Rapid diagnosis of human herpesvirus primary infections or reactivations is facilitated by quantitative PCRs. Quantitative PCR assays with a standard thermal cycling profile permitting simultaneous detection of herpes simplex virus (HSV), varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), and human herpesvirus 6 (HHV6) DNA were developed and validated for diagnostic use. High specificity and sensitivity were achieved and the new PCR assays correlated well with commercial PCR assays. Twenty two thousand eight hundred sixty eight PCR tests were undertaken on specimens obtained from immunosuppressed patients. DNAemia was frequent with EBV (43.5%), HHV6 (32.4%), CMV (12.8%), and VZV (12.9%). As already described for EBV and CMV, high virus loads of HHV6 and VZV were associated with clinical symptoms and poor clinical outcome, for example, three of four patients with VZV virus loads >10(5) copies/ml died. A high proportion of lower respiratory specimens was positive for EBV- (38.8%), HHV6- (29.4%), and CMV-DNA (18.2%). For CMV, infection was confirmed in 66.7% of patients by virus isolation or positive pp65 antigenaemia. Differentiation of HHV6A, -B and HSV-1, -2 by melting curve analysis revealed that HHV6A and HSV-2 represented only 1.8% and 3.3% of all positive specimens, respectively. In conclusion, these results indicate significant improvements for the early diagnosis of primary infections or reactivations of five human herpesviruses especially in immunosuppressed patients. Detection of coinfections with multiple herpesviruses is facilitated. Quantitative results enable monitoring of virus load during antiviral therapy. A standard thermal cycling profile permits time and cost effective use in a routine diagnostic setting.
Hepatitis B infection after heart transplantation leads to chronic liver disease in the majority of the affected patients, causing cirrhosis in more than 55% within the first decade after transplantation. Liver failure is a common cause of death in the infected group of patients. Active HBV vaccination is mandatory for all organ transplant candidates, in particular before heart transplantation.
Famciclovir improves not only biochemical and virological features but also hepatic inflammation and liver fibrosis in patients with chronic hepatitis B under heavy immunosuppression. Virological breakthrough may develop and requires close monitoring.
The decomposition of magnesium chIoride hexahydrate was followed by differential thermal analysis and thermogravimetry in combination with evolved gas analysis 9 The examinations were carried out by means of a Q-derivatograph (temperature range 20-400 ~ ; pressure 1 bar) under quasiisothermal and dynamic heating conditions, with variation of the crucible type. The temperatures of the stepwise decomposition of HzO and HC1 are influenced by the partial pressures of HzO and HC1. Depending on the conditions, it is possible to remove 2 moles of water from solid MgClz " 6 H20 or from a melt in a nonisothermal step. Under quasiisobaric conditions MgCle 9 4 H20 is transformed in isothermal steps to MgCI 2 " 2 H20 and stable basic magnesium chlorides.Der thermische Abbau von MgC12 9 6 H20 ist ein komplexer ProzeB, der im Untersuchungsgebiet bis 400 ~ fiber Hydratstufen zu basischen Magnesiumchloriden ffihrt [1,5,10]. Bei thermoanalytischen Untersuchungen werden unter temperaturdynamischen Bedingungen vier, mit Masseabgabe verbundene endotherme Reaktionen gefunden. Wfihrend die Reaktionen 1 und 2 unter H20-Abspaltung zu MgC12 " 9 4 H20 und MgCI,) 9 2 H20 ffihren, entstehen im Verlauf der Reaktionen 3 und 4 infolge gleichzeitiger HC1-Abspaltung basische Magnesiumchloride [3]. Aufheizgeschwindigkeit, Art und Druck der Gasatmosphfire beeinflussen die Temperatur der Teilreaktionen und den Abbaugrad besonders im Gebiet der entstehenden basischen Magnesiumchloride [1-4], weshalb diesbeztigliche Angaben in der Literatur teilweise differieren. Einheitlichkeit besteht in der Interpretation eines zusfitzlichen DTA-Effektes bei 117 ~ als Bildung einer inkongruenten Schmelze durch Abspaltung yon 2 mol Wasser pro 1 mol MgC12 " 6 H20 und Entstehen einer ges/ittigten MgC12-L6sung mit MgC12 " 4 H20 als BodenkSrper [2,3,4,9,11,12]. Bei Untersuchung unter niedrigem H20 HC1-Partialdruck fiber der Substanz im offenen Tiegel ist der Schmelzvorgang der ersten Dehydratationsstufe fiberlagert [2, 3], unter hSheremH20-HC1-Partialdruck, zum Beispiel unter <
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