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Factors affecting the incidence of viral pneumonia in patients with hematological malignancies


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Abstract

The aim of the study was to analyze clinical significance of herpes viruses DNA monitoring in bronchoalveolar lavage fluid (BALF) of patients with hematological malignancies and pneumonia during or after chemotherapy. Samples of 171 enrolled patients were tested for human cytomegalovirus (CMV) DNA, herpes simplex virus I and II types (HSV) DNA, Epstein-Barr virus (EBV) DNA and human herpes virus 6 type (HV6) DNA. Viral load in BALF was also measured. Factors potentially increasing the rate of reactivation of endogenous herpes viruses have been evaluated. Among them: age of 50 years and over, laboratory sights of immunodeficiency like neutropenia and/or hypogammaglobulinemia, severity of condition/need for admission to ICU. Results. HSV DNA proved the highest detection in BALF frequency. Statistically significant difference for HSV DNA detection rate was obtained (Chi-sq. = 7.65; p = 0.022) for patients with all evaluated factors. HSV 1 and 2 of types were shown to be the most frequently identified viruses. In majority of samples HSV viral load in BALF lies within high values such as 30% and above of ICU patient's BALF samples. In the vast majority of positive samples of DNA the concentration of this virus was in the area of high values (up to 10 copies/ml). Age over 50 years, and also such laboratory signs of immunodeficiency as neutropenia and/or hypogammaglobulinemia had no significant effect on the incidence rate of the development of herpes virus-associated pneumonia. There are no data evaluating the severity of virus-associated pneumonia against the background of immunodeficiency. There is no data describing the severity of the course of herpes virus associated pneumonia in patients with hematological malignancies.


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