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Abstract：
Metagenomics revealed novel and routinely overlooked viruses, representing sources of unrecognized infections after allogeneic hematopoietic stem cell transplantation (allo-HSCT). We aim to describe DNA and RNA virus prevalence and kinetics in allo-HSCT recipients\' plasma for one year post HSCT. We included 109 adult patients with first allo-HSCT from 1 March 2017 to 31 January 2019 in this observational cohort study. Seventeen DNA and three RNA viral species were screened with qualitative and/or quantitative r(RT)-PCR assays using plasma samples collected at 0, 1, 3, 6, and 12 months post HSCT. TTV infected 97% of patients, followed by HPgV-1 (prevalence: 26-36%). TTV (median 3.29 × 105 copies/mL) and HPgV-1 (median 1.18 × 106 copies/mL) viral loads peaked at month 3. At least one Polyomaviridae virus (BKPyV, JCPyV, MCPyV, HPyV6/7) was detected in >10% of patients. HPyV6 and HPyV7 prevalence reached 27% and 12% at month 3; CMV prevalence reached 27%. HSV, VZV, EBV, HHV-7, HAdV and B19V prevalence remained <5%. HPyV9, TSPyV, HBoV, EV and HPg-V2 were never detected. At month 3, 72% of patients had co-infections. TTV and HPgV-1 infections were highly prevalent. BKPyV, MCPyV and HPyV6/7 were frequently detected relative to classical culprits. Further investigation is needed into associations between these viral infections and immune reconstitution or clinical outcomes.
摘要：
宏基因组学揭示了新颖且经常被忽视的病毒，代表异基因造血干细胞移植（allo-HSCT）后未识别的感染来源。我们的目的是描述HSCT后一年的同种异体HSCT接受者血浆中DNA和RNA病毒的流行和动力学。在这项观察性队列研究中，我们纳入了2017年3月1日至2019年1月31日首次接受allo-HSCT的109例成年患者。使用在HSCT后0、1、3、6和12个月收集的血浆样品,通过定性和/或定量r(RT)-PCR测定筛选17种DNA和3种RNA病毒种类。TTV感染了97%的患者，其次是HPgV-1（患病率：26-36%）。TTV（中位数3.29×105拷贝/mL）和HPgV-1（中位数1.18×106拷贝/mL）病毒载量在第3个月达到峰值。至少一种多病毒科病毒（BKPyV，JCPyV,MCPyV,在>10%的患者中检测到HPyV6/7)。在第3个月，HPyV6和HPyV7的患病率分别达到27％和12％；CMV的患病率达到27％。HSV,VZV,EBV,HHV-7、HAdV和B19V患病率保持<5%。HPyV9,TSPyV,HBoV,从未检测到EV和HPg-V2。在第3个月，72％的患者合并感染。TTV和HPgV-1感染非常普遍。BKPyV,相对于经典罪犯，经常检测到MCPyV和HPyV6/7。需要进一步研究这些病毒感染与免疫重建或临床结果之间的关联。
