目的探讨CMV包膜糖蛋白B(CMVgB)基因分型对造血干细胞移植后CMV感染患者病毒载量和抗病毒疗程的影响。方法选择接受造血干细胞移植且CMV—DNA阳性的l15例CMV感染患者,采用荧光定量PCR检测病毒载量,限制性片段长度多态性PCR(PCR—RFLP)法鉴定CMVgB基因分型,分析不同CMVgB基因型感染患者病毒载量和抗病毒疗程的差异。结果①115例患者CM—VgB基因型分布:gBl型42例(36.52%),gB2型3例(2.61%),gB3型43例(37.39%),gB4型2例(41.74%),混合分型20例(17.39%),5例(4.35%)因缺乏RsaI酶切位点命名为gB5。②CMVgBl、gB3和混合型感染患者CMV.DNA拷贝数的中位值分别为2.7×10^3(1.81×10’~6.03×10^4)、4.0×10^3(1.32×10^3~6.39×10^4)和1.2×10。(2.28X10^3~6.50×10^5)。CMVgBl型和gB3型CMV—DNA拷贝数比较,差异无统计学意义(P〉0.05)。单一CMVgB基因型感染(gBl型或gB3型)与混合型感染比较,CMV—DNA拷贝数差异有统计学意义(P〈0.05)。③单一CMVgB感染患者CMV—DNA转阴中位时间为14(7—34)d,混合型感染患者CMV—DNA转阴中位时间为17(11—42)d,差异有统计学意义(P〈0.05)。结论CMVgB基因分型对CMV感染患者病毒载量和治疗疗程有影响。
Objective To explore the effect of CMV gB genotypes on viral load and treatment time in patients with CMV infection 'after hematopoietic stem cell transplantation (HSCT). Methods Viral load was detected by real-time(RT) quantitative polymerase chain reaction(PCR) (Q-PCR), CMV gB genotypes by PCR restriction fragment length polymorphism (RFLP) (PCR-RFLP) in 115 patients with CMV infection (CMV-DNA positive) after HSCT during July 2004 and May 2010. Results ①The distribution of CMV gB genotypes in HSCT recipients were as following: gB1, 42/115 (36.52%) ; gB2, 3/115 (2.61%) ; gB3, 43/115 (37.39%) ; glM, 2/115 ( 1.74% ). 20 patients ( 17.39% ) had a combination of 2 different CMV genntypes and 5 patients (4.35%) had a CMV variant that lacked an RsaI digestion site, herein named gBS. ②The median viral load were 2.7 x 103 ( 1.81 × 10^3 - 6.03 x 10^4 ) in gB1, 4.0 × 10^3 ( 1.32× 10^3 - 6.39 × 10^4 ) in gB3 and 1.2 × 10^4 (2.28 × 10^3 - 6.50 × 10^5 ) in mixed gB. There was no statistical difference in vi- ral load between gB1 and gB3 (P 〉 0.050). There was significantly statistical difference in viral load between single-gB ( gB1 or gB3 ) and mixed-gB (P 〈 0.05 ).③The median treatment time was 17 days in mixed-gB and 14 days in single-gB. There was significantly statistical difference between two groups (P 〈 0.05 ). Conclusion gB genotype may have an impact on CMV DNA load and treatment time in HSCT recipients with CMV infection.