Ocena częstości występowania zakażeń wirusami hepatotropowymi u pacjentów poddanych allogenicznej transplantacji krwiotwórczych komórek macierzystych od dawcy niespokrewnionego

Introduction. The broad indications for allogenic transplantation of hematopoietic stem cells (allo-HSCT) and the use of immunosuppression after transplantation pose a risk of frequent occurrence of viral infections. Aim. The subject of the work is the analysis of serological status and prevalence of primarily (HBV, HCV) and secondarily (CMV, EBV) hepatotropic viruses in the group of patients treated with allo-HSCT from unrelated donors and assessment of the usefulness of serological and biomolecular methods in virological diagnostics both before and after transplantation. Material and methods. The study included 157 patients after allo-HSCT performed due to hematopoietic system diseases in the period 01.2015-03.2017. Results. The presence of anti-HBc and anti-EBV antibodies in the IgM class was demonstrated in 6 and 2.5% of patients before transplantation, in which DNA testing excluded presence of the viral load what allowed to perform the transplantation. Reactivation of HBV-DNA after transplantation was found in two patients with a long history of hepatitis B. In the post-transplant period, EBV viremia was detected in 31% of patients and CMV in 39% of patients. The frequency of CMV reactivation varied depending on the initial serological status of the donor-recipient pairs prior to transplantation. The reactivation of EBV and CMV had an effect on the survival of the patients and often occurred simultaneously. There was no case of HCV infection. Conclusions. Molecular studies of hepatotropic viruses prior to allo-HSCT are justified in the presence of serological markers suggesting the possibility of infection, which most often concerns HBV and EBV. Examination of CMV-DNA and EBV-DNA after allo-HSCT enables to detect reactivation of the virus in a significant proportion of patients, which is associated with an increased risk of adverse course of the disease. CMV viremia, the detection of which enables the implementation of proper treatment, occurs most frequently in patients whose serological status of CMV before transplantation was positive.