Infections and Transplants

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Infections and Transplants

Postby mrhodes40 » Sun May 25, 2008 9:48 am

I was going to post this on the hicy forum but decided to put it here as it is speculative and only tangentially related to treatment with hicy.

I wondered about permanently latent virii like:
-HSV1 (cold sores on the lips)
-HHV6 lives in you forever after contacting it as a kid (we all have it)
-EBV lives in your b cells forever, and possibly the marrow

those are all viruses that the vast majority of the population has dormant/latent in their body.

I am interested in the status of the person's infection load post treatment with revimmune or ASCT because there has been research for years associating RA and MS with EBV and HHV6. Could treatment eradicate the reservoir for EBV? What impact might it have on the other virii?

For me, cold sores usually mean an MS worsening and my first MS and RA attack came dramatically after my first cold sores (my husband always got them, but I resisted for years).

Maybe germs are eradicated by cyclophosphamide themselves? One comment in the full text below speculates that may be at issue, though primarily they think the marrow being killed by radiation made the differencein the EBV status.

Here is an abstract related to EBV and marrow transplants. Full text available on link ... tid=282526

Wild-type strains of Epstein-Barr virus (EBV) can be distinguished on the basis of variations in the molecular weight of virus-encoded, growth transformation-associated proteins. This approach was used to study the persistence of EBV in two seropositive recipients of allogeneic bone marrow transplants. The first patient received marrow from her EBV-seronegative brother, became EBV seronegative after grafting, and remained so for greater than 1200 days. Subsequently, she became infected with a new EBV strain that differed from her pretransplant strain but was indistinguishable from the virus isolated from her husband. The second patient received marrow from his EBV-seropositive brother. This patient showed only a transient decrease in IgG antibodies to EBV capsid antigen. His pretransplant strain differed from the virus of his donor. On days 252 and 915 after transplantation, lymphoblastoid cell lines were grown from the peripheral blood of the patient and were found to carry exclusively the virus of the donor. These results suggest that the latently EBV-infected host cells reside in a cellular compartment that can be destroyed by graft-versus-host reactivity, irradiation, or cytotoxic drugs. Hemopoietic tissue is the most likely candidate.

Essentially in these patients it appears they have the sero-status of their marrow donor, so that suggests it lives in the marrow not just the peripheral b cells.

The whole text is available and about the third page has a discussion of the reservoirs of EBV. Apparently those patients who had radiation also
got acyclovir (an antiviral) afterwards for cold sores (HSV) and shingles (hzv) protection, so that recognizes and proactively treats the latent germs showing up post ASCT.

In this abstract they discuss HHV6 and transplantation. Apparently it reactivates and causes problems pretty often after treatment, again ASCT in this case.

I am interested in revimmune and the reboot idea, but it does not radiate the marrow, so it is probable that ebv status will be unaffected; I am guessing here.

I have personally been strongly believing that MS is probably infective for some time now, but I wondered if there was a way to see ASCT and reviummune as having an impact on other MS models besides autoimmunity.

I am a curious person so there's lots to think about if you have MS!
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