RESUMO
Pediatric solid organ transplant (SOT) recipients face a challenging balance between immunosuppression and graft rejection. While Epstein-Barr Virus (EBV) and cytomegalovirus (HCMV) are known contributors to post-transplant lymphoproliferative disease and graft rejection, respectively, the roles of herpesvirus 6 and 7 (HHV6 and HHV7) and the impact of these herpesviruses on cytokine levels remain unclear, leading to gaps in clinical practice. In this associative study, we measured 17 cytokines using a Bio-Plex assay in a meticulously curated plasma sample pool (N = 158) from pediatric kidney and liver transplant recipients over a one-year follow-up period. The samples included virus-negative and virus-positive cases, either individually or in combination, along with episodes of graft rejection. We observed that the elevation of IL-4, IL-8, and IL-10 correlated with graft rejection. These cytokines were elevated in samples where HCMV or HHV6 were detected alone or where EBV and HHV7 were co-detected. Interestingly, latent EBV, when detected independently, exhibited an immunomodulatory effect by downregulating cytokine levels. However, in co-detection scenarios with ß-herpesviruses, EBV transitioned to a lytic state, also associating with heightened cytokinemia and graft rejection. These findings highlight the complex interactions between the immune response and herpesviruses in transplant recipients. The study advocates for enhanced monitoring of not only EBV and HCMV but also HHV6 and HHV7, providing valuable insights for improved risk assessment and targeted interventions in pediatric SOT recipients.
Assuntos
Citocinas , Citomegalovirus , Rejeição de Enxerto , Herpesvirus Humano 6 , Herpesvirus Humano 7 , Transplante de Rim , Transplante de Fígado , Humanos , Transplante de Rim/efeitos adversos , Citocinas/sangue , Citocinas/metabolismo , Criança , Herpesvirus Humano 6/imunologia , Masculino , Feminino , Pré-Escolar , Transplante de Fígado/efeitos adversos , Citomegalovirus/imunologia , Rejeição de Enxerto/virologia , Rejeição de Enxerto/imunologia , Herpesvirus Humano 4/imunologia , Adolescente , Lactente , Infecções por Herpesviridae/virologia , Infecções por Herpesviridae/imunologia , Transplantados , Infecções por Vírus Epstein-Barr/virologia , Infecções por Vírus Epstein-Barr/imunologia , Infecções por Citomegalovirus/virologia , Infecções por Citomegalovirus/imunologia , HerpesviridaeRESUMO
BACKGROUND: Certain clinical manifestations of coronavirus disease (COVID-19) mimic those associated with human herpesvirus (HHV) infection. In this study, we estimated the prevalence of herpesvirus in patients with COVID-19 and determined if coinfection is associated with poorer outcomes and neurological symptoms. METHODS: We analyzed samples of 53 patients diagnosed with COVID-19. The samples were evaluated for the presence of alphaherpesviruses, betaherpesviruses, and gammaherpesviruses, and the viral loads were quantified using quantitative polymerase chain reaction (qPCR) method. RESULTS: Among the patients, in 79.2% had detection at least one type of herpesvirus. HHV-6 (47.2%), cytomegalovirus (43.3%), and HHV-7 (39.6%) showed the highest detection rates. Patients with a high severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) load were more likely to show herpes simplex virus 1 detection (p = 0.037). Among patients coinfected with SARS-CoV-2 and HHVs, 26.4% showed central nervous system-associated neurological symptoms and herpetic manifestations. A statistically significant association was observed between neurological changes and HHV-6 detection (p = 0.034). CONCLUSIONS: The findings showed a high prevalence of herpesvirus in patients with COVID-19. Furthermore, even though SARS-CoV-2 and HHV coinfection was not associated with poorer outcomes, the findings demonstrated the association between neurological symptoms and HHV-6 detection.
Assuntos
COVID-19 , Infecções por Herpesviridae , Herpesviridae , Herpesvirus Humano 6 , Herpesvirus Humano 7 , COVID-19/complicações , Citomegalovirus , Infecções por Herpesviridae/complicações , Infecções por Herpesviridae/epidemiologia , Humanos , SARS-CoV-2RESUMO
Pityriasis rosea (PR) has been manifested in patients suffering from COVID-19 as well as after vaccine protocols against SARS-CoV-2. It has a possible association with the HHV-6B virus (roseola infantum) and can be controlled by antivirals such as acyclovir as well as by the amino acid l-Lysine that showed a positive result in reducing the number of lesions and healing time. The aim of this study was to report a case of PR after a second dose of Oxford-AstraZeneca, the adopted therapy and a brief literature review. A 53-year-old woman, phototype II, presented an erythematous lesion in the posterior right thigh 15 days after the second dose of Oxford-AstraZeneca vaccine. Eight days after the initial injury, new injuries appeared in the calf, buttocks and thighs. The diagnosis was PR with a 5-week eruption cycle. The treatment consisted of the use of l-Lysine, 3 grams loading dose and 500 mg for 30 days and moisturizing/healing lotion, starting 14 days after the herald patch. After the 5th week of the disease cycle, there were no new eruptions and the repair cycle continued for up to 8 weeks leaving some residual skin spots. It is concluded that the patient may be a carrier a latent virus, HHV-6, and the vaccine administration with immune system stimulation, would have activated the possible virus causing PR. l-Lysine helped to control the manifestation by limiting the number of lesions and their location, which were restricted to the legs, thighs and buttocks.
Assuntos
COVID-19 , Herpesvirus Humano 7 , Pitiríase Rósea , Vacinas , Feminino , Humanos , Pessoa de Meia-Idade , Pitiríase Rósea/induzido quimicamente , Pitiríase Rósea/diagnóstico , SARS-CoV-2RESUMO
Pityriasis rosea (PR) is a dermatological disease with an erythemato-papulosquamous manifestation, distributed on the trunk and extremities affecting healthy people, especially children and young people between 10 and 35 years of age. The evolution is 6 to 8 weeks and may remain for 3 to 6 months. It regresses spontaneously and can leave changes in the skin color but reversibly. Acyclovir is indicated to minimize clinical manifestations with the suspected of viral association (HHV-6 and 7). Another group of the human herpesvirus family (HHV-1 and 2), causes herpes simplex that is controlled with the antivirals, including acyclovir, as well as the amino acid L-lysine, both showing positive and similar results in reducing the number of annual manifestations and the healing time of the lesions. The aim of this study is to report a case of PR in a child, to review the literature on the etiopathogenesis of the disease and on the effects of L-lysine as well as another amino acid in the treatment. An 11-year-old girl, phototype II, presented lesions diagnosed as PR. The cycle would be 6 to 8 weeks on average. A solution of L-lysine was prescribed for 30 days, on an empty stomach. After the fourth day of therapy, the cycle of new eruptions was interrupted, initial lesions regressed, accelerating the repair of larger lesions resulting in an improvement of the clinical condition. We concluded that the administration of L-lysine, in therapeutic doses, can be a safe alternative for the PR control.
Assuntos
Herpesvirus Humano 6 , Herpesvirus Humano 7 , Pitiríase Rósea , Aciclovir/uso terapêutico , Adolescente , Criança , Feminino , Humanos , Lisina , Pitiríase Rósea/diagnóstico , Pitiríase Rósea/tratamento farmacológicoRESUMO
Guimarães Os vírus têm sido considerados como importantes patógenos no desenvolvimento de neoplasias em glândulas salivares, dentre estes, destacam-se os Betaherpesvirus humano como o Citomegalovirus humano (HCMV), Herpesvirus humano 6 (HHV-6) e Herpesvirus humano 7 (HHV-7). Os betaherpesvírus são característicos por apresentarem alta prevalência na população mundial, sem apresentar sazonalidade, capazes de causar infecção latente e reativação viral em seus hospedeiros. Devido a detecção destes vírus em amostras de saliva, tem sido proposto em alguns estudos a ação de betaherpesvírus em algumas patogenias de glândulas salivares, como a formação de patogenias nestes órgãos. Neoplasias em glândulas salivares representam cerca de 3-6% de todas as neoplasias de cabeça e pescoço, com incidência mundial anual de aproximadamente 0,4-13,5% por 100.000 indivíduos. Apesar de haver dados de detecção de betaherpesvírus em neoplasias salivares e em amostras de saliva, ainda existem estudos insuficientes que explorem o papel destes vírus nestas patogenias salivares. O objetivo deste estudo foi investigar a presença dos Betaherpesvirus humano (HCMV, HHV-6 e HHV-7) em neoplasias de glândula salivar parafinadas. Um ensaio de qPCR foi realizado para amplificação das regiões U54, U56 e U37 do HCMV, HHV-6 e HHV-7, respectivamente para quantificar a carga viral em 68 amostras parafinadas de lesões salivares. Dentre as 68 amostras processadas, 51,4% eram de mucocele (35/68), 39,7% de adenoma pleomórfico (27/68) e 8,8% de carcinoma mucoepidermoóide (6/68). A detecção de betaherpesvírus nestas lesões foi alta, apresentando maior detecção para HCMV com 52,9%, 47,05% para HHV-6 e 39,7% para HHV-7, possuindo predominância de detecção de betaherpesvírus na lesão do tipo adenoma pleomórfico. Foi observado que 50,0% das amostras apresentaram tripla-infecção por HCMV/HHV-6/HHV-7, sendo detectado 20,0% de coinfecções por HCMV/HHV-6, 20,0% de HCMV/HHV-7 e 10,0% de HHV-6/HHV-7, com coinfecções ocorrendo na lesão do tipo adenoma pleomórfico em maior taxa. A alta detecção de HCMV, HHV-6 e HHV-7 em glândulas salivares, indica que este órgão pode ser possível de sítio de replicação destes vírus
The viruses have been considered as important pathogens in the development of neoplasms in salivary glands, between these, Human betaherpesvirus such as Human cytomegalovirus (HCMV), Human herpesvirus 6 (HHV-6) and Human herpesvirus 7 (HHV-7) stand out. Betaherpesvirus is characteristic because they have a high prevalence in the world population, without presenting seasonality, capable of causing latent infection and viral reactivation in their hosts. Due to the detection of these viruses in saliva samples, the action of betaherpesvirus in some pathogenesis of salivary glands, such as the formation of pathogenesis in these organs, has been proposed in some studies. Salivary gland neoplasms account for about 3-6% of all head and neck neoplasms, with an annual worldwide incidence of approximately 0,4-13,5% per 100,000 individuals. Although there are data for the detection of betaherpesvirus in salivary neoplasms and saliva samples, thereare still insufficient studies exploring the role of these viruses in these salivary pathogeneses. The aim of this study was to investigate the presence of human Betaherpesvirus (HCMV, HHV-6 and HHV-7) in paraffin salivary gland neoplasms. A qPCR assay was performed to amplify the U54, U56 and U37 regions of HCMV, HHV-6 and HHV-7, respectively to quantify the viral load in 68 paraffin samples of salivary lesions. Among the 68 samples processed,51,4%were mucocele (35/68), 39.7% pleomorphic adenoma (27/68) and 8,8% mucoepidermoid carcinoma (6/68). The detection of betaherpesvirus in these lesions was high, presenting higher detection for HCMV with 52,9%, 47,05% for HHV6 and 39,7% for HHV-7, with predominance of detection of betaherpesvirus in the lesion of the pleomorphic adenoma type. It was observed that 50.0% of the samples presented triple-infection by HCMV/HHV-6/HHV-7, and 20.0% of co-infections by HCMV/HHV-6, 20.0% of HCMV/HHV-7 and 10.0% of HHV-6/HHV-7 were detected, with co-infections occurring with higher predominance of pleomorphic adenoma lesion. The high detection of HCMV, HHV-6 and HHV-7 in salivary glands indicates that this organ may be possible from replication site.
Assuntos
Neoplasias das Glândulas Salivares , Betaherpesvirinae , Herpesvirus Humano 6 , Herpesvirus Humano 7RESUMO
BACKGROUND: Human herpesviruses (HHVs) are responsible for a significant number of clinical manifestations in systemic lupus erythematous (SLE) patients. The aim of this study was to determine the frequency of active HHV infections in SLE patients and correlating them with disease activity. METHODS: Serum samples were collected from 71 SLE patients and their DNAs were extracted and analyzed to detect HHV-DNA viruses using the nucleic acid amplification technique. RESULTS: Fifteen out of the 71 (21.1%) patients tested positive for the HHV-DNA virus. Of them, 11/15 HHV-DNA-positive patients (73.3%) had SLE activity index (SLEDAI - Systemic Lupus Erythematosus Disease Activity Index) ≥8 (p = 0.0001). Active HCMV infection was the mostly frequently observed infection, occurring in 6/15 patients (40%). The frequencies of other active viral infections were 22% for HSV-1, 16.7% for HHV-7, and 5.5% for HSV-2. Viral coinfection (two or more viruses detected in the same sample) occurred in three patients (16.7%). Active HHV infections in SLE patients are more frequent in those with active SLE (≥8), who is at high risk of HHV reactivation and HCMV disease. CONCLUSION: Viral surveillance is important to identify active HHV infections that can cause clinical symptoms and other complication in SLE patients.
Assuntos
Infecções por Herpesviridae , Lúpus Eritematoso Sistêmico , Infecções por Citomegalovirus , DNA Viral/análise , Infecções por Herpesviridae/complicações , Herpesvirus Humano 1 , Herpesvirus Humano 4 , Herpesvirus Humano 7 , Humanos , Lúpus Eritematoso Sistêmico/complicaçõesRESUMO
BACKGROUND: The objective was to assess the oral shedding and viremia of human herpesviruses in renal transplant recipients. METHODS: This is a cohort study in which the participants were examined in three different periods: the first within 24 hours before renal transplantation and the second and third ones 15-20 and 45-60 days after the transplantation. Mouthwash and blood samples were collected in each period and then submitted to screening for the presence of eight types of human herpesviruses by using multiplex PCR. RESULTS: HSV-1 and EBV were more frequent in the saliva after renal transplantation, 15- to 20-day period after the transplant. EBV was found in the saliva of 26 (35.6%) patients before renal transplantation and in 56.2% and 46.6% of them, in the 15- to 20-day and 45- to 60-day periods after the transplant, respectively. High detection rates (75.3%-78.1%) were found for HHV-7 despite the lack of significant variations between the study periods. There was no concordance between herpesviruses oral shedding and viremia. CONCLUSION: We concluded that the pattern of excretion of HSV-1 and EBV in saliva is changed immediately after renal transplantation, increasing in the 15- to 20-day period after the transplant surgery. No concordance between herpesviruses oral shedding and viremia was observed.
Assuntos
Infecções por Herpesviridae/diagnóstico , Transplante de Rim/efeitos adversos , Boca/virologia , Transplantados/estatística & dados numéricos , Viremia , Eliminação de Partículas Virais , Adulto , Estudos de Coortes , Citomegalovirus/isolamento & purificação , Infecções por Citomegalovirus/diagnóstico , Infecções por Citomegalovirus/virologia , Feminino , Herpesviridae/isolamento & purificação , Herpesvirus Humano 1/isolamento & purificação , Herpesvirus Humano 4/isolamento & purificação , Herpesvirus Humano 7/isolamento & purificação , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Saliva/virologia , Carga ViralRESUMO
INTRODUCTION: Human herpesvirus (HHV)-7 establishes a latent infection during the lifetime of the host and can reactivate after the primary infection, leading to lytic replication in immunosuppressed patients. METHODS: This study aimed to develop an enzyme-linked immunosorbent assay (ELISA) to identify HHV-7 serum antibodies and compare its performance with that of an indirect immunofluorescence assay (IFA). RESULTS: Serum samples (n=102) were tested by IgG-IFA and by ELISA. IFA and ELISA showed IgG-positive results in 77 and 73 samples, respectively. Qualitative concordance of 96% was demonstrated between the two techniques. CONCLUSIONS: ELISA may be useful to diagnose HHV-7 infection.
Assuntos
Anticorpos Antivirais/sangue , Herpesvirus Humano 7/imunologia , Imunoglobulina G/sangue , Infecções por Roseolovirus/diagnóstico , Ensaio de Imunoadsorção Enzimática , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Curva ROC , Sensibilidade e EspecificidadeRESUMO
OBJECTIVES: This study was performed to characterise oral shedding of herpesviruses in patients who underwent allogeneic hematopoietic stem cell transplantation (alloHSCT) and to investigate its relationship with oral mucositis (OM). MATERIALS AND METHODS: PCR and enzymatic digestion were conducted to identify oral shedding of herpesviruses and its correlation with OM development in 31 patients. The samples were collected at three sites in the oral cavity and at 5 times during follow-up; two additional collections were made from patients who developed ulcerative OM. RESULTS: HSV-1, EBV, CMV, HHV-6A, HHV-6B, and HHV-7 were detected in 4.97%, 16.02%, 4.41%, 2.20%, 3.31%, and 68% of the oral mucosal samples, respectively; 4.41%, 16.57%, 5.52%, 2.20%, 5.52%, and 63.53% of supragingival samples, respectively, and 4.41%, 18.23%, 2.76%, 1.65%, 2.75%, and 35.91% of subgingival samples, respectively. OM was diagnosed in 13 patients. The presence of HHV-7 in C1 (oral mucosa: p = 0.032) and C2 (supragingival: p = 0.009; subgingival: p = 0.002) was significantly increased in patients who developed OM, and patients exhibiting HHV-7 shedding in the oral cavity were 3.32-fold more likely to develop OM. CONCLUSIONS: Patients who developed OM showed higher HHV-7 shedding in the oral cavity at nadir (immediately prior to OM development), suggesting modifications to the inflammatory microenvironment. CLINICAL RELEVANCE: HHV-7 may be involved in oral dysbiosis in HSCT-related OM; enhanced understanding of its role in the pathogenesis of OM may lead to the development of strategies for managing and preventing this common side effect of alloHSCT.