Parvoviridae Infections

细小病毒科感染
  • 文章类型: Journal Article
    在犬细小病毒性肠炎(CPE)期间,潜在的预后指标与生存率降低相关。比如体重,性别,和临床病理参数。很少有研究报道意大利CPE的预后因素;因此,这项研究的目的是确定与佩鲁贾大学兽医教学医院收治的狗的生存相关的预后因素,自然感染了犬细小病毒。对2017年至2021年确诊为细小病毒感染的狗的76份医疗记录进行了审查,并将其纳入研究。从医疗记录中提取了信号数据,历史,临床检查,血液学,血清生物化学,治疗,住院期间临床体征的进展和结果。对数据进行了单变量和多变量统计分析。我们的结果显示了冬季,男性,养狗,小品种,正常的感官状态,正常心率,正常水合状态,腹痛,毛细血管再灌注时间增加,白细胞计数正常为积极预后因素。生存模型证实了诸如男性等参数,小品种,和所有权增加了住院期间的生存率。本研究报告的数据与先前的研究部分一致,并增加了有关意大利受CPE影响的狗的可能预后因素的新信息。
    Potential prognostic indicators have been associated with decreased survival during canine parvoviral enteritis (CPE), such as body weight, sex, and clinicopathological parameters. Few studies reported the prognostic factors for CPE in Italy; therefore, the aim of this study was to identify prognostic factors associated with the survival of dogs admitted to the Veterinary Teaching Hospital of Perugia University, naturally infected with canine parvovirus. Seventy-six medical records of dogs with a definitive diagnosis of parvoviral infection admitted from 2017 to 2021 have been reviewed and included in the study. From medical records were extracted data on signalment, history, clinical examination, hematology, serum biochemistry, treatments, progression of clinical signs during hospitalization and outcome. The data have been subjected to univariate and multivariate statistical analysis. Our results showed winter season, male sex, dog ownership, small breed, normal sensory status, normal heart rate, normal hydration status, abdominal pain, increased capillary reperfusion time, and normal white blood cell count as positive prognostic factors. The survival model confirmed that parameters such as male sex, small breed, and ownership increased the survival rate during hospitalization. Data reported in the present study are partially in agreement with previous studies and added new information on the possible prognostic factors in dogs affected by CPE in Italy.
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  • 文章类型: Journal Article
    背景:人细小病毒B19(B19V)感染与免疫功能低下患者的纯红细胞再生障碍(PRCA)有关;然而,在异基因造血干细胞移植(alloHSCT)受者中与B19V相关的表现谱很少有报道.
    方法:在本研究中,我们旨在报道alloHSCT后B19V感染的临床和免疫特征。我们回顾性收集并分析了2010年至2021年在我们中心通过聚合酶链反应(PCR)检测到的所有B19VDNAmia或组织感染的移植患者的临床和微生物学数据。
    结果:我们报告了33例患者中35例B19V感染。从移植到B19V第一次PCR阳性的中位时间为6.9个月(四分位距(IQR)[1.6-18.9])。没有优先免疫特征,确定了移植或调节的类型。血液学损害是最常见的体征,其次是皮疹和发烧。还检测到非常规临床形式,如急性脊髓炎和肌炎。在某些情况下,症状与B19V感染之间的直接关系难以证实,但通过靶向组织PCR阳性提示.当血液学损害不在最前线时,网织红细胞减少症有助于诊断B19V感染。治疗主要以大剂量静脉注射免疫球蛋白为主。
    结论:尽管血液学损害是最常见的体征,B19V可以影响多个靶标并导致非典型表现。由于其临床表现的异质性,B19V感染可能诊断不足。异常B19V器官受累的诊断需要结合参数,包括靶向组织PCR。
    BACKGROUND: Human parvovirus B19 (B19V) infection is associated with pure red cell aplasia (PRCA) in immunocompromised patients; however, the spectrum of manifestations associated with B19V in allogeneic hematopoietic stem cell transplantation recipients (alloHSCT) has rarely been reported.
    METHODS: In this study, we aimed to report clinical and immune features of B19V infection after alloHSCT. We retrospectively collected and analyzed clinical and microbiological data of all transplanted patients with B19V DNAmia or tissue infection detected by polymerase chain reaction (PCR) in our center from 2010 to 2021.
    RESULTS: We report 35 cases of B19V infections in 33 patients. Median time from transplant to B19V first PCR positivity was 6.9 months (interquartile range (IQR) [1.6-18.9]). No preferential immune profile, type of transplantation or conditioning was identified. Hematological impairment was the most frequent sign, followed by rash and fever. Unconventional clinical forms were also detected, such as acute myelitis and myositis. For some cases, the direct relationship between symptoms and B19V infection was difficult to prove but was suggested by targeted tissue PCR positivity. When hematological impairment was not at the forefront, reticulocytopenia helped to diagnose B19V infections. Treatment was mainly based on high dose intravenous immunoglobulin.
    CONCLUSIONS: Although hematological impairment was the most frequent sign, B19V can affect multiple targets and lead to atypical manifestations. Because of its heterogeneous clinical presentation, B19V infection is likely under-diagnosed. Diagnosis of unusual B19V organ involvement needs combination of arguments which can include targeted tissue PCR.
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  • 文章类型: Journal Article
    犬细小病毒2(CPV-2)自1978年出现以来,在家犬中导致大量死亡。主要是,它是严重出血性腹泻的原因,呕吐,和脱水。CPV-2有三个已知的主要变体2a,2b,2c。由于需要监测病毒的进化参数,以及伊朗缺乏对CPV2的全面研究,这项研究是该国首次进行的,不仅是为了表征伊朗CPV的基因组,而且还研究了CPV的进化参数和系统动力学。使用最大似然(ML)方法构建系统发育树。通过使用贝叶斯蒙特卡罗马尔可夫链(BMCMC)方法,研究了该病毒的进化分析和系统动力学。系统发育结果表明,所有伊朗分离株都被分类为CPV-2a变体。伊朗的中部被认为是病毒的起源,尤其是Alborz省.在它在全国流行之前,病毒在中部传播,在Thran,卡拉杰,还有Qom.突变分析显示CPV-2a的正选择压力。调查病毒的进化参数,提出1970年是病毒的出生日期,在1953年至1987年之间有95%的可信区间。从2012年到2015年,有效感染人数急剧增加,然后从2015年到2019年面临小幅下降的趋势。从2019年中期开始,出现了相当大的奖励模式,这可以被视为对疫苗接种失败风险的担忧。
    Canine Parvo Virus 2 (CPV-2) culminated in lots of fatalities in domestic dogs since its emergence in 1978. Mainly, it is responsible for severe hemorrhagic diarrhea, vomiting, and dehydration. CPV-2 has three main variants known as 2a, 2b, and 2c. Due to the necessity of monitoring the evolutionary parameters of the virus, and also the lack of comprehensive study of CPV2 in Iran, this study is done for the first time in this country not only to characterize Iranian CPV genomes but also to study the evolutionary parameters and phylodynamics of CPV. The phylogenetic trees were constructed using the Maximum Likelihood (ML) method. By the use of the Bayesian Monte Carlo Markov Chain (BMCMC) method, evolutionary analysis and phylodynamics of the virus were investigated. Phylogenetic results showed that all Iranian isolates were classified in the CPV-2a variant. The central part of Iran was suggested to be the origin of the virus, especially the Alborz province. Before its prevalence throughout the country, the virus circulated in the central part, in Thran, Karaj, and Qom. Mutational analysis showed a positive selection pressure of CPV-2a. Investigating the evolutionary parameters of the virus proposed 1970 to be the date of birth of the virus, with a 95% credible interval between 1953 and 1987. The effective number of infections increased dramatically from 2012 to 2015, then faced a slightly decreasing trend from 2015 to 2019. A considerable up warding pattern was witnessed from the middle of 2019, which can be taken as a concern about the risk of vaccination failure.
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  • 文章类型: Journal Article
    一组称为细小病毒的DNA病毒,对癌症治疗和基因工程应用具有重大影响。穿过细胞膜到达细胞质后,它沿着微管向核膜移动。核定位信号(NLS)被来自核膜外复合物的importin-β(impβ)和其他蛋白质识别,并通过核孔复合物(NPC)结合进入细胞核。病毒进入细胞核有两种主要途径。经典途径是通过impα和impβ通过NPC与NLS的相互作用。另一种是由impβ和it的组合介导的NPC。当衣壳通过经典的核转导引入细胞核时,还存在短暂的核膜溶解,导致被动转运到细胞核中,这是近年来提出的。本文主要讨论了几种核进入途径和相关蛋白,病毒进入途径的后续研究提供参考。
    A group of DNA viruses called parvoviruses that have significant effects on cancer therapy and genetic engineering applications. After passing through the cell membrane to reach the cytosol, it moves along the microtubule toward the nuclear membrane. The nuclear localization signal (NLS) is recognized by importin-beta (impβ) and other proteins from the complex outside the nuclear membrane and binds to enter the nucleus via the nuclear pore complex (NPC). There are two main pathways for viruses to enter the nucleus. The classical pathway is through the interaction of imp α and impβ with NLS via NPC. The other is the NPC mediated by the combination of impβ and it. While the capsid is introduced into the nucleus through classical nuclear transduction, there is also a transient nuclear membrane dissolution leading to passive transport into the nucleus, which has been proposed in recent years. This article mainly discusses several nuclear entry pathways and related proteins, providing a reference for subsequent research on viral entry pathways.
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  • 文章类型: Journal Article
    确定澳大利亚幼儿的人类博卡病毒1(HBoV1)感染特征。数据来自儿童传染病观察研究(ORChID)研究,布里斯班,基于澳大利亚的健康出生队列,term,新生儿前瞻性随访2年。父母记录每天的症状,保持一份疾病负担日记,每周收集鼻拭子,测试了17种呼吸道病毒,包括HBoV1,通过实时聚合酶链反应(PCR)测定。测量的主要结果是感染发生率,危险因素,症状,和医疗保健使用。ORChID队列中的一百五十八名儿童每周提供11,126次棉签,其中157个拭子为HBoV1阳性,涉及107个事件。在65/157(41.4%)HBoV1阳性拭子(或41/107[38.3%]感染发作)中观察到共同检测,主要是鼻病毒。64.5%的发作期脱落时间为1周。在生命的前2年中,HBoV1感染的发生率为0.58次/儿童年(95%置信区间[CI]0.47-0.71),包括与呼吸道症状相关的0.38次/儿童年(95%CI0.30-0.49)。18/87(20.7%)儿童在初次感染后反复发作。在生命的头两年,HBoV1发作的发生率随着年龄的增长而增加,在冬季和照顾孩子。总的来说,64.2%的HBoV1发作是有症状的,26.4%有医疗保健联系。儿童有症状时的病毒载量估计值高于无症状时(平均差异=3.4;95%CI1.0-5.7PCR循环阈值单位)。6个月后,HBoV1在生命的前2年经常被检测到,尤其是在冬天。症状通常是轻微的,并与较高的病毒载量有关。
    To determine human bocavirus-1 (HBoV1) infection characteristics in young Australian children. Data were from the Observational Research in Childhood Infectious Diseases (ORChID) study, a Brisbane, Australia-based birth cohort of healthy, term, newborns followed prospectively for 2 years. Parents recorded daily symptoms, maintained an illness-burden diary, and collected weekly nasal swabs, which were tested for 17 respiratory viruses, including HBoV1, by real-time polymerase chain reaction (PCR) assays. Main outcomes measured were infection incidence, risk factors, symptoms, and healthcare use. One hundred fifty-eight children in the ORChID cohort provided 11,126 weekly swabs, of which 157 swabs were HBoV1 positive involving 107 incident episodes. Co-detections were observed in 65/157 (41.4%) HBoV1-positive swabs (or 41/107 [38.3%] infection episodes), principally with rhinovirus. Shedding duration was 1 week in 64.5% of episodes. The incidence of HBoV1 infections in the first 2 years of life was 0.58 episodes per child-year (95% confidence interval [CI] 0.47-0.71), including 0.38 episodes per child-year (95% CI 0.30-0.49) associated with respiratory symptoms. Recurrent episodes occurred in 18/87 (20.7%) children following their primary infection. In the first 2 years of life, incidence of HBoV1 episodes increased with age, during winter and with childcare attendance. Overall, 64.2% of HBoV1 episodes were symptomatic, with 26.4% having healthcare contact. Viral load estimates were higher when children were symptomatic than when asymptomatic (mean difference = 3.4; 95% CI 1.0-5.7 PCR cycle threshold units). After age 6 months, HBoV1 is detected frequently in the first 2 years of life, especially during winter. Symptoms are usually mild and associated with higher viral loads.
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  • 文章类型: Multicenter Study
    目的:评估宫内人细小病毒B19感染导致严重贫血的胎儿在妊娠20+0周之前或之后宫内输血(IUT)后的手术相关并发症和围产期结局。
    方法:一项回顾性研究,调查了2002年12月至2021年12月在两个三级转诊中心因胎儿ParvoB19感染而需要IUT的胎儿。手术相关并发症,宫内胎儿死亡(IUFD),围产期结局与首次IUT的胎龄(GA)相关,有无积水和胎儿采血结果。
    结果:总共在103例胎儿中进行了186例IUT。第一次IUT时的中位GA为妊娠19+3(13+0-31+4)周。IUFD发生在16/103胎儿(15.5%)。总生存率为84.5%(87/103)。水(p=0.001),首次IUT时平均血红蛋白较低(p=0.001)和血小板较低(p=0.002)与IUFD密切相关.在妊娠20+0周之前或之后输血的胎儿中没有观察到差异。
    结论:在专业中心,IUT是一种成功的治疗方案,适用于因细小病毒B19感染导致严重贫血的胎儿。在有经验的手中,在20周前IUT与较差的围产期结局无关。
    Evaluating procedure-related complications and perinatal outcomes after intrauterine transfusion (IUT) before or after 20+0 weeks of gestation in fetuses with severe anemia due to intrauterine human parvovirus B19 infection.
    A retrospective study investigating fetuses requiring IUT for fetal Parvo B19 infection in two tertiary referral centers between December 2002 and December 2021. Procedure-related complications, intrauterine fetal death (IUFD), and perinatal outcome were correlated to gestational age (GA) at first IUT, the presence of hydrops and fetal blood sampling results.
    A total of 186 IUTs were performed in 103 fetuses. The median GA at first IUT was 19+3 (13+0-31+4) weeks of gestation. IUFD occurred in 16/103 fetuses (15.5%). Overall survival was 84.5% (87/103). Hydrops (p = 0.001), lower mean hemoglobin at first IUT (p = 0.001) and low platelets (p = 0.002) were strongly associated with IUFD. There was no difference observed in fetuses transfused before or after 20+0 weeks of gestation.
    IUT is a successful treatment option in fetuses affected by severe anemia due to parvovirus B19 infection in specialized centers. In experienced hands, IUT before 20 weeks is not related to worse perinatal outcome.
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  • 文章类型: Journal Article
    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.
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  • 文章类型: Journal Article
    缺乏关于肾移植(KT)接受者中细小病毒B19(B19V)感染的过程和临床特征的流行病学研究。本研究旨在为临床B19V感染的诊断和治疗提供建议。
    定期收集KT受体的血清样本并检测B19V-DNA拷贝,B19V-IgG/IgM水平,以及肾脏和肝脏的血液学参数和功能。根据血清学和DNA检测结果描述了B19V感染的过程,并结合临床和流行病学资料进行分析。
    75%的B19V感染发生在KT后2周内(n=9)。KT受者B19V感染率较高,即10.17%(n=12)。10例患者的IgM抗体B19V(IgM+)和DNAB19V(DNA+),而2例患者为IgM阴性(IgM-),但DNA+。感染B19V的KT患者表现出几种症状,包括贫血(100%),血小板减少(8.33%),和损害肝(75%)和肾功能(16.67%)的患者在KT后的前两周进行性贫血,再加上网织红细胞的减少,更有可能感染B19V。已分析了KT患者B19V感染的四个主要治疗危险因素的关联。B19V感染与使用巴利昔单抗(OR=1.19;95%-CI:1.08-1.32;P=0.003)和使用胸腺球蛋白(OR=0.84;95%-CI:0.76-0.93;P=0.003)相关。
    医生应该警惕B19V感染,特别是在移植后的前两周内免疫缺陷患者。
    There is a lack of epidemiological studies on the course and clinical characteristics of Parvovirus B19 (B19V) infections in kidney transplant (KT) recipients. This study was undertaken to provide recommendations for clinical B19V infection diagnosis and treatment.
    Serum samples of KT recipients were regularly collected and tested for B19V-DNA copies, B19V-IgG/IgM levels, as well as hematological parameters and functions of kidney and liver. The course of B19V infection was described according to the results of serology and DNA testing, and the clinical and epidemiological data were combined for analysis.
    75% B19V infections occurred within 2 weeks after KT(n = 9). The infection rate of B19V in KT recipients was high, namely 10.17% (n = 12). The number of 10 patients IgM antibodies against B19V (IgM+) and theDNA B19V (DNA+), whereas 2 patients were IgM negative (IgM-) but DNA+. The B19V infected KT patients showed several symptoms, including anemia (100%), reduction of platelets (8.33%), and damage to liver (75%) and kidney function (16.67%) Patients with progressive anemia in the first two weeks after KT, which combined with the decrease of reticulocytes, are more likely to have B19V infection. Associations of four main therapeutic risk factors for B19V infections in KT patients have been analyzed. B19V infection was associated with use of basiliximab (OR = 1.19; 95%- CI: 1.08-1.32; P = 0.003) and use of thymoglobulins (OR = 0.84; 95%-CI: 0.76-0.93; P = 0.003).
    Doctors should be alert to B19V infection, especially in the immunodeficient patients within the first two weeks after transplantation.
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  • 文章类型: Journal Article
    背景:细小病毒性肠炎(PE)是狗的病毒性胃肠道(GI)感染。PE的恢复与生命后期持续的GI体征有关。本研究的目的是:(i)确定与未感染的对照狗相比,已经从PE恢复的狗(post-parvo狗)是否具有增加的持续性GI体征的风险。(ii)研究与后犬持续胃肠道症状相关的生活方式和临床病理因素。
    方法:在这项回顾性队列研究中,共招募了86只parvo后犬和52只年龄匹配的对照犬。因PE住院多年后,使用问卷对主人的狗的健康和习惯进行了采访。我们使用广义线性混合效应模型来测试细小病毒肠炎和其他危险因素是否与所有狗的主人认可的一般健康问题以及后狗的主人认可的持续胃肠道症状有关。
    结果:与对照犬相比,parvo后犬的持续GI体征的患病率明显更高(57%vs25%,P<0.001)。入院时疾病严重程度的标志物,如中性粒细胞减少症,体温低(BT),止吐药物(甲氧氯普胺)治疗是术后犬持续胃肠道症状的重要危险因素。例如,与体温过高的狗(BT为40.4°C)相比,入院时体温过低(BT为37.2°C)的受PE影响的狗在以后的生活中出现GI体征的可能性要高16.6倍。Parvo后狗中持续存在的GI体征是其他器官系统健康问题的风险因素。
    结论:细小病毒肠炎是狗持续胃肠道症状的重要危险因素,突出了预防的重要性。本研究中确定的危险因素可能会指导有关细小病毒肠炎与狗的慢性健康问题联系的机制的未来研究。
    BACKGROUND: Parvoviral enteritis (PE) is a viral gastrointestinal (GI) infection of dogs. Recovery from PE has been associated with persistent GI signs later in life. The objectives of this study were: (i) To determine whether dogs that have recovered from PE (post-parvo dogs) had an increased risk of persistent GI signs compared to uninfected control dogs. (ii) To investigate the lifestyle and clinicopathologic factors that are associated with persistent GI signs in post-parvo dogs.
    METHODS: A total of 86 post-parvo dogs and 52 age-matched control dogs were enrolled in this retrospective cohort study. Many years after hospitalization for PE, the owners were interviewed about the health and habits of their dogs using a questionnaire. We used generalized linear mixed effects models to test whether parvovirus enteritis and other risk factors are associated with owner-recognized general health problems in all dogs and with owner-recognized persistent GI signs in post-parvo dogs.
    RESULTS: The prevalence of persistent GI signs was significantly higher in post-parvo dogs compared to control dogs (57% vs 25%, P < 0.001). Markers of disease severity at the time of hospital admission such as neutropenia, low body temperature (BT), and treatment with an antiemetic medication (metoclopramide) were significant risk factors for persistent GI signs in post-parvo dogs. For example, PE-affected dogs that were hypothermic at hospital admission (BT of 37.2 °C) were 16.6 × more likely to have GI signs later in life compared to hyperthermic dogs (BT of 40.4 °C). The presence of persistent GI signs in post-parvo dogs was a risk factor for health problems in other organ systems.
    CONCLUSIONS: Parvovirus enteritis is a significant risk factor for persistent GI signs in dogs highlighting the importance of prevention. The risk factors identified in the present study may guide future investigations on the mechanisms that link parvovirus enteritis to chronic health problems in dogs.
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  • 文章类型: Clinical Trial, Phase II
    人细小病毒B19(B19V)是目前在心内膜活检(EMBs)中检测到的主要病毒。最近的研究结果表明,具体来说,具有可检测病毒RNA的转录活性B19V在炎性病毒性心肌病中具有预后相关性。我们旨在评估干扰素β-1b(IFN-β)治疗后的前瞻性随机安慰剂对照II期多中心BICC试验(Betaferon在慢性病毒性心肌病中)的子集体中的B19V复制状态(病毒RNA)和有益作用。回顾性分析n=64例B19V单感染组织的EMBs。在n=18/64(28.1%)的B19VDNA阳性样本(平均年龄51.7岁,12男),其中n=13已接受IFN-β治疗。五名患者接受了安慰剂。PCR分析在随访中证实,EMBs显着降低IFN-β治疗患者的n=11/13(84.6%)的病毒RNA载量(p=0.001),独立于IFN-β剂量,与安慰剂组相比,病毒RNA载量不受影响甚至增加。因此,用IFN-β治疗后,左心室射血分数(LVEF)显着改善(LVEF平均基线51.6±14.1%vs.随访61.0±17.5%,p=0.03)。相比之下,在安慰剂组中,在n=4/5(80.0%)的患者中评估了LVEF恶化.我们可以首次显示IFN-β治疗的有益效果,抑制B19V病毒RNA并改善血液动力学过程。我们的结果需要在更大的前瞻性随机对照试验中进一步验证。
    Human parvovirus B19 (B19V) is the predominant virus currently detected in endomyocardial biopsies (EMBs). Recent findings indicate that, specifically, transcriptionally active B19V with detectable viral RNA is of prognostic relevance in inflammatory viral cardiomyopathy. We aimed to evaluate B19V replicative status (viral RNA) and beneficial effects in a sub-collective of the prospective randomized placebo-controlled phase II multi-center BICC-Trial (Betaferon In Chronic Viral Cardiomyopathy) after interferon beta-1b (IFN-β) treatment. EMBs of n = 64 patients with B19V mono-infected tissue were retrospectively analyzed. Viral RNA could be detected in n = 18/64 (28.1%) of B19V DNA positive samples (mean age 51.7 years, 12 male), of whom n = 13 had been treated with IFN-ß. Five patients had received placebo. PCR analysis confirmed in follow-up that EMBs significantly reduced viral RNA loads in n = 11/13 (84.6%) of IFN-ß treated patients (p = 0.001), independently from the IFN-ß dose, in contrast to the placebo group, where viral RNA load was not affected or even increased. Consequently, a significant improvement of left ventricular ejection fraction (LVEF) after treatment with IFN-ß was observed (LVEF mean baseline 51.6 ± 14.1% vs. follow-up 61.0 ± 17.5%, p = 0.03). In contrast, in the placebo group, worsening of LVEF was evaluated in n = 4/5 (80.0%) of patients. We could show for the first-time the beneficial effects from treatment with IFN-ß, suppressing B19V viral RNA and improving the hemodynamic course. Our results need further verification in a larger prospective randomized controlled trial.
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