Comparative study between chronic immune thrombocytopenia patients and healthy population on Epstein-Barr virus infection status by polymerase chain reaction

Expert Rev Hematol. 2020 Jul;13(7):781-786. doi: 10.1080/17474086.2020.1772746. Epub 2020 Jun 4.

Abstract

Background: Immune thrombocytopenia (ITP) has been known to be associated with assorted virus infections. This study aims to investigate the Epstein-Barr virus infection status in chronic ITP patients by real-time quantitative polymerase chain reaction.

Methods: 42 chronic ITP patients and 42 healthy donors were retrospectively included via propensity score matching with gender and age. EBV-DNA levels in whole blood of patients and donors were assessed by RT-qPCR, and correlations between virus load and platelet count were analyzed.

Results: The positive rate of EBV-DNA in lymphocytes of chronic ITP patients was significantly higher than that in donors (52.4% vs 31.0%, p = 0.046). Platelet count [18(8-45)×109/L] of patients with high virus load in lymphocytes was significantly lower than that [51(30-87)×109/L] of patients with low virus load (p = 0.0001), whereas no difference was observed in platelet count between EBV-DNA-positive and negative subgroups of donors (p = 0.984). And a significant inverse correlation was observed between EBV-DNA levels in lymphocytes and platelet count (r = -0.4958, p = 0.019) in patients, which was independent from the presence of platelet-associated IgG.

Conclusions: EBV infection has a potential role in the development of chronic ITP. Identification and control of this underlying infection should be emphasized in the treatment of chronic ITP.

Keywords: Chronic immune thrombocytopenia; Epstein–Barr virus infection; healthy donors; platelet; real-time quantitative polymerase chain reaction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers
  • Case-Control Studies
  • DNA, Viral
  • Disease Management
  • Disease Susceptibility*
  • Epstein-Barr Virus Infections / complications
  • Epstein-Barr Virus Infections / diagnosis*
  • Epstein-Barr Virus Infections / virology*
  • Female
  • Herpesvirus 4, Human / genetics*
  • Humans
  • Male
  • Middle Aged
  • Platelet Count
  • Polymerase Chain Reaction*
  • Purpura, Thrombocytopenic, Idiopathic / blood
  • Purpura, Thrombocytopenic, Idiopathic / diagnosis
  • Purpura, Thrombocytopenic, Idiopathic / etiology*
  • Purpura, Thrombocytopenic, Idiopathic / therapy
  • Real-Time Polymerase Chain Reaction
  • Viral Load
  • Young Adult

Substances

  • Biomarkers
  • DNA, Viral