Treatment phasespecific frequency and conditions for developing ТТV and HGV infection in children with new onset acute lymphoblastic leukemia

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Abstract

Currently, it is believed that TTV and HGV display multifaceted activities in developing diverse acute and chronic processes (disorders affecting the liver, respiratory tract, hematopoiesis oncology diseases etc.). Transfusion of contaminated blood and its components contribute in transmission of HGV and TTV infections. In connection with this, examining a role for HGV and TTV in etiological structure of pediatric liver damage in acute lymphoblastic leukemia (ALL) as well as their relation to developing toxic liver damage against during ongoing therapy is of special interest. Our study was aimed at assessing hospital-acquired HGV and TTV infection and its potential effect on the incidence rate and liver damage intensity in children with acute lymphoblastic leukemia. A rationale for the current study was previously verified hepatitis of unknown etiology excluding viral hepatitis B and C in such patients. In the study, there were examined 99 patients stayed at the Department of Hematology as well as 286 samples from diverse donor bloodderived products. The data obtained were examined by using epidemiological methods (retrospective and near real-time epidemiological analysis, prospective observation), microbiological monitoring, ELISA, PCR followed by analyzing with variation statistics methods. It was found that 51 children, mainly aged 2–4 years (47.1%), were diagnosed with new onset acute lymphoblastic leukemia during a six-year follow-up study. Treatment phase-specific dynamic investigation demonstrated a progressive increase in frequency of HGV-infected ALL patients from 9.8% (day 15 of therapy) up to 45.1% (maintenance therapy). Moreover, a therapeutic intervention was associated with TTV infection detected in 100% cases in baseline TTV DNA-negative patients 100%, and its rate was significantly increased. Thus, our study allowed to demonstrate that 48% and 77% ALL pediatric patients were infected HGV and TTV, respectively, at initial treatment phase (remission induction), that was paralleled with administering the maximum-dose parenteral therapy, including transfusion therapy. Finally, assessing blood donor-derived preparations allowed to detect HGV RNA and TTV DNA in 6.6±1.46% and 19.3±2.9% cases, respectively.

About the authors

L. Yu. Poslova

Privolzhsky Research Medical University, Ministry of Health Care of the Russian Federation; Nizhny Novgorod Regional Children’s Clinical Hospital

Email: pok195@yandex.ru

Poslova Ludmila Yurievna - PhD (Medicine), Assistant Professor, Department of Epidemiology, Privolzhsky Research Medical University of the Ministry of Health of the Russian Federation; Head of the Epidemiology Department, Nizhny Novgorod Regional Children’s Clinical Hospital.

Phone: +7(905) 194-77-06. 

Russian Federation

A. B. Alekseev

Nizhny Novgorod Regional Children’s Clinical Hospital

Email: info@nodkb.ru

Alekseev Alexander Borisovich - Haematologist, Nizhny Novgorod Regional Children’s Clinical Hospital.

Nizhny Novgorod.

Russian Federation

A. V. Sergeeva

Privolzhsky Research Medical University, Ministry of Health Care of the Russian Federation

Email: sergeeva-av2013@yandex.ru

Sergeeva Anzhelika Vyacheslavovna - PhD (Medicine), Associate Professor, Department of Epidemiology, Head of the PCR Research Laboratory, Institute of Preventive Medicine, Privolzhsky Research Medical University of the Ministry of Health of the Russian Federation.

603950, Nizhny Novgorod, Minin and Pozharsky sq., 10/1.

Phone: +7 (903) 060-39-84.

Russian Federation

O. V. Kovalishena

Privolzhsky Research Medical University, Ministry of Health Care of the Russian Federation

Email: kovalishena@mail.ru

Kovalishena Olga Vasilievna - PhD, MD (Medicine), Professor; Head of the Department of Epidemiology, Deputy Director for Science, Institute of Preventive Medicine of the Privolzhsky Research Medical University of the Ministry of Health of the Russian Federation.

Nizhny Novgorod.

Phone: +7(831)436-94-81.

Russian Federation

V. V. Shkarin

Privolzhsky Research Medical University, Ministry of Health Care of the Russian Federation

Email: nn_epidemiolog@nizhgma.ru

Shkarin Vyacheslav Vasilievich - PhD, MD (Medicine), Professor, Department of Epidemiology, Privolzhsky Research Medical University of the Ministry of Health of the Russian Federation.

Nizhny Novgorod.

Tel. +7 (831) 436-94-81.

Russian Federation

N. E. Senagina

Privolzhsky Research Medical University, Ministry of Health Care of the Russian Federation

Email: det_infekcii@nizhgma.ru

Senagina Natalia Evgenyevna - PhD (Medicine), Associate Professor, Department of Childhood Infections, Privolzhsky Research Medical University of the Ministry of Health of the Russian Federation.

Nizhny Novgorod.

Phone: +7(831)248-80-09.

Russian Federation

N. F. Brusnigina

Nizhny Novgorod Scientific and Research Institute of Epidemiology and Microbiology named after Academician I.N. Blokhina, Federal Service on Surveillance for Consumer Rights Protection and Human Welfare (Rospotrebnadzor)

Email: mazepavn@mail.ru

Brusnigina Nina Fedorovna - PhD (Medicine), Associate Professor, Head of the Laboratory of Metagenomics and Molecular Pathogen Diagnostics, Nizhny Novgorod Scientific and Research Institute of Epidemiology and Microbiology named after academician I.N. Blokhina.

Nizhny Novgorod.

Phone: +7(831) 432-87-91.

Russian Federation

T. Yu. Butina

Nizhny Novgorod Scientific and Research Institute of Epidemiology and Microbiology named after Academician I.N. Blokhina, Federal Service on Surveillance for Consumer Rights Protection and Human Welfare (Rospotrebnadzor)

Author for correspondence.
Email: prokaids@mail.ru

Butina Tatiana Yurievna - Clinical Laboratory Diagnostics Specialist, Volga District Center for AIDS Prevention and Control, Nizhny Novgorod Research Institute of Epidemiology and Microbiology named after Academician I. N. Blokhina.

Nizhny Novgorod.

Phone: +7(831) 469-79-07.

Russian Federation

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Copyright (c) 2019 Poslova L.Y., Alekseev A.B., Sergeeva A.V., Kovalishena O.V., Shkarin V.V., Senagina N.E., Brusnigina N.F., Butina T.Y.

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