Quantitative Detection of Epstein-Barr Virus in Bronchoalveolar Lavage From Transplant and Nontransplant Patients

Costa, Cristina; Elia, Mariateresa; Astegiano, Sara; Sidoti, Francesca; Terlizzi, Maria Elena; Solidoro, Paolo; Botto, Sara; Libertucci, Daniela; Bergallo, Massimiliano; Cavallo, Rossana

doi:10.1097/tp.0b013e3181890415

Cited by 38 publications

(27 citation statements)

References 39 publications

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“…Although cytomegalovirus (CMV) is a known cause (21,22), other members of this family may cause pneumonia in both healthy and immunocompromised individuals (3,23,24). Patients with acute respiratory distress syndrome (ARDS) and acute lung injury (ALI) or viral pneumonia of unknown etiology should be examined for HHVs (1,24).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Human Herpes Viruses in Bronchoalveolar Lavage of Critically Ill Children Undergoing Mechanical Ventilation at a Pediatric Intensive Care Unit

Amanati

Karimi

Fahimzad

et al. 2018

Arch Pediatr Infect Dis

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Background: Critically ill children at the intensive care unit frequently develop hospital-acquired pneumonia (HAP). Human herpes viruses (HHVs), primarily or by reactivation may cause bronchopneumonitis in mechanically ventilated patients. The exact prevalence and role of HHVs in morbidity and mortality of pediatric patients undergoing mechanical ventilation is unclear. The current study was conducted to evaluate the prevalence of 5 Herpes viruses by polymerase chain reaction (PCR) method in bronchoalveolar lavage (BAL) samples in critically ill children at a pediatric intensive care unit (PICU). Methods: Overall, 140 bronchoalveolar lavage samples from 83 mechanically ventilated cases were studied. Samples were taken via the mini-BAL technique. Samples were analyzed by qualitative PCR for detection of herpes simplex virus type 1 and 2 (HSV1/HSV2), human herpes virus type 6 and 7 (HHV6/HHV7), Ebstein-Barr virus (EBV), and cytomegalovirus (CMV).

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Section: Introductionmentioning

confidence: 99%

Prevalence of Human Herpes Viruses in Bronchoalveolar Lavage of Critically Ill Children Undergoing Mechanical Ventilation at a Pediatric Intensive Care Unit

Amanati

Karimi

Fahimzad

et al. 2018

Arch Pediatr Infect Dis

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“…Several works have reported the detection of EBV DNA in the lower respiratory tract or in the blood of intensive care unit (ICU) patients without showing specific pathogenesis except inflammation. [10,11] During reactivation, EBV produces an interleukin-10 (IL-10) homolog, which is able to disturb the immune response, particularly, the activity of natural killer (NK) and CD4+ T cells. [12] EBV also produces proteins that impair the production of cytokines such as interferon, mainly during the lytic phase.…”

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confidence: 99%

Epstein-Barr virus reactivation in critically ill immunocompetent patients

et al. 2015

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O ver the past years, particular attention has been given to herpes virus reactivations among immunocompetent critically ill patients. Although the true pathogenicity of these reactivations is still debated, some authors have hypothesized that it could be related to specific immune failure caused by sepsis or multi-organ failure. Others have argued that it is only a marker of severity. There is increasing evidence that reactivation of cytomegalovirus (CMV) and herpes simplex virus (HSV) is associated with mortality or morbidity, mainly for ventilator-acquired pneumonia. [1,2] CMV seroprevalence ranges from 40% to 95% depending on several factors, including age and geographic area. HSV1 seroprevalence is around 65% among the French population. Epstein-Barr virus (EBV) reactivation has been well docu- Original Article Epstein-Barr Virus Reactivation in Critically IllImmunocompetent Patients Background: Herpes viruses can be reactivated among immunocompetent patients in intensive care unit (ICU). Cytomegalovirus (CMV) and herpes simplex virus (HSV) have been the most studied. We hypothesized that Epstein-Barr virus (EBV) could also be reactivated in immunocompetent patients during their stay in ICU and that this would be associated with morbidity and mortality. Methods:This prospective observational study included 90 patients with an ICU stay of ≥ 5 days. CMV and HSV were considered when clinically suspected and DNA was researched in blood or bronchoalveolar lavage (BAL). EBV DNA viral quantification was performed in the blood samples. Results:EBV DNA was detected in blood of 61 patients (median length for positivity of 7.5 days). CMV DNA was detected in blood of 16 patients (median length for positivity of 13.5 days) and BAL of 6 patients. HSV1 DNA was detected in the BAL of 28 patients (median length for positivity of 7.5 days). Nineteen patients had no viral reactivation, 1 experienced only CMV, 32 had only EBV, 5 had only HSV, 6 had EBV and CMV, 14 had EBV and HSV, and 9 patients reactivated three viruses. Mortality was higher among patients with EBV reactivation (33/61 vs. 7/25, p = 0.02). Length of stay (21 vs. 10 days, p < 0.001) and length of mechanical ventilation (15 vs. 7 days, p < 0.001) were higher among patients with EBV reactivation. Conclusions: This study shows that EBV DNA is detected in blood of diverse ICU patients with ≥ ≥ 5 days of stay and that it is associated with morbidity and mortality. Larger dynamic prospective studies are needed to correlate viral reactivation with immune system evolution during ICU stay and to determine the role of polyviral reactivations. (Biomed J 2015;38:70-76)

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“…It was demonstrated that the lower respiratory tract might represent a major reservoir for EBV [19]. Furthermore, EBV genomes were detected frequently in broncheoalveolar lavages obtained from 100 immunocompromised and 94 immunocompetent patients [17]. However, several authors reported a diVuse severe pneumonia occurring as a rare complication of EBV primary infection in adults [20,21].…”

Section: Discussionmentioning

confidence: 97%

“…The implication of EBV to infections of the lower respiratory tract is still unclear [17]. It was demonstrated that the lower respiratory tract might represent a major reservoir for EBV [19].…”

Section: Discussionmentioning

confidence: 99%

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Epstein-Barr virus-associated pneumonia and bronchiolitis obliterans syndrome in a lung transplant recipient

Krumbholz

Sandhaus

Göhlert

et al. 2010

Med Microbiol Immunol

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We report the case of a 25-year-old lung and liver transplant recipient who developed respiratory failure. High levels of Epstein-Barr virus (EBV) genome copies were detectable in respiratory tract specimens, while the search for various other viral, bacterial or fungal pathogens remained empty. Post-transplant lymphoproliferative disease was excluded. Due to the rapid progression of respiratory insufficiency, a re-transplantation of the lung was performed. EBV-encoded small RNAs could be demonstrated by in situ hybridization within pneumocytes and lymphocytes of the explanted lung tissue. The clinical situation improved soon after re-transplantation, and the EBV load detected in the lower respiratory tract decreased significantly.

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Quantitative Detection of Epstein-Barr Virus in Bronchoalveolar Lavage From Transplant and Nontransplant Patients

Cited by 38 publications

References 39 publications

Prevalence of Human Herpes Viruses in Bronchoalveolar Lavage of Critically Ill Children Undergoing Mechanical Ventilation at a Pediatric Intensive Care Unit

Prevalence of Human Herpes Viruses in Bronchoalveolar Lavage of Critically Ill Children Undergoing Mechanical Ventilation at a Pediatric Intensive Care Unit

Epstein-Barr virus reactivation in critically ill immunocompetent patients

Epstein-Barr virus-associated pneumonia and bronchiolitis obliterans syndrome in a lung transplant recipient

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