Human Astrovirus among Children with Cancer in Basrah Human Astrovirus among Children with Cancer in Basrah
Main Article Content
Keywords
cancer in children, human astrovirus, Basrah
Abstract
Background. The impairment of the T-lymphocyte system leads to reduced viral clearance, resulting in intensified disease and the possibility of prolonged infection.(2) The poor functioning of B lymphocytes makes the host susceptible to bacterial and viral infections, especially in cases of malignant disease.
Aim of the study. The present study set out to determine the frequency of human astrovirus infection among patients who suffered from malignancies who were being treated in the Oncology Center of the Basrah Children’s Specialty Hospital.
Patients and Method. A cross-sectional study was approved for a population of children with cancers during the period from October 1, 2015 through the end of January, 2016. Forty-five children (24 females and 21 males), all with cancers, were admitted to the Oncology Center of Basrah Children’s Specialty Hospital. Their ages ranged from under 1 year to 15 years. According to the results of a specially designed questionnaire, data were obtained from patients who were either symptomatic or asymptomatic for human astrovirus infections, including 3 newly diagnosed cases (before chemotherapy) and 38 cases (during chemotherapy), with the remaining 4 cases admitted after chemotherapy. Ninety stool samples were collected at day 0 and day 4 after admission, and all were tested using astrovirus antigen enzyme-linked immuno sorbent assay (ELISA) kits (EIA-4456).
Results. On both days, the rate of astrovirus infections was 15.6% in the hospitalized children with cancers, and there were no statically significant differences between hematological malignancies and solid tumors (P value was 0.857). Among hematological malignancies, astrovirus was detected at a significant rate (the P value was 0.0001) in patients with acute myeloblastic leukemia, while patients with solid tumors exhibited significant expression of rhabdomyosarcoma (the P value was 0.001).
Astrovirus infection was more prevalent in females (85.8%) than in males (the P-value was 0.001). Infection was most prevalent in the age group of >1–5 years (57%), and most of the infected patients (85.8%) were from rural areas (the P-value was 0.012). In most of the symptomatic infected cases (71.4%) the symptom was acute diarrhea (the P-value was 0.05), and this was typical during chemotherapy.
Conclusion. Astrovirus infections occur at significant rates in acute myeloblastic leukemia, among hematological malignancies, and in patients with rhabdomyosarcoma, in the solid-tumor category. Therefore, astrovirus screening should be done for all children with cancers, and especially for patients with acute myeloblastic leukemia or rhabdomyosarcoma.
References
2. Guo L, Gonzalez R, Wang W, Li Y, Paranhos-Baccalà G, Vernet G, et al. Complete genome sequence of human astrovirus genotype 6. Virol J. 2010;7(29):1-9.
3. Aminu M, Esona M, Geyer A, Steele A. Epidemiology of rotavirus and astrovirus infections in children in Northwestern Nigeria. Ann Afr Med. 2008;7(4):168-74.
4. Coppo P, Scieux C, Ferchal F, Clauvel J, Lassoued K. Astrovirus enteritis in chronic lymphocytic leukemia patient treated with fludarabine monophosphate. Ann Hematol. 2000;79:43-45.
5. Jeong H, Jeong A, Cheon D. Epidemiology of astrovirus infection in children. Korean J Pediatr. 2012;55(3):77-82.
6. Al-Hadad S, Al-Jadiry M, Al-Darraji A, Al-Saeed R, Al-Badr S, Ghali H. Reality of pediatric cancer in Iraq. Pediatr Hematol Oncol. 2011;33(2):154-56.
7. Alsaraji M, Al-Mukhtar M, Muzahim H, Husain A, Jasim K, Mutleg L, et al. Iraqi cancer registry. Iraq Cancer Board. 2011;2:140-47.
8. Koskenvuo M, Ruuskanan O, Salmi T, Rajantie J, KorppI M, Heikinheimo M. Febrile infections in children with leukemia with special reference to respiratory viral infections. Medica-Odontologica. 2008;1-85.
9. Alizadeh D, Larmonier N. Chemotherapeutic targeting of cancer-induced immunosuppres-sive Cells. Amer Assoc Cancer Res. 2014;74:2663-68.
10. Rabinovich G, Gabrilovich D, Sotomayor E. Immunosuppressive strategies that are mediated by tumor cells. Annu Rev Immunol. 2007;25: 267-96.
11. Cheng C, Chan J, Cembrowski G, Assendelft V. Complete blood count reference interval diagrams derived from NHANES III: stratification by age, sex, and race. Lab Hematol. 2004;10(1):42-53.
12. Caballero S, Guix S, El-Senousy W, Calicó I, Pintó R, Bosch A. Persistent gastroenteritis in children infected with astrovirus: association with serotype-3 strains. J Med Virol. 2003;71:245-50.
13. Silva A, Leite E, Assis R, S Majerowicz, Leite J. An outbreak of gastroenteritis associated with astrovirus serotype 1 in a daycare center. Rio de Janeiro. 2001;96(8): 1069-1073.
14. Quaye O, McDonald S, Esona M, Lyde F, Rustempasic S, Roy S, et al. Recently identified novel human astroviruses in children with diarrhea, China. J Emerg Infect Dis. 2013;19(8):1333-35.
15. Koopmans M, Bijen M, Monroe S, Vinje J. Age-stratified seroprevalence of neutralizing antibodies to astrovirus types 1 to 7 in humans in the Netherlands. Clin Diag Lab Immunol. 1998;5(1):33-37.
16. Rodriguez-Baez N, O’Brien R, Qui S, Blass D. Astrovirus, adenovirus and rotavirus in hospitalized children: prevalence and association with gastroenteritis. J Pediatr Gastroenterol Nutr. 2002;35:64-68.
17. Oishi I, Yamazaki K, Kemoto T. A large outbreak of acute gastroenteritis associated with astrovirus among students and teachers in Osaka, Japan. J Infect Dis. 1994;170:439-43.
18. Maldonado Y, Cantwell M, Old M, Hill D, Sanchez ML, Logan L, et al. Population-based prevalence of symptomatic and asymptomatic astrovirus infection in rural Mayan infants. J Infect Dis. 1998;178:334–39.
19. Thewiny H, Hasony H, Salman B. Human astrovirus among hospitalized children under five years of age with acute diarrhea in Basrah, Iraq. Med J of Basrah Univ. 2014;32(2):71-76.
20. Shastri S, Doane A, Gonzales J, Upadhyayula U, Bass D. Prevalence of astroviruses in a children’s hospital. J Clin Microbiol. 1998;36(9): 2571–74.
21. Gabbay Y, Linhares A, Cavalcante-Pepino E, Nakamura L, Oliveira D, Silva L, et al. Prevalence of human astrovirus genotypes associated with acute gastroenteritis among children in Belem, Brazil. J Med Vir. 2007;79(5):530-38.
22. Mitchell D, Madson D, Jiang X, Berke T, Monroe S, Carter M, et al. Molecular epidemiology of childhood astrovirus infection in child care centers. J Infec Dis. 1999;180:514–17.
23. Chikhi-Brachet R, Bon F, Toubiana L, Pothier P, Nicolas J, Flahault A, et al. Virus diversity in a winter epidemic of acute diarrhea in France. J Clin Microbiol. 2002;40:4266-72.
24. Kang Y, Park Y, Ahn J, Yeun J, Jee Y. Identification of human astrovirus infections from stool samples with diarrhea in Korea. Arch Virol. 2002;147:1821-27.
25. Nguyen T, Hoang L, Pham I, Hoang K, Mizuguchi M, Okitsu S, et al. Identification of human astrovirus infections among children with acute gastroenteritis in the southern part of Vietnam during 2005–2006. J Med Virol. 2008;80:298-305.
26. Maham S, Marhamati N, Fallah F, Raheleh Sadat Sajadi R,
Atashrazm F. Epidemiology of astrovirus infection in young children hospitalized with gastroenteritis in Iran, over a period of seven years, using reverse transcriptase-polymerase chain reaction (RT-PCR). J Public Health Epidemiol. 2013;5(1):37-42.
27. Fang Z, Sun Y, Ye X, Wang H, Zhang Q, Duan Z, et al. Astrovirus infection among hospitalized children with acute diarrhea in seven regions of China, 1998–2005. Zhonghua Liu Xing Bing Xue Za Zhi. 2006;27:673-76.
28. Walter J, Mitchell D. Astrovirus infection in children. Curr Opin Infect Dis. 2003;16:247-53.
29. Papaventsis D, Dove W, Cunliffe N, Nakagomi O, Combe P,
Grosjean P, et al. Human astrovirus gastroenteritis in children, Madagascar, 2004–2005. Emerg Infect Dis. 2008;14:844-46.
30. Monroe S, Glass R, Noah N, Jiang X. Electron microscopic reporting of gastrointestinal viruses in the United Kingdom, 1985–87. J Med Virol. 1991;33(3):193-98.
31. Mendez-Toss M, Griffin D, Calva J, Contreras J, Puerto F, Mota F, et al. Prevalence and genetic diversity of human astroviruses in Mexican children with symptomatic and asymptomatic infections. J Clin Microbiol. 2004;42 (1):151-57.
32. Herrmann J, Nowak N, Perron-Henry D, Hudson R, Cubitt W, and Blackiow N. Diagnosis of astrovirus gastroenteritis by antigen detection with monoclonal antibodies. J Infect Dis. 1990;161(2):226-29.
33. Meliopoulos V, Kayali G, Burnham A, Olshansky C, Thomas P,
Gray G, et al. Detection of antibodies against turkey astrovirus in humans. PLoS ONE. 2014;9(5):1-6.
34. Rodriguez-Baez N, O’Brien R, Qiu SQ, Bass D. Astrovirus, adenovirus, and rotavirus in hospitalized children: Prevalence and association with gastroenteritis. J Pediatr Gastroenterol Nutr. 2002;35:64-68.
35. Coates T. Neutrophils. In: Kliegman R, Stanton B, Geme J, Schor N, Behrman R. Nelson Textbook of Pediatrics. 20th ed. Philadelphia: Elsevier; 2016:1048-3473.
36. Mozhgani S, Samarbaf-Zadeh A, Makvandi M, Shamsi-Zadeh A, Parsanahad M, Jalilian S. Relative frequency of astrovirus in
children suffering from gastroenteritis referred to Aboozar Hospital, Ahvaz. JJM. 2011; 4(1):67-70.
37. Meqdam M, Thwiny I. Prevalence of group A rotavirus, enteric adenovirus, norovirus and astrovirus infections among children with acute gastroenteritis in Al-Qassim, Saudi Arabia. Pak J Med Sci. 2007;23(4):551-55.
38. Chen S, Chang Y, Lee Y, Chao H, Tsao K, Lin T, et al. Molecular epidemiology and clinical manifestations of viral gastroenteritis in hospitalized pediatric patients in Northern Taiwan. J Clin Microbiol. 2007;45: 2054-57.
39. Ham H, Oh S, Jang J, Jo S, Choi S, Pak S. Prevalence of human astrovirus in patients with acute gastroenteritis. Ann Lab Med. 2014;34:145-47.
40. Bhattacharya R, Sahoo G, Nayak M, Ghosh S, Dutta P, Bhattacharya M, et al. Molecular epidemiology of human astrovirus infections in Kolkata, India. Infect Genet Evol. 2006;6:425-35.
41. Phan T, Okame M, Nguyen T, Maneekarn N, Nishio O, Okitsu S, et al. Human astrovirus, norovirus (GI, GII), and sapovirus infections in Pakistani children with diarrhea. J Med Virol. 2004;73:256–61.
42. Guix S, Caballero S, Villena C, Bartolome R, Latorre C, Rabella N, et al. Molecular epidemiology of astrovirus infection in Barcelona, Spain. J Clin Microbiol. 2002;40(1): 133-39.
43. Naficy A, Rao M, Holmes J, Abu-Elyazeed R, Savarino S, Wierzba T, et al. Astrovirus diarrhea in Egyptian children. J Infect Dis. 2000;182:685-90.
44. Maryam A, Dewar J, Ahmad A, Umoh J. Molecular epidemiology of rotaviruses, astroviruses, and adenoviruses associated with gastroenteritis in children in northwestern Nigeria. Diarrheal Pathogens Research Unit. 2006;1:1-292.
45. Dennehy P, Nelson S, Spangenberger S, Noel J, Monroe S, and Glass R. A prospective case-control study of the role of astrovirus in acute diarrhea among hospitalized young children. J Infect Dis. 2001;184:1-15.
46. Gabbay Y, NedaLuz C, Costa I, Cavalcante-Pepino E, Sousa M, Oliveira K, et al. Prevalence and genetic diversity of astroviruses in children with and without diarrhea in São Luís, Maranhão, Brazil Mem Inst Oswaldo Cruz, Rio de Janeiro. 2005;100(7):709-14.
47. Liste M, Natera I, Suarez J, Pujol F, Liprandi F, Ludert J. Enteric virus infections and diarrhea in healthy and human immunodeficiency virus-infected children. J Clin Microbiol. 2000;38(8):2873-77