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Villar LM, da Silva LL, do Lago BV, Pereira JG, Guimarães ACS, Mello FCDA, de Paula VS. Could Herpesviridae be the cause of severe acute hepatitis of unknown origin in children? Expert Rev Anti Infect Ther 2024; 22:5-17. [PMID: 38224018 DOI: 10.1080/14787210.2024.2304637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
INTRODUCTION Severe acute hepatitis (SAH) is defined by a severe inflammation of hepatocytes in the liver parenchyma which can lead to an acute liver failure, a clinical condition with high mortality rate that can be triggered by several factors but is usually associated to hepatotropic viruses' infection. In 2022, cases of children with severe acute hepatitis of unknown origin hospitalized in Glasgow, Scotland, were reported. Possible causes of this condition include, but are not limited to, undiagnosed viral (and non-viral) infections, autoimmune hepatitis, drug and/or chemical toxicity, mitochondrial chain respiratory and metabolic disorders. AREAS COVERED Herpesviruses can cause severe acute hepatitis, but little is known about the role and the mechanisms of herpesviruses as a causative agent of this type of hepatitis. We review the role of herpesviruses as causative agent of SAH in children and other possible mechanisms involved in this disease. EXPERT OPINION Differential diagnosis for herpesvirus in SAH should be implemented in all settings. Alternative fluids, such as saliva and dried blood, could be used in the diagnosis to overwhelm the availability of biological specimens at sufficient volume. In the future, genetic studies could also be added to increase the knowledge about severe acute hepatitis in children.
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Affiliation(s)
- Livia Melo Villar
- Viral Hepatitis Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Lucas Lima da Silva
- Viral Hepatitis Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Barbara Vieira do Lago
- Viral Hepatitis Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Jessica Gonçalves Pereira
- Laboratory of Molecular Virology and Parasitology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Ana Carolina Silva Guimarães
- Laboratory of Molecular Virology and Parasitology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Vanessa Salete de Paula
- Laboratory of Molecular Virology and Parasitology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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2
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Pereira JG, Leon LAA, de Almeida NAA, Raposo-Vedovi JV, Fontes-Dantas FL, Farinhas JGD, Pereira VCSR, Alves-Leon SV, de Paula VS. Higher frequency of Human herpesvirus-6 (HHV-6) viral DNA simultaneously with low frequency of Epstein-Barr virus (EBV) viral DNA in a cohort of multiple sclerosis patients from Rio de Janeiro, Brazil. Mult Scler Relat Disord 2023; 76:104747. [PMID: 37267685 DOI: 10.1016/j.msard.2023.104747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 04/18/2023] [Accepted: 04/30/2023] [Indexed: 06/04/2023]
Abstract
Multiple sclerosis (MS) is a chronic neuroinflammatory and neurodegenerative disease of the central nervous system (CNS). The etiology of MS is not well understood, but it's likely one of the genetic and environmental factors. Approximately 85% of patients have relapsing-remitting MS (RRMS), while 10-15% have primary progressive MS (PPMS). Epstein-Barr virus (EBV) and Human herpesvirus 6 (HHV-6), members of the human Herpesviridae family, are strong candidates for representing the macroenvironmental factors associated with MS) pathogenesis. Antigenic mimicry of EBV involving B-cells has been implicate in MS risk factors and concomitance of EBV and HHV-6 latent infection has been associated to inflammatory MS cascade. To verify the possible role of EBV and HHV-6 as triggering or aggravating factors in RRMS and PPMS, we compare their frequency in blood samples collected from 166 MS patients. The presence of herpes DNA was searched by real-time PCR (qPCR). The frequency of EBV and HHV-6 in MS patients were 1.8% (3/166) and 8.9% (14/166), respectively. Among the positive patients, 100% (3/3) EBV and 85.8% (12/14) HHV-6 are RRMS and 14.4% (2/14) HHV-6 are PPMS. Detection of EBV was 1.2% (2/166) and HHV-6 was 0.6% (1/166) in blood donors. About clinical phenotype of these patients, incomplete multifocal myelitis, and optic neuritis were the main CNS manifestations. These are the first data about concomitant infection of these viruses in MS patients from Brazil. Up to date, our findings confirm a higher prevalence in female with MS and a high frequency of EBV and HHV-6 in RRMS patients.
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Affiliation(s)
| | - Luciane A Amado Leon
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute/ Fiocruz, Rio de Janeiro, Brazil
| | | | - Jéssica Vasques Raposo-Vedovi
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro/UNIRIO, Rio de Janeiro, Brazil
| | - Fabrícia Lima Fontes-Dantas
- Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, (UERJ), Rio de Janeiro, Brazil
| | - João Gabriel Dib Farinhas
- Department of Neurology/Reference and Research Center for Multiple Sclerosis and Other Central Nervous System Idiopathic Demyelinating Inflammatory Diseases, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Valéria Coelho Santa Rita Pereira
- Department of Neurology/Reference and Research Center for Multiple Sclerosis and Other Central Nervous System Idiopathic Demyelinating Inflammatory Diseases, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Soniza V Alves-Leon
- Department of Neurology/Reference and Research Center for Multiple Sclerosis and Other Central Nervous System Idiopathic Demyelinating Inflammatory Diseases, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro/UNIRIO, Rio de Janeiro, Brazil.
| | - Vanessa S de Paula
- Laboratory of Molecular Virology, Oswaldo Cruz Institute/ Fiocruz, Rio de Janeiro, Brazil
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3
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Alves ADR, Raposo JV, de Sousa RMP, Cardoso CAA, Costa PKSDF, Araújo JM, Barreiro STA, Bressan CDS, Calvet GA, de Souza RV, Brasil P, Cubel Garcia RDCN, Pinto MA, de Paula VS, Amado LA. Beyond arboviruses: A multicenter study to evaluate differential diagnosis of rash diseases and acute febrile illness cases in Rio de Janeiro, Brazil. PLoS One 2022; 17:e0271758. [PMID: 35905118 PMCID: PMC9337664 DOI: 10.1371/journal.pone.0271758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 07/07/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction
A wide variety of viruses can cause rash diseases (RDs) or acute febrile illness (AFIs) in children, adolescents and adults; however, approximately 19% of RD cases and 40% of AFI cases remain without a defined etiology. Parvovirus B19 (B19V) and herpesvirus infection can also cause RD and/or AFI, and in some risk groups, these infections can become persistent (or latent) and may require hospital treatment. Since these infections do not have mandatory reporting, they can be hidden by other diseases, such as those caused by arboviruses (e.g., dengue virus). In this context, the aim of this study was to pursue the differential laboratory diagnoses of B19V and herpesvirus infections in patients with RD and AFI, without a defined etiology, seen in hospitals and/or reference centers for infectious diseases in Rio de Janeiro.
Methods
A total of 114 participants were enrolled in the study, including 54 children and 60 adults. B19V infection was assessed by real-time PCR (qPCR) and ELISA (anti-B19V IgM and IgG). EBV was assessed through qPCR, and betaherpesviruses (HCMV, HHV-6 and HHV-7) were assessed through multiplex qPCR. Sociodemographic and clinical data were obtained from the medical record data of these participants.
Results
The median age of children with RD was 2 years (interquartile range (IQR): 5), and 55.6% were male. Among adults with AFI, the median age was 38 years (IQR: 21), and 56.7% were female. Regarding RD patients, viral prevalence (and load) were 5.5%(104IU/mL), 3.4%(104IU/mL), 5.5%(104IU/mL) and 11.1%(105IU/mL) for B19V, EBV, HCMV and HHV-6 infection, respectively, and in AFI patients they were 6.6%(105IU/mL), 1.6%(103IU/mL), 3.3%(104IU/mL) for B19V, HCMV and HHV-6, respectively. HHV-7 was not detected in RD or AFI patients.
Conclusion
These results suggest the importance of including B19V and herpesviruses in the differential laboratory diagnoses for patients with RD and AFI, not only for epidemiological purposes but also for the proper management of the patient.
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Affiliation(s)
- Arthur Daniel Rocha Alves
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Jéssica Vasques Raposo
- Laboratório de Virologia Molecular, Instituto Oswaldo cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | | | | | | | | | | | - Clarisse da Silveira Bressan
- Laboratório de Pesquisa Clínica em Doenças Febris Agudas, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Guilherme Amaral Calvet
- Laboratório de Pesquisa Clínica em Doenças Febris Agudas, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Rogério Valls de Souza
- Laboratório de Pesquisa Clínica em Doenças Febris Agudas, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Patrícia Brasil
- Laboratório de Pesquisa Clínica em Doenças Febris Agudas, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | | | - Marcelo Alves Pinto
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Vanessa Salete de Paula
- Laboratório de Virologia Molecular, Instituto Oswaldo cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
- * E-mail:
| | - Luciane Almeida Amado
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
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Carneiro VCDS, Alves-Leon SV, Sarmento DJDS, Coelho WLDCNP, Moreira ODC, Salvio AL, Ramos CHF, Ramos Filho CHF, Marques CAB, da Costa Gonçalves JP, Leon LAA, de Paula VS. Herpesvirus and neurological manifestations in patients with severe coronavirus disease. Virol J 2022; 19:101. [PMID: 35676707 PMCID: PMC9174631 DOI: 10.1186/s12985-022-01828-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/25/2022] [Indexed: 12/14/2022] Open
Abstract
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. Supplementary Information The online version contains supplementary material available at 10.1186/s12985-022-01828-9.
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5
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Lino K, Alves LS, Trizzotti N, Raposo JV, Souza CF, da Silva AA, de Paula VS, Almeida JR. Evaluation of herpesvirus members on hospital admission in patients with systemic lupus erythematous shows higher frequency of Epstein-Barr virus and its associated renal dysfunction. J Bras Nefrol 2022; 44:490-497. [PMID: 35385570 PMCID: PMC9838661 DOI: 10.1590/2175-8239-jbn-2021-0184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/08/2021] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Members of the Herpesviridae family have been described in patients with systemic lupus erythematous (SLE), but the clinical impact on renal function is not well known. METHODS HSV1, HSV2, VZV, EBV, CMV, HHV-6, HHV-7, and HHV-8 were evaluated by molecular biology on admission in blood samples from 40 consecutive SLE patients hospitalized for lupus activity. RESULTS Patients were 90.0% female, 77.5% non-white, with average age of 32.7 ± 13.6 years. We found positivity for EBV (65.0%), CMV (30.0%), HSV-1 (30.0%), HHV-6 (12.5%), and HHV-7 (7.5%). For all viruses, age, SLEDAI, hematological tests, ferritin, LDH, C-reactive protein, and erythrocyte sedimentation rate (ESR) were not significant. However, EBV positivity was a significant factor for higher serum creatinine (3.0 ± 2.8 vs. 0.9 ± 0.8; P = 0.001) and urea (86 ± 51 vs. 50 ± 46; P = 0.03). Moreover, positive cases for EBV only or with combined co-infections (66.7%-CMV; 58.3%-HSV-1) or negative for EBV only were evaluated by Kruskal-Wallis test again showed statistical significance for serum creatinine and urea (both P ≤ 0.01), with posttest also showing statistical differences for renal dysfunction and EBV presence (alone or in combined co-infections). The presence of EBV viral load was also significant for nephrotic-range proteinuria, renal flare, and the need for hemodialysis. CONCLUSION Members of the Herpeviridae family (mainly EBV, HSV-1 and CMV) are common on hospital admission of SLE patients, reaching 65% for EBV, which seems to be associated with renal dysfunction and could reflect a previous association or overlapping disease, which is not well understood.
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Affiliation(s)
- Katia Lino
- Universidade Federal Fluminense, Hospital Universitário Antônio Pedro, Niterói, RJ, Brasil.,Universidade Federal Fluminense, Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Niterói, RJ, Brasil.,Universidade Federal Fluminense, Programa de Pós-graduação em Ciências Médicas, Niterói, RJ, Brasil
| | - Lilian Santos Alves
- Universidade Federal Fluminense, Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Niterói, RJ, Brasil.,Universidade Federal Fluminense, Faculdade de Medicina, Programa de Pós-Graduação em Patologia, Niterói, RJ, Brasil
| | - Natalia Trizzotti
- Universidade Federal Fluminense, Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Niterói, RJ, Brasil
| | - Jessica Vasques Raposo
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Virologia Molecular, RJ, Brasil
| | - Cintia Fernandes Souza
- Universidade Federal Fluminense, Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Niterói, RJ, Brasil.,Universidade Federal Fluminense, Programa de Pós-graduação em Ciências Médicas, Niterói, RJ, Brasil
| | - Andrea Alice da Silva
- Universidade Federal Fluminense, Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Niterói, RJ, Brasil.,Universidade Federal Fluminense, Departamento de Patologia, Niterói, RJ, Brasil.,Universidade Federal Fluminense, Programa de Pós-graduação em Ciências Médicas, Niterói, RJ, Brasil.,Universidade Federal Fluminense, Faculdade de Medicina, Programa de Pós-Graduação em Patologia, Niterói, RJ, Brasil
| | - Vanessa Salete de Paula
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Virologia Molecular, RJ, Brasil
| | - Jorge Reis Almeida
- Universidade Federal Fluminense, Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Niterói, RJ, Brasil.,Universidade Federal Fluminense, Departamento de Medicina Clínica, Niterói, RJ, Brasil.,Universidade Federal Fluminense, Programa de Pós-graduação em Ciências Médicas, Niterói, RJ, Brasil
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6
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Lino K, Alves LS, Raposo JV, Medeiros T, Souza CF, Silva AAD, de Paula VS, Almeida JR. Presence and clinical impact of human herpesvirus-6 infection in patients with moderate to critical coronavirus disease-19. J Med Virol 2021; 94:1212-1216. [PMID: 34647632 PMCID: PMC8662171 DOI: 10.1002/jmv.27392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 09/30/2021] [Accepted: 10/12/2021] [Indexed: 12/28/2022]
Abstract
Human herpesvirus-6 (HHV-6) may cause serious diseases in immunocompromised individuals. SARS-CoV-2/HHV-6 coinfection has been emphasized in previous works, mostly case reports, small series, or epidemiological studies, but few are known about its real clinical outcomes. Here we present a real-world pilot study aiming to understand the frequency and the clinical impact of HHV-6 coinfection in moderate to critically ill patients hospitalized due to COVID-19. SARS-CoV-2 and HHV-6 were evaluated in nasopharyngeal samples at the hospital admission of suspected COVID-19 patients. From 173 consecutive cases, 60 were SARS-CoV-2 positive and 13/60 (21.7%) were HHV-6 positive after identified as the HHV-6B species by a Sanger sequencing. The SARS-CoV-2+/HHV-6+ group was younger but not significant for cardiovascular diseases, diabetes, obesity, and cancer, but significant among therapeutic immunosuppressed patients (as systemic lupus erythematosus and kidney transplant patients). In the medical records, only sparse data on cutaneous or neurological manifestations were found. Biochemical and hematological data showed only a trend towards hyperferritinemic status and lymphopenia. In conclusion, despite the impressive high frequency of HHV-6 coinfection in SARS-CoV-2 positive cases, it did not impact general mortality. We suggest larger future prospective studies to better elucidate the influence of HHV-6 reactivation in cases of COVID-19, designed to specific assessment of clinical outcomes and viral reactivation mechanisms.
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Affiliation(s)
- Katia Lino
- Multiuser Laboratory for Research Support in Nephrology and Medical Sciences, Faculty of Medicine, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Postgraduation Program in Medical Sciences, Faculty of Medicine, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Lilian S Alves
- Multiuser Laboratory for Research Support in Nephrology and Medical Sciences, Faculty of Medicine, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Postgraduation Program in Pathology, Faculty of Medicine, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Jessica V Raposo
- Laboratory of Molecular Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Thalia Medeiros
- Multiuser Laboratory for Research Support in Nephrology and Medical Sciences, Faculty of Medicine, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Postgraduation Program in Pathology, Faculty of Medicine, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Cintia F Souza
- Multiuser Laboratory for Research Support in Nephrology and Medical Sciences, Faculty of Medicine, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Postgraduation Program in Medical Sciences, Faculty of Medicine, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Andrea A da Silva
- Multiuser Laboratory for Research Support in Nephrology and Medical Sciences, Faculty of Medicine, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Department of Pathology, Faculty of Medicine, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Postgraduation Program in Pathology, Faculty of Medicine, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Vanessa S de Paula
- Laboratory of Molecular Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Jorge R Almeida
- Multiuser Laboratory for Research Support in Nephrology and Medical Sciences, Faculty of Medicine, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Department of Clinical Medicine, Faculty of Medicine, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Postgraduation Program in Medical Sciences, Faculty of Medicine, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
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7
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Raposo JV, Spitz N, Dos Santos DCM, Pinto MA, de Paula VS. Triple Infection by Betaherpesviruses (HCMV, HHV-6 and HHV-7) in a Child with Acute Liver Failure. Indian J Pediatr 2021; 88:410-411. [PMID: 33420639 DOI: 10.1007/s12098-020-03633-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Jéssica Vasques Raposo
- Laboratory of Molecular Virology, Oswaldo Cruz Institute/Fiocruz, Oswaldo Cruz Foundation, IOC, Av. Brasil 4365-Manguinhos, Pav. Helio e Peggy Pereira B10, Rio de Janeiro, 21040-360, Brazil
| | - Natália Spitz
- Laboratory of Molecular Virology, Oswaldo Cruz Institute/Fiocruz, Oswaldo Cruz Foundation, IOC, Av. Brasil 4365-Manguinhos, Pav. Helio e Peggy Pereira B10, Rio de Janeiro, 21040-360, Brazil
| | | | - Marcelo Alves Pinto
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute/Fiocruz, Rio de Janeiro, Brazil
| | - Vanessa Salete de Paula
- Laboratory of Molecular Virology, Oswaldo Cruz Institute/Fiocruz, Oswaldo Cruz Foundation, IOC, Av. Brasil 4365-Manguinhos, Pav. Helio e Peggy Pereira B10, Rio de Janeiro, 21040-360, Brazil.
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8
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Raposo JV, Sarmento DJDS, Pinto RBDS, Lopes AO, Gallottini M, Tozetto-Mendoza TR, Braz-Silva PH, de Paula VS. Longitudinal study on oral shedding of human betaherpesviruses 6 and 7 in renal transplant recipients reveals active replication. J Oral Microbiol 2020; 12:1785801. [PMID: 32944150 PMCID: PMC7482732 DOI: 10.1080/20002297.2020.1785801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUNG Roseolovirus latency and persistence in salivary glands that are frequently reactivated after renal transplantation to cause infection have been reported. However, limited information is available on the persistence and excretion of HHV-6 and HHV-7 during and after transplant. METHODS 32 renal transplant recipients were followed up before (T1) and after transplant (T2 and T3) and viral replication (via assessment of mRNA) in oral fluid samples investigated. Roseolovirus DNA was detected and quantified via multiplex qPCR. For evaluation of mRNA replication, positive samples were subjected to nested RT-PCR. RESULTS Viral replication of HHV-7 was significantly increased during T3 (72.9%), compared to the pre-transplant period T1 (25%; McNemar Test, p= 0.001). Analysis of the viral replicative to quantitative ratio disclosed ahigher number of DNA copies (>106) in positive cases of replication (p < 0.001). Astrong positive correlation (Spearman correlation coefficient = 0.781; p< 0.001) was evident between viral quantities of Roseoloviruses. CONCLUSION Our findings consistently suggest that the salivary gland is an important site of active and persistent infection by roseoloviruses. In view of the increasing problem of Roseoloviruses, pre- and post-transplantation, viral surveillance and monitoring of active replication are pivotal steps for effective screening and treatment of renal transplant patients.
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Affiliation(s)
| | | | | | - Amanda Oliveira Lopes
- Instituto Oswaldo Cruz – IOC/FIOCRUZ – Fundação Oswaldo Cruz, Rio De Janeiro, Brasil
| | - Marina Gallottini
- Departamento de Estomatologia, Faculdade de Odontologia da Universidade de São Paulo – FOUSP, São Paulo, SP, Brasil
| | - Tânia Regina Tozetto-Mendoza
- Laboratório de Virologia, Instituto de Medicina Tropical de São Paulo – IMTSP – Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Paulo Henrique Braz-Silva
- Departamento de Estomatologia, Faculdade de Odontologia da Universidade de São Paulo – FOUSP, São Paulo, SP, Brasil
- Laboratório de Virologia, Instituto de Medicina Tropical de São Paulo – IMTSP – Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
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9
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Sarmento DJDS, Tozetto-Mendoza TR, de Souza ACMF, Maciel R, Paiao H, Lima SH, Cristelli M, Pestana JOMDA, Braz-Silva PH, Gallottini M. Herpesviruses oral shedding and viremia in renal transplant recipients: A longitudinal study. Transpl Infect Dis 2020; 22:e13330. [PMID: 32418331 DOI: 10.1111/tid.13330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 04/27/2020] [Accepted: 05/06/2020] [Indexed: 12/27/2022]
Abstract
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.
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Affiliation(s)
| | - Tânia Regina Tozetto-Mendoza
- Laboratory of Virology, School of Medicine, Institute of Tropical Medicine of São Paulo, University of São Paulo, São Paulo, Brazil
| | | | - Rafael Maciel
- Division of Renal Transplantation, Social Institute of Healthcare, Campina Grande, Brazil
| | - Heuder Paiao
- Laboratory of Virology, School of Medicine, Institute of Tropical Medicine of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Silvia Helena Lima
- Laboratory of Virology, School of Medicine, Institute of Tropical Medicine of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Marina Cristelli
- Division of Renal Transplantation, Kidney and Hypertension Hospital, Federal University of São Paulo, São Paulo, Brazil
| | | | - Paulo Henrique Braz-Silva
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.,Laboratory of Virology, School of Medicine, Institute of Tropical Medicine of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Marina Gallottini
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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