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Allogeneic Hematopoietic Stem Cell Transplantation and Norovirus Gastroenteritis: A Previously Unrecognized Cause of Morbidity

Roddie, C. ; Paul, J. P. V. ; Benjamin, R. ; Gallimore, C. I. ; Xerry, J. ; Gray, J. J. ; Peggs, K. S. ; Morris, E. C. ; Thomson, K. J. ; Ward, K. N.

Clinical infectious diseases, 2009-10, Vol.49 (7), p.1061-1068 [Revista revisada por pares]

Oxford: The University of Chicago Press

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Allogeneic Hematopoietic Stem Cell Transplantation and Norovirus Gastroenteritis: A Previously Unrecognized Cause of Morbidity
Autor: Roddie, C. ; Paul, J. P. V. ; Benjamin, R. ; Gallimore, C. I. ; Xerry, J. ; Gray, J. J. ; Peggs, K. S. ; Morris, E. C. ; Thomson, K. J. ; Ward, K. N.
Materias: Adolescent ; Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Caliciviridae Infections - epidemiology ; Caliciviridae Infections - virology ; Diarrhea ; Electron microscopy ; Epidemiology ; Feces - virology ; Female ; Gastroenteritis ; Gastroenteritis - epidemiology ; Gastroenteritis - virology ; Genotypes ; Hematopoietic Stem Cell Transplantation - adverse effects ; Human viral diseases ; Humans ; IDSA PUBLIC POLICY ; Immunosuppression ; Infections ; Infectious diseases ; Male ; Medical sciences ; Middle Aged ; Molecular Sequence Data ; Morbidity ; Norovirus ; Norovirus - classification ; Norovirus - genetics ; Norovirus - isolation & purification ; Retrospective Studies ; Reverse transcriptase polymerase chain reaction ; Reverse Transcriptase Polymerase Chain Reaction - methods ; RNA, Viral - genetics ; Sequence Analysis, DNA ; Stem cells ; Studies ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Transplantation, Homologous - adverse effects ; Transplants & implants ; Viral diseases ; Viral diseases of the digestive system ; Viruses ; Vomiting ; Young Adult
Es parte de: Clinical infectious diseases, 2009-10, Vol.49 (7), p.1061-1068
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Descripción: Background.A retrospective study of the clinical, epidemiologic, and virologic features of norovirus gastroenteritis in 12 adult allogeneic hematopoietic stem cell transplant (HSCT) recipients. Methods.Norovirus infection was diagnosed by reverse-transcriptase polymerase chain reaction. Strains were genotyped by nucleic acid sequence of the most highly conserved region of the norovirus gene encoding the capsid S (shell) domain. Results.Ten of 12 patients presented with vomiting of short duration, but diarrhea was present in all. The median time from onset to norovirus diagnosis was 1 month (range, 0.25–6.0 months). Eleven patients were receiving immunosuppression when norovirus infection was diagnosed: 8 for graft-versus-host disease (GVHD) in an organ other than gut, 1 for previous gut GVHD, and 2 for presumed gut GVHD that proved to be norovirus gastroenteritis. Six patients required enteral or parenteral nutrition for severe weight loss. In 10 patients, diarrhea lasted a median of 3 months (range, 0.5–14 months) and virus was shed at a high level throughout. The remaining 2 patients died after 4 months of diarrhea (one died of unrelated complications, and the other died of malnutrition). The noroviruses found were GII (untyped), GII-3, GII-4, and GII-7 in 1, 1, 9, and 1 patients, respectively. Eleven of the 12 patients had acquired their infection in the community. Phylogenetic analysis of the GII-4 strains demonstrated that all differed. Conclusions.Noroviruses are a hitherto unsuspected cause of prolonged morbidity and mortality in adults after allogeneic HSCT. The use of reverse-transcriptase polymerase chain reaction to detect high viral load levels in feces distinguishes norovirus gastroenteritis from gut GVHD.
Editor: Oxford: The University of Chicago Press
Idioma: Inglés

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Allogeneic Hematopoietic Stem Cell Transplantation and Norovirus Gastroenteritis: A Previously Unrecognized Cause of Morbidity

Roddie, C. ; Paul, J. P. V. ; Benjamin, R. ; Gallimore, C. I. ; Xerry, J. ; Gray, J. J. ; Peggs, K. S. ; Morris, E. C. ; Thomson, K. J. ; Ward, K. N.

Oxford: The University of Chicago Press

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