Title |
Herpesvirus-Associated Central Nervous System Diseases after Allogeneic Hematopoietic Stem Cell Transplantation
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Published in |
PLOS ONE, October 2013
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DOI | 10.1371/journal.pone.0077805 |
Pubmed ID | |
Authors |
Meiqing Wu, Fen Huang, Xinmiao Jiang, Zhiping Fan, Hongsheng Zhou, Can Liu, Qianli Jiang, Yu Zhang, Ke Zhao, Li Xuan, Xiao Zhai, Fuhua Zhang, Changxin Yin, Jing Sun, Ru Feng, Qifa Liu |
Abstract |
Herpesvirus infections of the central nervous system (CNS) are associated with encephalitis/myelitis and lymphoproliferative diseases in immunocompromised individuals. As of now, data of herpesvirus-associated CNS diseases in transplant recipients is limited. Hence, in this prospective study, we investigated the incidence of herpesvirus-associated CNS diseases and explored the diagnosis of these diseases in 281 allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Herpesvirus-DNA and cerebrospinal fluid (CSF) cells were sampled from 58 recipients with herpesvirus-associated diseases or with unexplainable CNS manifestations. Results showed that 23 patients were diagnosed as herpesvirus-associated CNS diseases, including 15 Epstein-Barr virus (EBV)-associated diseases (4 encephalitis and 11 lymphoproliferative diseases), 5 herpes simplex virus type 1 encephalitis, 2 cytomegalovirus encephalitis/myelitis and 1 varicella zoster virus encephalitis. The median time of diseases onset was 65 (range 22-542) days post-transplantation. The 3-year cumulative incidence of herpesvirus-associated encephalitis/myelitis and post-transplant lymphoproliferative disorder (PTLD) was 6.3% ± 1.9% and 4.1% ± 1.2%, respectively. Of the evaluable cases, CSF cells mainly consisted of CD19(+)CD20(+) B cells (7/11) and had clonal rearrangement of immunoglobulin genes (3/11) in patients with CNS-PTLD. On the contrary, in patients with encephalitis/myelitis, CSF cells were comprised of different cell populations and none of the gene rearrangement was detected. Herpesvirus-associated CNS diseases are common in the early stages of allo-HSCT, wherein EBV is the most frequent causative virus. The immunophenotypic and clonal analysis of CSF cells might be helpful in the differential diagnosis between encephalitis and lymphoproliferative diseases. |
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United States | 1 | 50% |
Unknown | 1 | 50% |
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Scientists | 1 | 50% |
Members of the public | 1 | 50% |
Mendeley readers
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United Kingdom | 1 | 3% |
Unknown | 39 | 98% |
Demographic breakdown
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Student > Master | 7 | 18% |
Researcher | 7 | 18% |
Other | 5 | 13% |
Student > Doctoral Student | 5 | 13% |
Student > Bachelor | 3 | 8% |
Other | 3 | 8% |
Unknown | 10 | 25% |
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Immunology and Microbiology | 4 | 10% |
Chemical Engineering | 1 | 3% |
Biochemistry, Genetics and Molecular Biology | 1 | 3% |
Other | 2 | 5% |
Unknown | 13 | 33% |