ABSTRACT
PURPOSE: In Cuba, viral monitoring in the post-transplant period was not routinely performed. The aim of this research is to identify the most frequent viruses that affect transplanted Cuban children, by implementing a viral follow-up during the post-transplant period. METHODS: The study population included all Cuban pediatric patients who underwent solid organ transplantation (SOT) between November 2009 and December 2012. A total of 34 transplanted pediatric patients of kidney (n = 11) and liver (n = 23) were prospectively monitored during a 34-week period for viral DNAemia and DNAuria by simultaneous detection of cytomegalovirus (CMV), Epstein-Barr virus, herpes simplex virus type 1 and 2, varicella zoster virus, human herpesvirus 6, human adenovirus, and polyomaviruses (BKV and JCV) using quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS: Viral genome of at least one virus was detected in 21 of 34 recipients, 18 patients excreted virus in urine while 12 presented DNAemia. CMV (41.2%) and BKV (35.3%) were the most frequent viruses detected during the follow-up. CMV was the virus mainly associated with clinical symptoms and DNAemia. Its excretion in urine (with cut off value of 219 copies/mL) was associated with detection in plasma (p < 0.001); furthermore, CMV viruria was predictive of CMV viremia (OR:8.4, CI:2.4-29.1, p = 0.001). There was no association between high viral load and clinical complications, due to the prompt initiation of preemptive ganciclovir. CONCLUSION: This comprehensive viral monitoring program effectively prevents the development of critical viral disease, thus urge the implementation of qRT-PCR as routine for viral monitoring of transplanted Cuban organ recipients.
ABSTRACT
We investigated the frequency of BKV, JCV and SV40 reactivation in three groups of Cuban patients by multiplex nested PCR assay of 40 paraffin-embedded colorectal neoplasm tissues, 113 urine samples, and 125 plasma samples from 27 transplant recipients, and cerebrospinal fluid (CSF) from 67 HIV-1-infected individuals with central nervous system (CNS) disorders. None of these polyomaviruses were detected in colorectal neoplasms. JCV DNA was detected in 2 of 67 patients (2.9%) with CNS disorders, but neither BKV nor SV40 was identified. BKV was found in urine from 38.5% and 28.6% of adult and pediatric transplant recipients, respectively. In adult renal transplant recipients, excretion of BKV in urine was significantly associated with episodes of acute rejection (p=0.012) and with excretion of HCMV in urine (p= 0.008). In Cuba, the polyomaviruses studied here could not be related to colorectal neoplasms, and JCV was rarely detected in CSFs of HIV-1-infected individuals, whilst BKV reactivation was found to occur frequently in organ transplant recipients.
Subject(s)
BK Virus/isolation & purification , JC Virus/isolation & purification , Polyomavirus Infections/virology , Simian virus 40/isolation & purification , Tumor Virus Infections/virology , Adult , BK Virus/genetics , BK Virus/physiology , Cuba , Female , Humans , JC Virus/genetics , JC Virus/physiology , Male , Middle Aged , Simian virus 40/genetics , Simian virus 40/physiology , Young AdultABSTRACT
Se realizó un estudio de lípidos sanguíneos en 25 pacientes con leucemia mieloide crónica (LMC) (12 hombres y 13 mujeres), y en todos se determinó colesterol total, triglicéridos, fosfolípidos, lípidos totales y colesterol unidos a las lipoproteínas de densidad alta (LDA) densidad baja (LDB) y densidad muy baja (LDMB). Se informó que en los hombres con LMC se encontró una disminución significativa del colesterol total, colesterol unido a las LDB, lípidos totales y fosfolípidos. En las mujeres con LMC sólo se observó disminución de los fosfolípidos. El estudio evolutivo del colesterol en tres hombres con LMC mostró disminución del colesterol unido a las LDB y aumentó en las LDMB en correspondencia con el incremento de los leucocitos (AU)
Subject(s)
Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Lipids/blood , Lipoproteins , Cholesterol , Phospholipids , TriglyceridesABSTRACT
Se describe un paciente que presentó leucemia de tipo megacariopoyética como fase terminal de una mielofibrosis de evolución acelerada. Se estudió la sangre periférica mediante microscopia óptica y electrónica, y se pudo observar gran cantidad de macroplaquetas dismórficas y células blásticas que por su tamaño, características citoplasmáticas y ausencia de nucléolos, fueron clasificados como micromegacariocitos. Otros hallazgos sobresalientes fue la elevación de la HbF(AU)
