Unit:
Τομέας Υγείας - Μητέρας - ΠαιδιούLibrary of the School of Health Sciences
Author:
Παπαλουκάς Ευθύμιος-Ορέστης
Dissertation committee:
Kαθηγήτρια Βασιλική Παπαευαγγέλου
Original Title:
Yποκλινική αναζωπύρωση του ιού της ανεμευλογιάς σε παιδιά μετά από σοβαρό stress
Summary:
SUMMARY
A prospective observational study was conducted in order to examine the
hypothesis
of asymptomatic reactivation of VZV in immunocompetent children hospitalized in
the
Intensive Care Unit and the clinical repercussions of such hypothesis. Secondary
goal of the study was to estimate the effect of vaccination against VZV and
whether
vaccinated individuals are at lower risk of reactivating the virus than those
that were
naturally infected by it. Immunocompetent children hospitalized
in the ICU were
enrolled. Also a group of healthy children, matched for age and varicella
history to
their ICU counterparts, was used as control. The patients were prospectively
followed
for 28 days. Personal and clinical data were gathered. Upon admission in the
ICU,
serum samples were collected for TNF-α and cortisol levels
and for VZV-IgG
antibodies. Blood and saliva samples were collected for VZV-DNA detection using
real-time PCR. The same procedure was followed for the detection of HSV-DNA, as
a comparison. Reactivation of VZV was observed in 7/39 patients (17%). Children
that reactivated the virus exhibited prolonged fever duration (OR=1.17 95%
CI:1.02-
1.34). None of the vaccinated children or healthy controls revealed VZV-DNA in
any
of their blood or saliva samples. On the other hand, HSV-DNA was detected in
saliva
samples from 33% of the ICU patients and 2.6% of healthy controls. Among those
patients that reactivated the virus ,typing showed that the VZV was of the wild
type
and the HSV was HSV-1. In conclusion , VZV reactivation in
immunocompetent
children under severe stress was observed for the very first time. It was also
evident
that reactivation of the virus led to prolonged duration of fever.
Keywords:
Varicella, Herpes zoster, Vaccine, I.C.U., Reactivation
Number of references:
253
