Cytomegalovirus in Children receiving Haematopoietic Stem Cell Transplantation
Chief Investigators: David Whiley, Emma Sweeney, Adam Irwin, Helen Farrell, Julia Clark, Chris Fraser, Amy Jennison, David Warrilow
Masters Student: Jocelyn Hume
Aim
To develop novel molecular diagnostic assays to rapidly detect active Cytomegalovirus infection and associated antiviral resistance in children receiving haematopoietic stem cell transplantation.
Background
Cytomegalovirus is a type of Herpesviridae that is ubiquitous around the world. In healthy individuals it causes a mild illness, however it has the ability to evade the immune system and become latent for life. In immunosuppressed individuals it can reactivate, causing serious disease and increasing the risk of mortality.
Key Clinical Challenges Include:
- With the current diagnostic tests [polymerase chain reaction] being extremely sensitive, subclinical cytomegalovirus can be detected, leading to overtreatment of patients.
- Overtreatment of cytomegalovirus can lead to mutations occurring, allowing for antiviral resistance to develop.
- Antiviral resistance testing can take considerable time to perform, days to weeks in some cases. During this time, clinicians have little to no information regarding which treatments will be effective.
Impact
The novel molecular diagnostic assays developed with this project will allow for the differentiation between active and latent cytomegalovirus infections and rapidly detect associated antiviral resistance. This will empower clinicians to know when to start/stop treatment and which treatments will be effective, greatly improving the outcomes for children receiving haematopoietic stem cell transplantation.
