Epstein-Barr virus qPCR testing on bronchoalveolar lavage fluid from immunocompromised patients

IF 4 3区医学 Q2 VIROLOGY

Journal of Clinical Virology Pub Date : 2024-07-13 DOI:10.1016/j.jcv.2024.105705

Brooke Liang , Jordan Mah , Malaya K. Sahoo , Benjamin A. Pinsky

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引用次数: 0

Abstract

Background

Epstein-Barr Virus (EBV) is associated with lung disease in immunocompromised patients, particularly transplant recipients. EBV DNA testing of lower respiratory tract specimens may have diagnostic utility.

Methods

This was a retrospective, observational study of all patients with bronchoalveolar lavage (BAL) fluids submitted for EBV qPCR testing from February 2016 to June 2022 at the Stanford Clinical Virology Laboratory.

Results

There were 140 patients that underwent 251 EBV qPCR BAL tests (median 1; range 1 – 10). These patients had a mean age of 15.9 years (standard deviation, 15.1 years) and 50 % were female. Transplant recipients accounted for 67.1 % (94/140) of patients, including 67.0 % (63/94) solid organ transplant (SOT) and 33.0 % (31/94) hematopoietic cell transplant. Diagnostic testing was performed more commonly than surveillance testing [57.0 % (143/251) v. 43.0 % (108/251)]; 96.2 % (104/108) of surveillance samples were from lung transplant recipients. Excluding internal control failures, 34.7 % (83/239) of BAL had detectable EBV DNA, encompassing a wide range of viral loads (median=3.03 log₁₀ IU/mL, range 1.44 to 6.06). Overall agreement of EBV DNA in BAL compared to plasma was 74.1 % [117/158; 95 % confidence interval (CI): 66.5 % to 80.7 %], with a kappa coefficient of 0.44 (95 % CI: 0.30 to 0.57). Only 20.1 % (48/239) of results were discussed in a subsequent clinical note, and one result (0.4 %; 1/239) changed clinical management.

Conclusions

EBV qPCR testing on BAL offers limited clinical impact. Additional biomarkers are required to improve the diagnosis of EBV-associated lung diseases.

查看原文本刊更多论文

对免疫力低下患者支气管肺泡灌洗液进行 Epstein-Barr 病毒 qPCR 检测。

背景：爱泼斯坦-巴氏病毒（EBV）与免疫功能低下患者，尤其是移植受者的肺部疾病有关。对下呼吸道标本进行 EBV DNA 检测可能具有诊断作用：这是一项回顾性观察研究，研究对象是 2016 年 2 月至 2022 年 6 月在斯坦福大学临床病毒学实验室接受 EBV qPCR 检测的所有支气管肺泡灌洗液（BAL）患者：共有 140 名患者接受了 251 次 EBV qPCR BAL 检测（中位数为 1；范围为 1 - 10）。这些患者的平均年龄为 15.9 岁（标准差为 15.1 岁），50% 为女性。移植受者占患者总数的 67.1%（94/140），其中包括 67.0%（63/94）的实体器官移植（SOT）和 33.0%（31/94）的造血细胞移植。诊断性检测比监测性检测更常见[57.0%（143/251）v. 43.0%（108/251）]；96.2%（104/108）的监测样本来自肺移植受者。排除内部对照失败者，34.7%（83/239）的 BAL 可检测到 EBV DNA，病毒载量范围广泛（中位数=3.03 log10 IU/mL，范围从 1.44 到 6.06）。与血浆相比，BAL 中 EBV DNA 的总体一致性为 74.1 % [117/158；95 % 置信区间 (CI)：66.5 % 至 80.7 %]，卡帕系数为 0.44（95 % CI：0.30 至 0.57）。只有20.1%（48/239）的结果在随后的临床记录中进行了讨论，有一项结果（0.4%；1/239）改变了临床治疗：结论：对 BAL 进行 EBV qPCR 检测的临床效果有限。结论：对 BAL 进行 EBV qPCR 检测对临床的影响有限，需要其他生物标记物来改善 EBV 相关肺部疾病的诊断。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Virology 医学-病毒学

CiteScore

22.70

自引率

1.10%

发文量

149

审稿时长

24 days

期刊介绍： The Journal of Clinical Virology, an esteemed international publication, serves as the official journal for both the Pan American Society for Clinical Virology and The European Society for Clinical Virology. Dedicated to advancing the understanding of human virology in clinical settings, the Journal of Clinical Virology focuses on disseminating research papers and reviews pertaining to the clinical aspects of virology. Its scope encompasses articles discussing diagnostic methodologies and virus-induced clinical conditions, with an emphasis on practicality and relevance to clinical practice. The journal publishes on topics that include: • new diagnostic technologies • nucleic acid amplification and serologic testing • targeted and metagenomic next-generation sequencing • emerging pandemic viral threats • respiratory viruses • transplant viruses • chronic viral infections • cancer-associated viruses • gastrointestinal viruses • central nervous system viruses • one health (excludes animal health)