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目的了解人类疱疹病毒7型(HHV-7)在异基因造血干细胞移植(allo-HSCT)患者的感染现状。方法采集72例 allo-HSCT 患者外周血标本680份以及53例供者标本。采用巢式聚合酶链反应检测供者以及移植前、后患者 HHV-7 DNA 血症。结果 72例患者中有62例(86.1%)移植后至少1次检出 HHV-7 DNA 血症,中位时间为15.6(7～56)d。29例(40.3%)移植后出现持续性HHV-7 DNA 血症。47例接受含抗胸腺细胞球蛋白(ATG)预处理方案的人类白细胞抗原(HLA)配型不合移植或配型相合的非血缘移植患者中持续性 HHV-7血症的发生率为48.9%(23/47),显著高于接受不含 ATG 预处理方案的配型相合移植患者[24%(6/25),P=0.040]。应用糖皮质激素治疗的患者移植后持续性 HHV-7 DNA 血症的发生率为44.6%(39/65),显著高于未接受糖皮质激素治疗的患者[0%(0/7),P=0.037]。HHV-7血症与急性移植物抗宿主病、出血性膀胱炎、巨细胞病毒和人类疱疹病毒6型感染无显著相关性。结论 HHV-7感染在 allo-HSCT 后患者中很常见,且其持续感染与预处理方案中 ATG 和移植后糖皮质激素的应用密切相关。
Objective To understand the status of human herpesvirus type 7 (HHV-7) infection in allo-HSCT. Methods A total of 680 peripheral blood samples from 72 patients with allo-HSCT and 53 donor samples were collected. HNV-7 DNA was detected by nested polymerase chain reaction in the donor and before and after transplantation. RESULTS: Of the 72 patients, 62 (86.1%) had HHV-7 DNA at least once after transplantation, with a median time of 15.6 (7 to 56) days. Twenty-nine patients (40.3%) developed persistent HHV-7 DNA hyperlipidemia after transplantation. The incidence of persistent HHV-7 sera in 47 patients with non-HLA-matched HLA-matched or HLA-matched preconditioning regimens was 48.9% ( 23/47) were significantly higher than those who underwent matched conformal transplantation without ATG [24% (6/25), P = 0.040]. The incidence of persistent HHV-7 DNA haemorrhage in patients treated with glucocorticoids was 44.6% (39/65) after transplantation, significantly higher than those in patients who did not receive glucocorticoid [0% (0/7), P = 0.037]. There was no significant correlation between HHV-7 hyperlipidemia and acute graft-versus-host disease, hemorrhagic cystitis, cytomegalovirus and human herpesvirus 6 infection. Conclusions HHV-7 infection is common in all patients after allo-HSCT, and its persistent infection is closely related to the use of ATG and glucocorticoid in the pretreatment regimen.