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1.
Clin Microbiol Infect ; 18(8): E305-7, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22548647

ABSTRACT

The occurrence and clinical impact of herpes simplex virus (HSV) were evaluated in 342 bronchoalveolar lavage specimens from 237 patients. HSV-1 and HSV-2 were detected in 32.1% and <1% of patients, respectively. A significant difference of HSV-1 prevalence and load was found in relation to admission to intensive care unit, mechanical ventilation and mortality within 28 days; in particular, a viral load ≥10(5) copies/mL bronchoalveolar lavage fluid was significantly associated with critical features. No association was found with immune status or other characteristics. Nine of 21 (42.9%) cases of ventilator-associated pneumonia were positive for HSV-1, with poor outcome in six.


Subject(s)
Herpes Simplex/epidemiology , Herpes Simplex/virology , Herpesvirus 1, Human/isolation & purification , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/virology , Adult , Bronchoalveolar Lavage Fluid/virology , Female , Herpes Simplex/mortality , Herpes Simplex/pathology , Herpesvirus 2, Human/isolation & purification , Humans , Male , Middle Aged , Prevalence , Respiratory Tract Infections/mortality , Respiratory Tract Infections/pathology , Survival Analysis , Viral Load
2.
Int J Immunopathol Pharmacol ; 25(4): 1003-9, 2012.
Article in English | MEDLINE | ID: mdl-23298490

ABSTRACT

Cellular immune response has been demonstrated to play a role in the control of human cytomegalovirus (HCMV) replication in organ transplant recipients. Herein, HCMV-specific T-cell response and association to the onset of organ infection/disease were prospectively evaluated by EliSPOT assay in a population of 46 lung transplant (LT) recipients at 1, 3, 6, 9 and 12 months post-transplantation. According to our centre?s practice, a combined prolonged antiviral prophylaxis (HCMV-IG for 12 months and ganciclovir or valganciclovir for 3 weeks from postoperative day 21) was given to all LT recipients. HCMV-DNA was concomitantly detected on bronchoalveolar lavage (BAL) and whole blood by real-time PCR. Approximately one third of patients resulted HCMV persistently non-responder; the rate of HCMV infection, as evaluated by HCMV-DNA positivity, tended to be higher in non-responders. Mean viral load on BAL was significantly higher in non-responders vs other patients (p < 0.001). Temporal profile of infections appeared related to the HCMV responder status with a shorter time to onset of infection post-transplantation and a longer duration in non-responders. The occurrence of organ disease (i.e. pneumonia) tended to be higher in non-responders, with poor prognosis, as death occurred in one of three non-responder patients that developed HCMV pneumonia. The lack of HCMV-specific cellular response can contribute to the onset of organ infection and disease also in patients in which antiviral prophylaxis was adopted; this could be due to the potential occurrence of incomplete control of replication in lungs or a delayed priming of T-cell reconstitution.


Subject(s)
Cytomegalovirus Infections/etiology , Cytomegalovirus/immunology , Lung Transplantation/adverse effects , Adult , Aged , Antiviral Agents/therapeutic use , DNA, Viral/analysis , Female , Humans , Immunity, Cellular , Lung Transplantation/immunology , Male , Middle Aged
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