Zika and chikungunya virus infections in hematopoietic stem cell transplant recipients and oncohematological patients.

Autor:	Machado CM; Virology Laboratory, Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil.; HSCT Program, Amaral Carvalho Foundation, Jahu, São Paulo, Brazil., Pereira BBS; Virology Laboratory, Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil., Felix AC; Virology Laboratory, Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil., Oliveira MC; Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil., Darrigo LG Jr; Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil., de Souza MP; HSCT Program, Amaral Carvalho Foundation, Jahu, São Paulo, Brazil., Paton EJA; HSCT Program, Hospital de Câncer de Barretos, São Paulo, Brazil; and., Neves F; Santa Casa de Misericórdia de Itabuna, Bahia, Brazil., Colturato VR; HSCT Program, Amaral Carvalho Foundation, Jahu, São Paulo, Brazil., Simoes BP; Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	Blood advances [Blood Adv] 2017 Apr 10; Vol. 1 (10), pp. 624-627. Date of Electronic Publication: 2017 Apr 10 (Print Publication: 2017).
DOI:	10.1182/bloodadvances.2016003285
Abstrakt:	Aedes mosquitoes are well adapted in domestic environments and widespread in tropical regions. Since 2015, Brazil has been experiencing a triple epidemic of dengue (DENV), chikungunya (CHKV), and Zika (ZIKV) viruses. The last 2 viruses are likely following the path of DENV, which has been endemic in most parts of the country since the 1980s. Given this triple epidemic, we proposed a prospective and collaborative study to assess the prevalence, morbidity, and mortality of DENV, CHKV, and ZIKV infections in hematopoietic stem cell transplant (HSCT) recipients and oncohematological patients. A case definition strategy (fever and rash) was used to prompt diagnostic investigation of DENV, ZIKV, and CHKV, which was accomplished by real-time polymerase chain reaction with plasma and urine samples. Clinical follow-up was performed 7 and 30 days after symptom onset. We report here the first cases of ZIKV and CHKV infections diagnosed in this ongoing study. From February to May 2016, 9 of the 26 patients (34.6%) fulfilling case definition criteria were diagnosed with DENV (3 cases), ZIKV (4 cases), or CHKV (2 cases) infections. Prolonged viremia and viruria were observed in dengue and Zika fever cases, respectively. Thrombocytopenia was the most frequent complication. Delayed engraftment was noted in 1 patient who acquired ZIKV 25 days before HSCT. All patients survived without sequelae. With the geographic expansion of arboviruses, donor and recipient screening may become mandatory. Patients living in areas where these viruses are not endemic are also at risk, since these viruses can be transmitted by blood as well as organ or tissue transplantation. Competing Interests: Conflict-of-interest disclosure: The authors declare no competing financial interests.
Databáze:	MEDLINE
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