肾移植受者巨细胞病毒、单纯疱疹和水痘带状疱疹感染的血清学随访。

C Merlino
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摘要

本文对肾移植受者巨细胞病毒(CMV)、单纯疱疹病毒(HSV)和水痘-带状疱疹病毒(VZV)感染的血清学特征进行了研究。移植时cmv血清阳性率为88.2%。在研究结束时,原发性cmv感染的频率为58.3%,复发性感染(再感染或再激活)的频率为84.4%。57.1%的原发感染和64.5%的复发感染发生在移植后1 ~ 3个月。复发感染与免疫抑制治疗类型(CyA vs. Triple)之间没有相关性。接受同一名巨细胞病毒血清阳性供者肾脏的患者中,70%的患者反应相同:要么没有任何感染,要么都有活跃的巨细胞病毒感染。排斥反应与活跃的巨细胞病毒感染之间没有相关性。单纯疱疹病毒血清阳性率为96.2%。血清阳性患者未发生原发性单纯疱疹病毒感染,再激活率为31.4%。排斥反应与活跃的单纯疱疹病毒感染之间也没有相关性。移植时vzv感染血清阳性率为90%。未发生原发性vzv感染。在研究过程中,血清阳性患者的vzv抗体滴度出现变化,恢复到初始值。6%的患者在移植后第3个月和第9个月出现带状疱疹的临床症状,并经血清学证实。
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[Serologic follow-up of cytomegalovirus, herpes simplex and varicella-zoster infections in kidney transplant recipients].

In the present paper the characteristics of cytomegalovirus (CMV), herpes simplex virus (HSV) and varicella-zoster virus (VZV) infections were serologically investigated in renal transplant recipients. At transplantation CMV-seropositivity was 88.2%. At the end of the study, the frequency of primary CMV-infections was 58.3% and the frequency of recurrent infections (reinfections or reactivations) was 84.4%. The 57.1% of primary infections and the 64.5% of recurrent infections occurred between the first and the third month after transplantation. There was no correlation between recurrent infections and type of immunosuppressive treatment (CyA vs. Triple). The 70% of pairs of patients who received a kidney from the same CMV-seropositive donor reacted in the same way: or neither had any infection or both had active CMV-infection. There was no correlation between rejection and active CMV-infection. HSV-seropositivity was 96.2%. Primary HSV-infections didn't occur and the frequency of reactivation in seropositive patients was 31.4%. No correlation was found between rejection and active HSV-infection as well. As regards VZV-infection, seropositivity at transplantation was 90%. Primary VZV-infections didn't occur. During the study, seropositive patients showed variations in VZV-antibody titers which returned to initial values. Clinical signs of zoster were observed in 6% of patients at third and ninth month after transplantation and were serologically confirmed.

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