各种各样的病毒可导致儿童的皮疹疾病(RD)或急性发热性疾病(AFI),青少年和成年人;然而,大约19%的RD病例和40%的AFI病例没有明确的病因.细小病毒B19(B19V)和疱疹病毒感染也可引起RD和/或AFI,在一些风险群体中,这些感染可能会持续(或潜伏),可能需要住院治疗.由于这些感染没有强制性报告,它们可以被其他疾病隐藏,例如由虫媒病毒引起的(例如,登革热病毒)。在这种情况下,这项研究的目的是在RD和AFI患者中进行B19V和疱疹病毒感染的鉴别实验室诊断,没有明确的病因,在里约热内卢的医院和/或传染病参考中心看到。
共有114名参与者参加了这项研究,包括54名儿童和60名成人。通过实时PCR(qPCR)和ELISA(抗B19VIgM和IgG)评估B19V感染。通过qPCR评估EBV,和β疱疹病毒(HCMV,通过多重qPCR评估HHV-6和HHV-7)。从这些参与者的病历数据中获得社会人口统计学和临床数据。
RD儿童的中位年龄为2岁(四分位距(IQR):5),55.6%为男性。在患有AFI的成年人中,中位年龄为38岁(IQR:21),56.7%为女性。关于RD患者,病毒患病率(和载量)为5.5%(104IU/mL),3.4%(104IU/mL),B19V的5.5%(104IU/mL)和11.1%(105IU/mL),EBV,HCMV和HHV-6感染,分别,在AFI患者中,他们为6.6%(105IU/mL),1.6%(103IU/mL),B19V的3.3%(104IU/mL),HCMV和HHV-6。在RD或AFI患者中未检测到HHV-7。
这些结果表明在RD和AFI患者的鉴别实验室诊断中包括B19V和疱疹病毒的重要性。不仅用于流行病学目的,也用于患者的适当管理。
A wide variety of viruses can cause rash diseases (RDs) or acute febrile illness (AFIs) in children, adolescents and adults; however, approximately 19% of RD cases and 40% of AFI cases remain without a defined etiology. Parvovirus B19 (B19V) and herpesvirus infection can also cause RD and/or AFI, and in some risk groups, these infections can become persistent (or latent) and may require hospital treatment. Since these infections do not have mandatory reporting, they can be hidden by other diseases, such as those caused by arboviruses (e.g., dengue virus). In this context, the aim of this
study was to pursue the differential laboratory diagnoses of B19V and herpesvirus infections in patients with RD and AFI, without a defined etiology, seen in hospitals and/or reference centers for infectious diseases in Rio de Janeiro.
A total of 114 participants were enrolled in the
study, including 54 children and 60 adults. B19V infection was assessed by real-time PCR (qPCR) and ELISA (anti-B19V IgM and IgG). EBV was assessed through qPCR, and betaherpesviruses (HCMV, HHV-6 and HHV-7) were assessed through multiplex qPCR. Sociodemographic and clinical data were obtained from the medical record data of these participants.
The median age of children with RD was 2 years (interquartile range (IQR): 5), and 55.6% were male. Among adults with AFI, the median age was 38 years (IQR: 21), and 56.7% were female. Regarding RD patients, viral prevalence (and load) were 5.5%(104IU/mL), 3.4%(104IU/mL), 5.5%(104IU/mL) and 11.1%(105IU/mL) for B19V, EBV, HCMV and HHV-6 infection, respectively, and in AFI patients they were 6.6%(105IU/mL), 1.6%(103IU/mL), 3.3%(104IU/mL) for B19V, HCMV and HHV-6, respectively. HHV-7 was not detected in RD or AFI patients.
These results suggest the importance of including B19V and herpesviruses in the differential laboratory diagnoses for patients with RD and AFI, not only for epidemiological purposes but also for the proper management of the patient.