Dataset Information

Persistent rhinovirus infection in pediatric hematopoietic stem cell transplant recipients with impaired cellular immunity.

ABSTRACT:

Background

HRV infections are generally self-limiting in healthy subjects, whereas in immunocompromised hosts HRV infections can lead to severe complications and persistent infections. The persistence of HRV shedding could be due to the inefficient immunological control of a single infectious episode.

Objectives

To investigate the clinical, virologic and immunologic characteristics of pediatric HSCT recipients with HRV-PI infection.

Study design

During the period 2006-2012, eight hematopoietic stem cell transplant (HSCT) recipients presented with persistent rhinovirus infection (HRV-PI, ?30 days). Viral load and T-CD4(+), T-CD8(+), B and NK lymphocyte counts at the onset of infection were compared with those of fourteen HSCT recipients with acute HRV infection (HRV-AI, ?15 days).

Results

The median duration of HRV positivity in patients with HRV-PI was 61 days (range 30-174 days) and phylogenetic analysis showed the persistence of a single HRV type in all patients (100%). In HSCT recipients with HRV-PI, T-CD4(+), T-CD8(+) and NK cell counts at the onset of infection were significantly lower than those observed in recipients with HRV-AI (p<0.01), while B cell counts were similar in the two groups (p=?0.25). A decrease in HRV load was associated with a significant increase in T-CD4(+), T-CD8(+)and NK lymphocyte counts in HRV-PI patients (p<0.01).

Conclusions

This study suggests a role for cellular immunity in HRV clearance and highlights the importance of its recovery for the control of HRV infection in HSCT recipients.

SUBMITTER: Piralla A

PROVIDER: S-EPMC7172262 | biostudies-literature | 2015 Jun

REPOSITORIES: biostudies-literature

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Publications

Persistent rhinovirus infection in pediatric hematopoietic stem cell transplant recipients with impaired cellular immunity.

Piralla Antonio A Zecca Marco M Comoli Patrizia P Girello Alessia A Maccario Rita R Baldanti Fausto F

Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology 20150331

<h4>Background</h4>HRV infections are generally self-limiting in healthy subjects, whereas in immunocompromised hosts HRV infections can lead to severe complications and persistent infections. The persistence of HRV shedding could be due to the inefficient immunological control of a single infectious episode.<h4>Objectives</h4>To investigate the clinical, virologic and immunologic characteristics of pediatric HSCT recipients with HRV-PI infection.<h4>Study design</h4>During the period 2006-2012, ...[more]

PMID: 25959156

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Project description:Abstract Background Cytomegalovirus (CMV) causes substantial morbidity and mortality after hematopoietic stem cell transplantation (HSCT). There are limited data on risk factors for CMV viremia and the safety of antiviral medications used to treat CMV in children. Methods We conducted a single-center retrospective study of children who underwent HSCT between 2000 and 2016. We used log-logistic regression to evaluate associations between clinical characteristics and CMV-free survival at 100 days after HSCT. We compared the incidences of laboratory-defined adverse events (AEs) during treatment with ganciclovir and foscarnet. Results Among 969 children, the median (interquartile range) age was 6.5 (3.1–11.5) years, and 80% underwent allogeneic HSCT. Two hundred forty-four (25%) children developed CMV viremia. Older age (odds ratio [OR], 0.95; 95% CI, 0.92–0.98), male sex (OR, 0.71; 95% CI, 0.51–0.99), non-Black, non-White race (OR, 0.56; 95% CI, 0.36–0.87), umbilical cord blood donor source (OR, 0.28; 95% CI, 0.08–0.97), and CMV seropositivity (R-/D+: OR, 0.17; 95% CI, 0.07–0.41; R+/D-: OR, 0.14; 95% CI, 0.09–0.21; R+/D+: OR, 0.08; 95% CI, 0.04–0.15) were associated with lower odds of 100-day CMV-free survival. Compared with foscarnet, ganciclovir was associated with lower incidences of thrombocytopenia (incidence rate ratio [IRR], 0.38; 95% CI, 0.15–0.97), electrolyte AEs (IRR, 0.42; 95% CI, 0.24–0.75), endocrine AEs (IRR, 0.52; 95% CI, 0.34–0.79), and renal AEs (IRR, 0.36; 95% CI, 0.19–0.65). Conclusions CMV viremia occurred commonly among children after HSCT, and ganciclovir and foscarnet were associated with distinct toxicity profiles among children with CMV infection. These findings should be considered when developing CMV prevention and treatment strategies for children after HSCT. D/C/F/TAF is the reference for combination therapy based on protease inhibitors but has not been compared with regimens containing integrase inhibitors as initial ART. We could not demonstrate D/C/F/TAF noninferiority relative to DTG/ABC/3TC, although both regimens were similarly well tolerated.

Dataset Information

Persistent rhinovirus infection in pediatric hematopoietic stem cell transplant recipients with impaired cellular immunity.

Background

Objectives

Study design

Results

Conclusions

Publications

Persistent rhinovirus infection in pediatric hematopoietic stem cell transplant recipients with impaired cellular immunity.

Similar Datasets

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