İnsan parechoviruslarının özellikleri, epidemiyolojisi ve klinik önemi

İnsan Parechoviruslar (Human Parechovirus; HPeV) tek iplikli, pozitif polariteli RNA viruslarıdır. Başlangıçta klinik ve morfolojik özelliklerine göre insan enterovirusları içerisinde Echovirus 22 ve 23 olarak tanımlansalar da, genom organizasyonu, yapı ve replikasyonlarında birkaç farklı özellikleriyle enteroviruslar ve diğer picornavirus gruplarından farklı oldukları gösterilmiştir. HPeV’ler genetik ve antijenik heterojenlik göstermekte ve birçok tipi dünyanın her yerinde bulunan insan popülasyonunda yaygın bir şekilde bulunmaktadır. HPeV1 en yaygın genotip olup sıklıkla gastrointestinal ve solunum yolu hastalıklarına neden olmaktadır. HPeV3 enfeksiyonu yenidoğanlarda ve 3 aydan daha küçük infantlarda sepsis, meningoensefalit, nörolojik sekellere ve ölümlere yol açmaktadır. Küçük infantlarda tipik klinik tablo, ateş, şiddetli sinirlilik ve kızarıklıktan oluşur ve sıklıkla “ateşli, kırmızı döküntülü, kızgın bebekler” tanımına sebep olmaktadır. Günümüzde HPeV’lerin tanısı için en duyarlı metod real-time polimeraz zincir reaksiyonudur. Enfeksiyonlarının tedavisinde şimdiye kadar kadar herhangi bir spesifik antiviral tedavi mevcut olmayıp monoklonal antikorların kullanımı değerlendirilmektedir. HPeV’ler üzerine yapılacak daha fazla çalışma ile bu virusların spesifik karakteristiklerinin anlaşılmasına ve uygun tedavi stratejilerinin geliştirilmesine ihtiyaç vardır.

Characteristics, epidemiology and clinical importance of human parechoviruses

Human parechoviruses (HPeVs) are single-stranded, positive-sense RNA viruses. Although originally described as echovirus 22 and 23 within human enteroviruses because of their clinical and morphological properties, they have since been shown to be distinct from this and other picornavirus groups in several features of their genome organisation, structure and replication. HPeVs show genetic and antigenic heterogeneity and a number of distinct types are known to circulate widely in human populations throughout the world. HPeV1 causes mostly gastrointestinal and respiratory tract infections. HPeV3 can cause sepsis and meningoencephalitis in neonates and infants younger than 3 months, which could lead to neurological sequelae and death. In young infants, the typical clinical presentation includes fever, severe irritability, and rash, often leading to descriptions of “hot, red, angry babies”. Nowadays, the most sensitive method for detecting HPeV is real-time polymerase chain reaction assays. In the treatment of infections, no specific antiviral therapy has been available so far and the use of monoclonal antibodies is still being evaluated. More research is therefore needed to understand the specific characteristics of this viruses and to develop appropriate treatment strategies.

Keywords:

HPeV types, Clinical charecteristics Diagnosis, Epidemiology,

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