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Human polyomavirus in pregnancy. A model for the study of defence mechanisms to virus reactivation.

机译:人多瘤病毒在怀孕。研究病毒激活防御机制的模型。

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摘要

We have carried out a longitudinal study of human polyomavirus infection in 71 pregnant women and correlated the virological findings with changes in the defence system in the same patients. As reactivation of human polyomaviruses generally occurred late in the second trimester it was possible to distinguish between the immunological changes which preceded the onset of reactivation and those which were secondary to the infection. Evidence of reactivation was detected in 26 women; all had high or rising antibody titres against BK or JC virus, but only five of these developed viruria. A positive correlation was observed between a high monocyte count in early pregnancy and subsequent virus reactivation. The virus excretors had significantly lower neutrophil counts than the women who had no evidence of virus reactivation. In contrast, women with serological evidence of virus activity but no viruria has significantly higher neutrophil counts than the non-activators. They also had stronger lymphocyte responses to PHA than the virus excretors. Virus activators were found to have a significant lymphopenia in the third trimester compared to the non-activators. High antibody levels did not appear to inhibit virus excretion. These findings suggest that monocytosis may predispose to reactivation of human polyomaviruses in pregnancy. On the other hand, ability to contain the virus once it has been activated, was associated with neutrophilia, and relatively vigorous in vitro reactivity of lymphocytes to PHA. Persistent lymphopenia was probably secondary to virus reactivation. The model on which this study is based could be adapted to investigate the causes of reactivation of other viruses. It may also help to identify risk factors in patients who are particularly susceptible to infection with opportunistic viruses.
机译:我们对71名孕妇进行了人类多瘤病毒感染的纵向研究,并将病毒学发现与同一患者防御系统的变化相关联。由于人类多瘤病毒的重新激活通常发生在妊娠中期,因此可以区分重新激活之前的免疫学变化和继发于感染的免疫学变化。在26名妇女中发现了再激活的证据;所有的人对BK或JC病毒的抗体滴度都很高或在上升,但其中只有五种发展为病毒性病毒。怀孕初期单核细胞计数高与随后的病毒活化之间存在正相关。与没有病毒再激活证据的女性相比,病毒排泄者的中性粒细胞计数明显降低。相比之下,具有病毒活性但无病毒血症的血清学证据的妇女的中性粒细胞计数明显高于非活化剂。他们对PHA的淋巴细胞反应也比病毒排泄物强。与非激活剂相比,发现病毒激活剂在妊娠中期有明显的淋巴细胞减少。高抗体水平似乎没有抑制病毒排泄。这些发现表明,单核细胞增多症可能使人多瘤病毒在妊娠中重新活化。另一方面,一旦被激活,遏制病毒的能力与嗜中性粒细胞相关,并且淋巴细胞对PHA的体外反应性相对较强。持续性淋巴细胞减少可能是病毒激活后继发的。这项研究所基于的模型可以适用于调查其他病毒重新激活的原因。它还可能有助于确定特别容易受到机会性病毒感染的患者的危险因素。

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