can be classified as direct, while the disease is developed, or indirect, with an increase of acute rejection and chronic allograft dysfunction risks. Diagnosis must be made based on viremia by one of the standardized methods: antigenemia or PCR, which is more sensitive. The risk factors related to infection after transplantation are the serologic matching (positive donor and negative recipient) and anti-lymphocyte antibody drugs. One of the strategies to reduce risk of disease should be chosen for patients at high risk: preemptive treatment or universal prophylaxis. Recent clinical research has described ganciclovir resistance as an emergent problem in management of cytomegalovirus infection. Two types of mutation that cause resistance were described: UL97 (most frequent) and UL54. Today, sophisticated methods of immunologic monitoring to detect specific T-cell clones against cytomegalovirus are used in clinical practice to improve the management of high-risk patients after renal transplantation.


A infecção pelo citomegalovírus é uma das principais complicações após o transplante de rim, podendo ser classificada em primoinfecção, quando a transmissão ocorre por meio do enxerto, ou em reativação, quando o receptor é soropositivo. Do ponto de vista clínico, pode se apresentar como infecção, na ausência de sintomas, ou como doença, com dois diferentes espectros: a síndrome viral típica ou, menos comumente, a doença invasiva. Os efeitos podem ser diretos, que é o desenvolvimento da doença, ou indiretos, como aumento no risco de rejeição aguda e de disfunção crônica do enxerto. O diagnóstico deve ser feito por pesquisa de viremia por meio de um dos dois métodos padronizados: antigenemia ou PCR − sendo essa última a mais sensível. Os fatores de risco relacionados com a infecção após o transplante são o match sorológico (doador positivo e receptor negativo) e o uso de anticorpos antilinfócitos. Uma das estratégias de redução de risco de doença deve ser escolhida após o transplante nos pacientes de alto risco: tratamento preemptivo ou profilaxia. Recentemente, linhas de pesquisa clínica têm apontado a resistência ao ganciclovir como um problema emergente no manejo da infecção pelo citomegalovírus. Duas formas de mutação que causam resistência são descritas: UL97, que é a mais frequente, e a UL54. Atualmente, sofisticados métodos de monitorização imunológica, como a detecção de clones específicos de células T contra o citomegalovírus podem ser utilizados na prática clínica para o melhor manejo após o transplante renal dos pacientes de alto risco.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Cytomegalovirus Infections/virology , Kidney Transplantation , Postoperative Complications/virology , Cytomegalovirus Infections/prevention & control , Cytomegalovirus/pathogenicity , Graft Rejection/virology , Monitoring, Immunologic , Polymerase Chain Reaction , Prospective Studies , Postoperative Complications/prevention & control , Risk Factors , Virus Activation
16.
Chinese Journal of Cancer ; (12): 225-234, 2015.
Article in English | WPRIM | ID: wpr-349603

ABSTRACT

<p><b>INTRODUCTION</b>Hepatitis B virus (HBV) reactivation has been reported in B-cell lymphoma patients with resolved hepatitis B (hepatitis B surface antigen [HBsAg]-negative and hepatitis B core antibody [HBcAb]-positive). This study aimed to assess HBV reactivation and hepatitis occurrence in diffuse large B-cell lymphoma (DLBCL) patients with resolved hepatitis B receiving rituximab-containing chemotherapy compared with HBsAg-negative/HBcAb-negative patients to identify risk factors for HBV reactivation and hepatitis occurrence and to analyze whether HBV reactivation and hepatitis affect the survival of DLBCL patients with resolved hepatitis B.</p><p><b>METHODS</b>We reviewed the clinical data of 278 patients with DLBCL treated with rituximab-containing therapy between January 2004 and May 2008 at Sun Yat-sen University Cancer Center, China. Predictive factors for HBV reactivation, hepatitis development, and survival were examined by univariate analysis using the chi-square or Fisher's exact test and by multivariate analysis using the Cox regression model.</p><p><b>RESULTS</b>Among the 278 patients, 165 were HBsAg-negative. Among these 165 patients, 6 (10.9%) of 55 HBcAb-positive (resolved HBV infection) patients experienced HBV reactivation compared with none (0%) of 110 HBcAb-negative patients (P = 0.001). Patients with resolved hepatitis B had a higher hepatitis occurrence rate than HBsAg-negative/HBcAb-negative patients (21.8% vs. 8.2%, P = 0.013). HBcAb positivity and elevated baseline alanine aminotransferase (ALT) levels were independent risk factors for hepatitis. Among the 55 patients with resolved hepatitis B, patients with elevated baseline serum ALT or aspartate aminotransferase (AST) levels were more likely to develop hepatitis than those with normal serum ALT or AST levels (P = 0.037, P = 0.005, respectively). An elevated baseline AST level was an independent risk factor for hepatitis in these patients. Six patients with HBV reactivation recovered after immediate antiviral therapy, and chemotherapy was continued. HBcAb positivity, HBV reactivation, or hepatitis did not negatively affect the survival of DLBCL patients.</p><p><b>CONCLUSIONS</b>DLBCL patients with resolved hepatitis B may have a higher risk of developing HBV reactivation and hepatitis than HBsAg-negative/HBcAb-negative patients. Close monitoring and prompt antiviral therapy are required in these patients.</p>


Subject(s)
China , Hepatitis B , Hepatitis B Antibodies , Hepatitis B Surface Antigens , Hepatitis B virus , Humans , Lymphoma, Large B-Cell, Diffuse , Mortality , Prognosis , Risk Factors , Rituximab , Virus Activation
17.
Chinese Journal of Hematology ; (12): 389-392, 2015.
Article in Chinese | WPRIM | ID: wpr-282026

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the correlation between CMV reactivation and obliterative bronchiolitis (BO) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).</p><p><b>METHODS</b>From January 2011 to December 2013, 769 patients underwent allo-HSCT. The CMV infection was diagnosed by fluorescence quantitative PCR method for detecting the level of CMV-DNA and immunofluorescence staining of PP65 antigen in white blood cell. The frequency of BO in patients with and without CMV infection was compared, and the correlation between CMV infection and BO was analyzed. The clinical data of CMV infection patients with and without BO were analyzed and compared.</p><p><b>RESULTS</b>Of 259 diagnosed CMV infection patients, BO occurred in 32 cases, the incidence rate was 12.35%, while in 510 cases without CMV infection, BO occurred in 8 cases, the incidence was 1.56%. The incidence rate of BO is significantly higher in patients with CMV infection than that in patients without CMV infection (P<0.001). The CMV related clinical data between the 32 cases with BO and 227 cases without BO were analyzed among the 259 cases of diagnosed CMV infection patients. BO incidence is higher in patients with more than 10⁵ copies/ml CMV-DNA than that in patients with less than 10² copies/ml CMV-DNA.</p><p><b>CONCLUSION</b>Among the risk factors related to BO post allo-HSCT, CMV infection is one of them to be worthy of attention. CMV reactivation with high virus titer, multiple CMV reactivations and CMV pneumonia are the risk factors.</p>


Subject(s)
Allografts , Bronchiolitis , Bronchiolitis Obliterans , Cytomegalovirus , Cytomegalovirus Infections , Hematopoietic Stem Cell Transplantation , Humans , Real-Time Polymerase Chain Reaction , Risk Factors , Viral Load , Virus Activation
20.
Mem. Inst. Oswaldo Cruz ; 109(4): 499-501, 03/07/2014. tab, graf
Article in English | LILACS | ID: lil-716309

ABSTRACT

Antimony compounds are the cornerstone treatments for tegumentary leishmaniasis. The reactivation of herpes virus is a side effect described in few reports. We conducted an observational study to describe the incidence of herpes zoster reactivation during treatment with antimony compounds. The global incidence of herpes zoster is approximately 2.5 cases per 1,000 persons per month (or 30 cases per 1,000 persons per year). The estimated incidence of herpes zoster in patients undergoing antimony therapy is higher than previously reported.


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Antimony/adverse effects , Antiprotozoal Agents/adverse effects , Herpes Zoster/etiology , /physiology , Antimony/therapeutic use , Antiprotozoal Agents/therapeutic use , Herpes Zoster/virology , Leishmaniasis, Cutaneous/drug therapy , Virus Activation
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