Abstract
BackgroundActivation of herpes virus 6 (HHV6) has seen in Hodgkin's and non-Hodgkin's Lymphoma (HL&NHL) as a result of lymphoma associated immunosuppression. Multiple studies have suggested an association between both HHV6 and cytomegalovirus CMV for development of CMV disease affecting the pathogenesis of lymphoma. Therefore, this study investigated the frequency of HHV6, its impact on clinical manifestations of lymphoma and its possible association with risk for development of CMV infection in pediatric lymphoma patients.MethodsPresence of HHV6 DNA and CMV DNA was investigated by PCR assay in both WBC's and plasma samples from 50 patients diagnosed with HL or NHL. CMV antibody titer was also determined in sera obtained from each patient. Twenty apparently healthy siblings were used as a control group.ResultsIn a study group of 50 patients diagnosed with HL or NHL, 23/50 (46%) were found to be positive for herpes virus DNA (HHV6 or CMV) in WBC's or plasma by PCR assay and this was significantly higher than its presence in the pediatric control group 2/20 (10%) (p = 0.005). Ten out of these 23 (43%) were found to have active CMV infection. Fifty six percent of patients with CMV infection were found among NHL cases with B- subtype. The presence of both herpes viruses DNA was significantly associated with more frequent episodes of febrile neutropenia (median 3 episodes), absolute neutrophil count (< 0.8), lymphocytes (< 0.5), and low hemoglobin level (< 9.1), (p < 0.05).ConclusionThe presence of HHV6 can be considered as a predicting indicator of cellular immunosuppression preceding the onset of CMV infection which may result in a severe outcome among pediatric lymphoma patients.
Highlights
Human herpesvirus 6 (HHV6) was first reported in 1986, as human B-lymphotropic virus
Name was subsequently changed to human herpesvirus 6 as its tropism was further characterized [1,2] and it was identified as a member of the b family of herpes viruses [3]
Patients This cross sectional study was conducted on 50 pediatric lymphoma patients (Hodgkin’s & Non Hodgkin’s) diagnosed and treated at the Pediatric Oncology Department, National Cancer Institute (NCI), Cairo University between September 2007 and October 2008
Summary
Human herpesvirus 6 (HHV6) was first reported in 1986, as human B-lymphotropic virus. HHV6 shares with other members of the human Herpesviridae family an ability to cause latent infection with reactivation during periods of immunosuppression [5]. HHV6 and CMV share a tropism for cells of the immune system [6] and for induction of immunosuppression [7]. These similarities, Pediatric clinical presentations of HHV-6 infection vary depending upon the age and immune competence of the child. This study investigated the frequency of HHV6, its impact on clinical manifestations of lymphoma and its possible association with risk for development of CMV infection in pediatric lymphoma patients
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