RESUMEN
Having a tropism for erythroid progenitor cells, parvovirus B19 may cause partial red cell aplasia and thrombocytopenia. Early diagnosis of parvovirus B19 infection in immunocompromised patients is needed for timely antiviral therapy. A high-risk group for parvovirus B19 infection includes patients with blood diseases who receive multiple transfusions of blood components; those who have undergone donor organ transplantation and are long taking immunosuppressive drugs; and pregnant women. These patients require careful virological monitoring for major blood-borne viral infections. This paper describes a clinical case of parvovirus B19 infection in a pregnant woman who has undergone kidney transplantation and is continuously taking immunosuppressive medications. Identification of the cause of severe anemia and timely adequate therapy could lead to the recovery of effective erythropoiesis in the patient.
Asunto(s)
Antivirales/uso terapéutico , ADN Viral/análisis , Trasplante de Riñón , Infecciones por Parvoviridae/diagnóstico , Parvovirus B19 Humano/genética , Complicaciones Infecciosas del Embarazo , Adulto , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Fallo Renal Crónico/cirugía , Infecciones por Parvoviridae/tratamiento farmacológico , Infecciones por Parvoviridae/virología , EmbarazoRESUMEN
The mutation V617F of gene JAK2 is detected in 95% of patients with genuine polycythemia, in 50% of patients with essential thrombocytemia and idiopathic myelofibrosis. The mutation V617F can be applied as a molecular marker of response to treatment in patients with chronic myeloproliferative diseases associated with this mutation. The technique of quantitative evaluation of V617F (sensitivity up to 0.01%) using polymerase chain reaction is described. This method can be applied to assess the minimal residual disease in patients with chronic myeloproliferative diseases.
Asunto(s)
Enfermedad Crónica , Janus Quinasa 2/sangre , Mutación , Trastornos Mieloproliferativos/sangre , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Línea Celular , Niño , Estudios de Evaluación como Asunto , Humanos , Janus Quinasa 2/genética , Persona de Mediana Edad , Trastornos Mieloproliferativos/genética , Policitemia/sangre , Policitemia/genética , Mielofibrosis Primaria/sangre , Mielofibrosis Primaria/genética , Trombocitemia Esencial/sangre , Trombocitemia Esencial/genéticaRESUMEN
AIM: To specify trends in clinical and laboratory manifestations of virus hepatitis B and C (HBV and HCV) in patients with blood diseases from the moment of the first positive specific tests for HBV and HCV markers; to assess effects of HBV and HCV infection on efficacy of treatment of blood disease treatment, i.e. lifespan of patients with hematological diseases. MATERIAL AND METHODS: The study enrolled 257 patients: 205 with acute leukemia - AL, 40 with lymphoproliferative diseases, 4 - with CML and 8 - others; 8 healthy bone marrow donors. The patients were admitted to Russian Hematological Research Center in 2004-2006 Follow-up median was 253 days. A total of 7800 biological samples were studied, among them about 4000 tests for HBV DNA and HCV RNA. RESULTS: Positive tests for specific markers of HBV and HCV were absent only in 78 (29.4%) patients. Positive markers of coinfection were detected in 57 (32.8%) of 174 patients with HBV infection and in 81.4% of 70 patients with HCV infection. Probability of detection of HCV markers after positive tests for HBV markers and vice versa is about 3 times higher than probability of their isolated detection. Among patients infected with HBVsymptoms of hepatitis B are likely to appear in 56% patients to day 500 of follow-up from the date of the first positive specific test. Median of the interval between the first positive test for HBV markers and probable clinical signs of hepatitis was 30 days. Among patients with HCV infection, 85% develop hepatitis to follow-up day 300 since the date of the first specific positive test. Almost 100% patients infected with two viruses develop hepatitis to follow-up day 600. Median of the interval between the first positive test for HBV and HCV markers and probable hepatitis picture was 47 days. Overall 3-year survival of AL patients was 40%, of patients with lymphoproliferative diseases - 58%. Overall 7-month survival was 75% in AA patients. HBV infection in patients with blood disease is associated with high risk of death, especially in AA and AL. Association between HCV infection and survival is not proved. CONCLUSION: A high rate of clinical realization of viral hepatitis B and C, especially in coinfection, calls for virological and clinical monitoring of patients with any positive test for HBV and HCV markers.
Asunto(s)
Anemia Aplásica/mortalidad , Hepacivirus/aislamiento & purificación , Virus de la Hepatitis B/aislamiento & purificación , Leucemia/mortalidad , Trastornos Linfoproliferativos/mortalidad , Adolescente , Adulto , Anciano , Anemia Aplásica/tratamiento farmacológico , Anemia Aplásica/virología , Donantes de Sangre/estadística & datos numéricos , Transfusión Sanguínea/estadística & datos numéricos , Supervivencia sin Enfermedad , Femenino , Hepatitis B/sangre , Hepatitis B/virología , Anticuerpos contra la Hepatitis B/sangre , Hepatitis C/sangre , Hepatitis C/virología , Anticuerpos contra la Hepatitis C/sangre , Humanos , Leucemia/tratamiento farmacológico , Leucemia/virología , Trastornos Linfoproliferativos/tratamiento farmacológico , Trastornos Linfoproliferativos/virología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Adulto JovenRESUMEN
In this work a new type of the internal standard for the competitive RT-PCR is proposed: the RNA standard on the basis of the retrovirus vector. The internal standard has been developed for the qualitative and quantitative determination of hepatitis C virus RNA in patients' blood serum. The proposed internal standard consists of recombinant retrovirus particles in the culture medium of packing cells, containing the modified sequence of hepatitis virus C used for amplification in PCR. The presence of the selective marker--the gene of resistance to puromycin--in the vector makes it possible to determine the titer of virus particles of the standard in experiments of infecting cell cultures. The proposed retrovirus standard is obtained from the culture of packing cells by collecting the cultivation medium used for growing these cells. The virus particles thus obtained are not pathogenic for humans and animals.