Impact assessment and investigation of factors associated with herpesviruses viremia in the first year of renal transplantation

J Med Virol. 2020 Jan;92(1):107-112. doi: 10.1002/jmv.25580. Epub 2019 Sep 5.

Abstract

The increased risk for opportunistic infections after a renal transplant requires monitoring of viral infections to avoid future complications. Our goal was to investigate the impact and factors associated with Epstein-Barr virus (EBV), human cytomegalovirus (HCMV) and human herpesvirus type 6 (HHV-6) viremia in renal transplant recipients. Whole blood samples were collected monthly from 82 patients during the first semester and then quarterly up to 1 year after transplantation. EBV, HCMV, and HHV-6 were detected and quantified by TaqMan real-time polymerase chain reaction. The results showed that EBV and HCMV viremia were detected in 32 patients (39% each), while HHV-6 viremia in only 3 patients (3.7%). EBV was significantly associated with age (P = .050), thymoglobuline induction (P = .019), mTOR inhibitor-based therapy (P = .003), and female gender (P = .044). HCMV was significantly associated with basiliximab induction (P = .015), mycophenolate mofetil (MMF)-based therapy (P = .003) and allograft acute rejection (P = .033). Moreover, HCMV-disease was correlated with MMF-based therapy (P = .021) and female gender (P = .003). In conclusion, EBV and HCMV viremia were associated with different immunosuppressive induction and maintenance strategies. Additionally, higher HCMV viremia (> 10 4 copies/mL) was related to acute allograft rejection.

Keywords: Epstein-Barr virus; human cytomegalovirus; human herpesvirus type 6; transplant.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cytomegalovirus / genetics
  • Cytomegalovirus Infections / blood
  • DNA, Viral / blood*
  • Epstein-Barr Virus Infections / blood
  • Female
  • Herpesviridae / pathogenicity
  • Herpesviridae Infections / blood*
  • Herpesviridae Infections / etiology
  • Herpesvirus 4, Human / genetics
  • Humans
  • Kidney Transplantation / adverse effects*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Transplant Recipients*
  • Viral Load
  • Viremia / etiology*

Substances

  • DNA, Viral