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Publisher: Peytchinski Publishing
ISSN: 1312-773X (Online)
Issue: 2018, vol. 24, issue3
Subject Area: Medicine
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DOI: 10.5272/jimab.2018243.2129
Published online: 28 August 2018
Original article
J of IMAB. 2018 Jul-Sep;24(3):2129-2132
INVESTIGATION OF IMMUNOSUPPRESSED PATIENTS FOR THE PRESENCE OF EBV DNA IN REAL TIME PCR
Tsvetelina Kostadinova1
, Liliya Ivanova2, Zhivka Stoykova2, Tatina Todorova3, Liana Gercheva4, Dobromir Staykov5, Denitsa Tsaneva6.
1) Education and Research Sectors of Medical Laboratory Assistant, Medical College, Medical University, Varna, Bulgaria
2) Laboratory of Clinical Virology – University hospital St. Marina, Medical University, Varna, Bulgaria
3) Department of Preclinical and Clinical Sciences, Faculty of Pharmacy, Medical University Varna, Bulgaria
4) Clinic of Hematology at the University Hospital St. Marina, Medical University Varna, Bulgaria
5) Regional Center of Transfusion Hematology - Varna, Bulgaria
6) Department of Microbiology and Virology, Faculty of Medicine, Medical University Varna, Bulgaria.
ABSTRACT:
Epstein-Barr virus (EBV) reactivates during immunosuppression (IS) and immune deficiency. The introduction of stem cell transplantation and the development of transplantology require compliance with criteria for assessing the risk of reactivation of latent viral infections, including EBV. There are no published EBVDNA findings in Bulgaria for such patient groups,
Aim: The aim in this study is to assess the possible benefit of EBV PCR testing in immunosuppressed individuals.
Materials and Methods: We investigated 50 immunosuppressed patients – 28 with various haematological diseases, 17 after kidney transplantationand5 patients with autologous stem cell transplantation (HSCT). Patients were first tested in an indirect ELISA to detect anti-VCA IgM/IgG (Euroimmun, Luebeck, Germany) and then in quantitative PCR (Sacace Biotechnologies S.r.l., Como, Italy).
Results: We found ЕВV DNAin 14.0% (95% CI:5.8% - 26.7%, n=7) of all tested patients. The Real time PCR results were in the range 100-500 copies/ml at the lower limit of the 500 copies/ml test positivity. The highestistheproportionofpatientswithhaematological diseases (21.4%), predominantly with AML.
Conclusion: We found a relatively small proportion of IS patients with detectable EBV DNA. For HSC-transplanted patients, we anticipate probable reactivation or reinfection in one patient, who was anti-VCA IgG positive in the primary study.
Keywords: Epstein-Barr virus, Immunosuppressed patients, Acute myeloid leukaemia, Kidney transplantation, Autologous hematopoietic stem cells transplantation, Real time PCR,
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Please cite this article as: Kostadinova T, Ivanova L, Stoykova Z, Todorova T, Gercheva L, Staykov D, Tsaneva D. Investigation of immunosuppressed patients for the presence of EBV DNA in Real time PCR. J of IMAB. 2018 Jul-Sep;24(3):2129-2132. DOI: 10.5272/jimab.2018243.2129
Correspondence to: Tsvetelina Kostadinova, MD, PhD, Education and Research Sectors of Medical Laboratory Assistant, Medical College, Medical University; 84 Tsar Osvoboditel Blvd., Varna, Bulgaria; E-mail: ckostadinova@abv.bg,
REFERENCES:
1. Martelius T, Lappalainen M, Aalto SM, Nihtinen A, Hedman K, Anttila VJ. Clinical characteristics, outcome and the role of viral load in nontransplant patients with Epstein-Barr viraemia. Clin Microbiol Infect. 2010 Jun;16(6):657-62. [PubMed] [CrossRef]
2. Adler B, Schaadt E, Kempkes B, Zimber-Strobl U, Baier B, Bornkamm GW. Control of Epstein-Barr virus reactivation by activated CD40 and viral latent membrane protein 1. Proc Natl Acad Sci U S A. 2002 Jan 8;99 (1):437-42. [PubMed] [CrossRef]
3. Tsai M-H, Lin X, Shumilov A, Bernhardt K, Feederle R, Poirey R, et al. The biological properties of different Epstein-Barr virus strains explain their association with various types of cancers. Oncotarget. 2017 Feb;8 (6):10238-10254. [PubMed] [CrossRef]
4. De Paschale M, Clerici P. Serological diagnosis of Epstein-Barr virus infection: Problems and solutions. World J Virol. 2012 Feb;1(1):31-43. [PubMed] [CrossRef]
5. Elawad HE, Kafi SK, Elrahman IA, Elzaki SG, Eljaili A, Ornasir ME, et al. The Possible Involvement of Epstein -Barr virus In the Etiology of Leukemia. J Med Microb Diagn. 2014; 4(1):174. [Internet]
6. Tedeschi R, Bloigu A, Ogmundsdottir HM, Marus A, Dillner J, dePaoli P, et al. Activation of maternal Epstein-Barr virus infection and risk of acute leukemia in the offspring. Am J Epidemiol. 2007 Jan 15;165(2):134-7. [PubMed] [CrossRef]
7. Tedeschi R, Luostarinen T, Marus A, Bzhalava D, Ogmundsdottir HM, Dillner J, et al. No risk of maternal EBV infection for childhood leukemia. Cancer Epidemiol Biomarkers Prev. 2009 Oct;18(10):2790-2. [PubMed] [CrossRef]
8. Ogata M, Satou T, Kawano R, Yoshikawa T, Ikewaki J, Kohno K, et al. High incidence of cytomegalovirus, human herpesvirus-6, and Epstein-Barr virus reactivation in patients receiving cytotoxic chemotherapy for adult T cell leukemia. J Med Virol. 2011 Apr;83(4):702-9. [PubMed] [CrossRef]
9. Scheinberg P, Young NS, Barrett J. Response: EBV reactivation in the immunosuppressed: to treat or not to treat? Blood.2008; 111(3):1739-40. [CrossRef]
10. Taylor AL, Marcus R, Bradley JA. Post-transplant lymphoproliferative disorders (PTLD) after solid organ transplantation. Crit Rev Oncol Hematol. 2005 Oct;56(1):155-67. [PubMed] [CrossRef]
11. Caillard S, Lamy FX, Quelen C, Dantal J, Lebranchu Y, Lang P, et al. Epidemiology of Posttransplant Lymphoproliferative Disorders in Adult Kidney and Kidney Pancreas Recipients: Report of the French Registry and Analysis of Subgroups of Lymphomas. Am J Transplant. 2012 Mar;12(3):682-93. [PubMed] [CrossRef]
12. Mynarek M, Schober T, Behrends U, Maecker-Kolhoff B. Posttransplant lymphoproliferative disease after pediatric solid organ transplantation. Clin Dev Immunol. 2013;2013:814973. [PubMed] [CrossRef]
13. Kostadinova Ts, Ivanova L, Raykov T, Stojkova Z, Tsankova G. Seroprevalence of Epstein-Barr Virus in North-Eastern Bulgaria. Acta Microbiol Bul. 2016,32: 33-38.
14. Styczynski J, Gil L, Tridello G, Ljungman P, Donnelly JP, van der Velden W, et al. Response to rituximab-based therapy and risk factor analysis in Epstein Barr Virus-related lymphoproliferative disorder after hematopoietic stem cell transplant in children and adults: a study from the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Clin Infect Dis. 2013 Sep;57(6):794-802. [PubMed] [CrossRef]
15. Gulley M, Tang W. Using Epstein-Barr Viral Load Assays To Diagnose, Monitor, and Prevent Posttransplant Lymphoproliferative Disorder. Clin Microbiol Rev. 2010 Apr;23(2),350-66. [PubMed] [CrossRef]
16. Allen U, Alfieri C, Preiksaitis J, Humar A, Moore D, Tapiero B, et al. Epstein-Barr virus infection in transplant recipients: Summary of a workshop on surveillance, prevention and treatment. Can J Infect Dis. 2002 Mar;13(2):89-99. [PubMed]
17. Styczynski J, Reusser P, Einsele H, de la Camara R, Cordonnier C, Ward KN, et al. Management of HSV, VZV and EBV infections in patients with hematological malignancies and after SCT: guidelines from the Second European Conference on Infections in Leukemia, for the European Conference on Infections in Leukemia. Bone Marrow Transplant. 2009 May;43(10):757-70. [PubMed] [CrossRef]
18. Styczynski J, van der Velden W, Fox CP, Engelhard D, de la Camara R, Cordonnier C, et al. Management of Epstein-Barr Virus infections and post-transplant lymphoproliferative disorders in patients after allogeneic hematopoietic stem cell transplantation: Sixth European Conference on Infections in Leukemia (ECIL-6) guidelines. Haematologica. 2016 Jul;101(7):803-11. [PubMed] [CrossRef].
Received: 22 May 2018
Published online: 28 August 2018