PDF(Pubmed)
Abstract：
OBJECTIVE: This study aimed to investigate the prevalence and viral reactivations of clinical interest in the immunocompromised patient with particular focus on hematologic and solid organ transplant recipients.
METHODS: Molecular screening data of CMV, EBV, JCV and BKV from 2011 to 2023 were analyzed. This extensive time span allowed the access to more than 100,000 samples from over 20,000 patients treated at Policlinico Umberto I. It was possible to temporally investigate patient attendance patterns, average age distribution, seasonality of infections, and positivity rates of the analyzed viruses.
RESULTS: Between 2019 and 2022 a significant reduction in organ transplants performed and in the positive molecular detection of EBV, JCV and BKV was observed. Additionally, there has been a noteworthy decrease in CMV reactivations, with a reduction of up to 50% starting in 2019. A remarkable reduction of 39% in the rate of CMV viral reactivation has been also achieved in SOT between 2016 and 2023.
CONCLUSIONS: The years following 2019 were profoundly impacted by the COVID-19 pandemic era. This period resulted in a substantial reduction in healthcare services and hospital visits. Furthermore, the introduction of the drug Letermovir in Italy in 2019 demonstrated remarkable efficacy, evidenced by a reduction in CMV reactivations. Additionally, the adoption of a novel clinical approach centered on personalized therapy facilitated improved management of immunocompromised patients.
METHODS: Molecular screening data of CMV, EBV, JCV and BKV from 2011 to 2023 were analyzed. This extensive time span allowed the access to more than 100,000 samples from over 20,000 patients treated at Policlinico Umberto I. It was possible to temporally investigate patient attendance patterns, average age distribution, seasonality of infections, and positivity rates of the analyzed viruses.
RESULTS: Between 2019 and 2022 a significant reduction in organ transplants performed and in the positive molecular detection of EBV, JCV and BKV was observed. Additionally, there has been a noteworthy decrease in CMV reactivations, with a reduction of up to 50% starting in 2019. A remarkable reduction of 39% in the rate of CMV viral reactivation has been also achieved in SOT between 2016 and 2023.
CONCLUSIONS: The years following 2019 were profoundly impacted by the COVID-19 pandemic era. This period resulted in a substantial reduction in healthcare services and hospital visits. Furthermore, the introduction of the drug Letermovir in Italy in 2019 demonstrated remarkable efficacy, evidenced by a reduction in CMV reactivations. Additionally, the adoption of a novel clinical approach centered on personalized therapy facilitated improved management of immunocompromised patients.
摘要：
目的：本研究旨在调查免疫功能低下患者的患病率和临床关注的病毒再激活情况，尤其是血液系统和实体器官移植受者。
方法：CMV，EBV,对2011-2023年的JCV和BKV进行了分析。这种广泛的时间跨度允许访问来自PoliclinicoUmbertoI治疗的20,000多名患者的100,000多个样本。平均年龄分布，感染的季节性，和分析病毒的阳性率。
结果：在2019年至2022年之间，进行的器官移植和EBV的阳性分子检测显着减少，观察到JCV和BKV。此外,CMV再激活量出现了显著下降，从2019年开始，降幅高达50%。在2016年至2023年的SOT中，CMV病毒再激活率也显着降低了39％。
结论：2019年后的几年受到COVID-19大流行时代的深刻影响。这一时期导致医疗服务和住院人数大幅减少。此外，2019年在意大利推出的Letermovir药物显示出显著的疗效，CMV再激活的减少证明。此外,采用以个性化治疗为中心的新型临床方法有助于改善免疫功能低下患者的管理.
方法：CMV，EBV,对2011-2023年的JCV和BKV进行了分析。这种广泛的时间跨度允许访问来自PoliclinicoUmbertoI治疗的20,000多名患者的100,000多个样本。平均年龄分布，感染的季节性，和分析病毒的阳性率。
结果：在2019年至2022年之间，进行的器官移植和EBV的阳性分子检测显着减少，观察到JCV和BKV。此外,CMV再激活量出现了显著下降，从2019年开始，降幅高达50%。在2016年至2023年的SOT中，CMV病毒再激活率也显着降低了39％。
结论：2019年后的几年受到COVID-19大流行时代的深刻影响。这一时期导致医疗服务和住院人数大幅减少。此外，2019年在意大利推出的Letermovir药物显示出显著的疗效，CMV再激活的减少证明。此外,采用以个性化治疗为中心的新型临床方法有助于改善免疫功能低下患者的管理.
