Human Cytomegalovirus (HCMV) is the most important viral pathogen in people undergoing bone marrow transplantation (BMT). HCMV detection in the early stages makes is possible to save the patients’ lives through immediate and timely treatment. The aim of this study was to investigate the status of HCMV using the real-time PCR method in BMT patients in Kermanshah, west of Iran. HCMV monitoring was done in 120 patients who underwent BMT, 38 allogeneic cases and 82 autologous cases, using the ELISA serology test before transplantation. The participants were followed up 100 days after transplantation for HCMV detection in blood samples using real-time PCR. Preemptive therapy started with Ganciclovir and Foscarnet when the viral load was > 200 HCMV DNA copies/ml. Despite preemptive therapy, infection recurred in less than 1 month. HCMV recurred more frequently in patients undergoing allogenic transplation versus those receiving autologous transplantation. Recurrence was seen in 5 patients receiving allogenic transplantation. HCMV recurrence occurred in five patients with allogeneic transplantation. Twelve patients undergoing allogeneic or autologous transplantation (83%) and a virus load of > 1000 copies/ml showed HCMV-related symptoms. Three patients died, two due to HCMV-related pneumonia and the other one due to a fungal infection. Real-time PCR may be a useful method for quantification and monitoring of HCMV recurrence and may be helpful in choosing more efficient HCMV preemptive treatment in BMT recipients.

中文翻译：

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伊朗西部克尔曼沙赫同种异体和自体干细胞移植中的 HCMV 实时 PCR 调查

人类巨细胞病毒 (HCMV) 是接受骨髓移植 (BMT) 患者最重要的病毒病原体。早期检测 HCMV 可以通过立即、及时的治疗来挽救患者的生命。本研究的目的是利用实时 PCR 方法调查伊朗西部克尔曼沙赫 BMT 患者的 HCMV 状况。采用移植前ELISA血清学检测对120例接受BMT的患者、38例同种异体病例和82例自体病例进行HCMV监测。移植后 100 天对参与者进行随访，使用实时 PCR 检测血液样本中的 HCMV。当病毒载量 > 200 HCMV DNA 拷贝/ml 时，开始使用更昔洛韦和膦甲酸进行先发性治疗。尽管采取了先发制人的治疗，但不到 1 个月感染就复发了。与接受自体移植的患者相比，接受同种异体移植的患者 HCMV 复发的频率更高。5 例接受同种异体移植的患者出现复发。5 名接受同种异体移植的患者出现 HCMV 复发。12 名接受同种异体或自体移植的患者 (83%) 且病毒载量 > 1000 拷贝/ml 出现 HCMV 相关症状。三名患者死亡，其中两名死于 HCMV 相关肺炎，另一名则死于真菌感染。实时 PCR 可能是量化和监测 HCMV 复发的有用方法，并且可能有助于 BMT 受者选择更有效的 HCMV 抢先治疗。