1. Molecular monitoring of viral infections in immunocompromised patients in a large university hospital in Italy: reflections after thirteen years of real-life activity.
- Author
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Cinti L, Roberto P, Rossi M, Napoli A, Russo G, Iori AP, Gentile G, Augurusa M, Girmenia C, Antonelli G, and Gaeta A
- Subjects
- Humans, Italy epidemiology, Male, Middle Aged, COVID-19 epidemiology, COVID-19 virology, Female, Virus Activation, Virus Diseases epidemiology, Virus Diseases virology, Aged, Adult, JC Virus genetics, JC Virus isolation & purification, JC Virus immunology, BK Virus genetics, BK Virus isolation & purification, Cytomegalovirus Infections epidemiology, Cytomegalovirus Infections drug therapy, Herpesvirus 4, Human genetics, Herpesvirus 4, Human immunology, Prevalence, Organ Transplantation adverse effects, Transplant Recipients statistics & numerical data, Cytomegalovirus genetics, Cytomegalovirus immunology, Polyomavirus Infections epidemiology, Polyomavirus Infections virology, Immunocompromised Host, Hospitals, University statistics & numerical data
- Abstract
Purpose: This study aimed to investigate the prevalence and viral reactivations of clinical interest in the immunocompromised patient with particular focus on hematologic and solid organ transplant recipients., Methods: Molecular screening data of CMV, EBV, JCV and BKV from 2011 to 2023 were analyzed. This extensive time span allowed the access to more than 100,000 samples from over 20,000 patients treated at Policlinico Umberto I. It was possible to temporally investigate patient attendance patterns, average age distribution, seasonality of infections, and positivity rates of the analyzed viruses., Results: Between 2019 and 2022 a significant reduction in organ transplants performed and in the positive molecular detection of EBV, JCV and BKV was observed. Additionally, there has been a noteworthy decrease in CMV reactivations, with a reduction of up to 50% starting in 2019. A remarkable reduction of 39% in the rate of CMV viral reactivation has been also achieved in SOT between 2016 and 2023., Conclusion: The years following 2019 were profoundly impacted by the COVID-19 pandemic era. This period resulted in a substantial reduction in healthcare services and hospital visits. Furthermore, the introduction of the drug Letermovir in Italy in 2019 demonstrated remarkable efficacy, evidenced by a reduction in CMV reactivations. Additionally, the adoption of a novel clinical approach centered on personalized therapy facilitated improved management of immunocompromised patients., (© 2024. The Author(s).)
- Published
- 2024
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