Impacto das infecções virais em pacientes com anemia aplástica: uma revisão sistemática

Abstract

Introduction: Aplastic anemia (AA) is a severe and rare hematological condition characterized by bone marrow failure and consequent pancytopenia. Among its main complications, it is essential to note the impairment of the immune system, which results from leukopenia. This condition makes patients more susceptible to infections, particularly those of viral origin. Objectives: To present a synthesis of the scientific literature regarding the impacts of viral infections on individuals with aplastic anemia. Methods: A systematic literature review was conducted following the PRISMA 2020 model, registered on the OSF platform. Studies were selected from the PubMed and Scopus databases using the health descriptors "Aplastic Anemia" and "Viruses," combined with the Boolean operator "AND," to consider research addressing the impacts of viral infections in patients with aplastic anemia. Results: The data indicated the presence of various viruses in patients with aplastic anemia, such as coronavirus, HIV, and, predominantly, Epstein–Barr virus (EBV). These patients exhibit increased susceptibility to viral infections, which tend to present with more systemic and severe clinical manifestations compared to the healthy population. This condition can be attributed to the immunological dysfunction inherent to the disease. It was also observed that viral infections contributed to the worsening of hematological disease prognosis by influencing the activity of autoreactive T lymphocytes (TLCs) during bone marrow degeneration, given their distinct immunological profile compared to that of healthy individuals. Conclusion: Viral infections represent a significant concern for patients with aplastic anemia, not only due to the challenges in diagnosis but mainly because of their potential impact on immune modulation and disease progression.