Epidemiology of viral infections among children undergoing hematopoietic stem cell transplant: Α prospective single-center study.

Authors:
Konstantinos Tsoumakas
Konstantinos Tsoumakas
National & Kapodestrian University of Athens
Konstantina Giamaiou
Konstantina Giamaiou
"Aghia Sophia" Children's Hospital
Greece
Evgenios Goussetis
Evgenios Goussetis
Aghia Sophia Children's Hospital
Greece
Stelios Graphakos
Stelios Graphakos
St Sophia Children's Hospital
Greece
Athanasios Kossyvakis
Athanasios Kossyvakis
Centro Nacional de Microbiología
Spain
Elina Horefti
Elina Horefti
Hellenic Pasteur Institute
Greece
Andreas Mentis
Andreas Mentis
Hellenic Pasteur Institute
Greece
Ioannis Elefsiniotis
Ioannis Elefsiniotis
University of Athens
Irvine | United States

Transpl Infect Dis 2019 Apr 16:e13095. Epub 2019 Apr 16.

Faculty of Nursing, Pediatric Clinic, "P & A Kyriakou" Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Background: Viral infections are a significant cause of morbidity and mortality in pediatric transplant populations. We analyzed the epidemiology of viral infections in pediatric hematopoietic stem cell transplant (HSCT) patients, including their incidence, associated risk factors, and outcome.

Methods: In a prospective study from September 2011 to September 2015, blood, urine, and stool specimens were monitored weekly from transplantation to day 100 or after if clinically suspected, by use of real-time polymerase chain reaction. Cytomegalovirus (CMV), Epstein-Barr virus (EBV), BK polyomavirus (BKV), Herpes simplex virus-1,2, Varicella zoster virus, Human herpes virus-6,7, and Adenovirus infections were monitored. All children and adolescents who underwent HSCT received long-term follow up in the regular outpatient clinics (range 2-48 months).

Results: A total of 192 HSCTs (autologous/allogeneic: 53/139) were performed in 165 subjects (median age: 5.6 years). Viruses most commonly isolated were CMV (46.1%), BKV (25.9%) and EBV (22.6%) and were more frequent in allogeneic versus autologous transplants (P < 0.05). Almost all high-risk allogeneic recipients developed EBV infections post-HSCT. EBV-PTLD was the only cause of death among those who developed viral disease. The factors significantly associated with the development of viral infections were recipient's advanced age, unrelated donor, mismatched graft and use of peripheral blood stem cells grafts.

Conclusions: Viral infections were common among our pediatric recipients. Data suggest that monitoring of viral load may be significant to the prevention of viral disease. Particular demographic and transplantation characteristics were associated with the development of viral infections post-HSCT.

Download full-text PDF

Source
http://dx.doi.org/10.1111/tid.13095DOI Listing
April 2019
1 Read

Publication Analysis

Top Keywords

viral infections
12
hematopoietic stem
8
stem cell
8
cell transplant
8
epidemiology viral
8
median age
4
chain reaction
4
real-time polymerase
4
suspected real-time
4
age years
4
polymerase chain
4
cytomegalovirus cmv
4
subjects median
4
ebv polyomavirus
4
polyomavirus bkv
4
virus ebv
4
epstein-barr virus
4
clinically suspected
4
cmv epstein-barr
4
reaction cytomegalovirus
4

References

(Supplied by CrossRef)
Early detection of cytomegalovirus infection in allogeneic hematopoietic stem cell transplant patients by real time‐quantitative PCR
Ceballos ME et al.
Rev Chilena Infectol 2014
Novel multiplex real‐time PCR assay for detection and differentiation of herpes simplex virus type 1 and 2 DNA
Machura P et al.
Med Dosw Mikrobiol 2015

Similar Publications