Epstein-Barr virus and cytomegalovirus infections and their clinical relevance in Egyptian leukemic pediatric patients

Abstract

BackgroundEpstein-Barr virus (EBV) and human cytomegalovirus (CMV) infections are environmental risk factors affecting the outcome of cancer due to an impairment in the cell-mediated immunity. Therefore, this study aimed to detect the frequency of EBV and CMV DNA and their association with clinical characteristics and outcome of pediatric leukemic patients.MethodsSamples of 50 immunocompromised pediatric leukemic patients and 30 apparently healthy children were subjected to the amplification of EBV DNA by one version of PCR targeting the Bam H1 W region of the genomic region of EBV, and the amplification of CMV DNA by targeting the CMV UL97 genomic region by a second round PCR. All investigations were performed on WBCs and sera. Results were correlated with the clinical and laboratory characteristics of the disease, and with overall survival.ResultsEBV and CMV DNA were detected in 20 and 54% of leukemic patients, respectively. Nine out of ten patients with EBV DNA (90%) were positive for CMV DNA in their sera. The presence of EBV DNA or CMV DNA was associated with neutropenia and a low total leukocyte count (TLC) (p = 0.02, 0.03, respectively). The presence of severe CMV disease, longer duration of febrile neutropenia, neutropenia, lymphopenia, thrombocytopenia and the presence of EBV DNA in patients’ sera were significantly associated with worse overall survival.ConclusionThe detection of CMV disease and EBV DNA is relatively common in leukemic children and is significantly associated with a decline in the overall survival.

Trend and seroprevalence of Epstein–Barr virus in Bahrain: 2001–2015

“…Hospitalization itself is a form of stress, which in turn could stimulate reactivation of herpesviruses including EBV (23). A strong relation was found in a study between cytomegalovirus super-infection and EBV reactivation leading the authors to suggest that cytomegalovirus might be an important co-factor in EBV pathogenesis, especially in immunocompromised patients (24). There were 3 cases of malaria infection preceding reactivation of EBV in our study.…”

Cytomegalovirus and Epstein-Barr Infections: Prevalence and Impact on Patients with Hematological Diseases

“…Another study detected EBV and CMV coinfection in pediatric patients with leukemia. The researchers noted a borderline association with worse overall survival, indicating that EBV and CMV infections may act upon the prognosis and the survival rates of these patients [ 62 ]. In HIV-1 seropositive patients from India, Patekar et al (2015) [ 63 ] ascertained that patients with high antibody titers against EBV/CMV exhibited the lower T cell CD4+ counts (less than 200 cells/mm 3 ).…”

“…Loutfy et al (2017) [ 62 ] found EBV or CMV DNA in 56% of pediatric patients with leukemia, who showed an EBV/CMV coinfection rate of 18%. Nevertheless, as the number of EBV/CMV coinfected patients was small, no statistical association between coinfection and leukemia severity was found.…”

Prevalencia del virus de Epstein-Barr en niños con leucemia del Estado de Chiapas, México

“…La detección de la enfermedad por CMV y ADN del VEB es relativamente común en niños con leucemia y se asocia significativamente con una disminución en la supervivencia general 14 . El VEB afecta a las células B; consideramos que el resultado obtenido es consecuencia de un segundo «golpe» derivado de la inmunosupresión por la enfermedad, conduciendo a la reactivación del virus.…”