Cargando…
Seroprevalence of cytomegalovirus in donors & opportunistic viral infections in liver transplant recipients
BACKGROUND & OBJECTIVES: Opportunistic virus infections are common in liver transplant (LT) recipients. There is a risk of developing infection with cytomegalovirus (CMV) and herpes-related viruses such as herpes simplex virus-1 and 2 (HSV-1 & 2), Epstein-Barr virus (EBV) and Varicella Zoste...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5663172/ https://www.ncbi.nlm.nih.gov/pubmed/28862190 http://dx.doi.org/10.4103/ijmr.IJMR_1024_14 |
_version_ | 1783274781973413888 |
---|---|
author | Varghese, Joy Subramanian, S. Reddy, Mettu Srinivas Shanmugam, Naresh Balajee, G. Srinivasan, Vijaya Venkataraman, Jayanthi Mohamed, Rela |
author_facet | Varghese, Joy Subramanian, S. Reddy, Mettu Srinivas Shanmugam, Naresh Balajee, G. Srinivasan, Vijaya Venkataraman, Jayanthi Mohamed, Rela |
author_sort | Varghese, Joy |
collection | PubMed |
description | BACKGROUND & OBJECTIVES: Opportunistic virus infections are common in liver transplant (LT) recipients. There is a risk of developing infection with cytomegalovirus (CMV) and herpes-related viruses such as herpes simplex virus-1 and 2 (HSV-1 & 2), Epstein-Barr virus (EBV) and Varicella Zoster virus (VZV), reactivation of infection and recurrent infection. This study was conducted to determine CMV seropositivity in donors and its influence on LT recipients and seropositivity of CMV, HSV-1 and 2, EB viral capsid antigen (EBVCA) and VZV in LT recipients and their reactivation. METHODS: Pre-transplant data for IgG and IgM for CMV (and donor), HSV-1 and -2, EB viral capsid antigen (VCA) and VZV were available for 153 recipients. All recipients were on ganciclovir or valganciclovir prophylaxis for three months after LT. For reactivation rates, findings of post-transplant CMV quantitative reverse transcription polymerase chain reaction (CMV qRT-PCR) assay were associated with pre-transplant serological profile. RESULTS: Of the 153 LT recipients, 131 were men (85.6%). The median age of LT was 46 yr (range 9 months-71 yr). Overall exposure to CMV was 71.8 per cent followed by EB VCA (61.4%) and VZV (49.6%). Susceptibility to both HSV-1 and -2 was high across all decades (P<0.001). Seropositivity of CMV in donor was 90.9 per cent (100 out of 110). Post-transplant CMV qRT- PCR was positive in 17 (26.6%; 3 in recipient negative) of 64 samples tested. qRT-PCR assay was positive in one out of four (25%) tested for HSV-1 and nine out of 19 (47.4%) tested for EBV. Two recipients tested for HSV-2 and one for VZV were negative. There were three deaths in recipients (D+ R+) who were also positive for CMV qRT PCR. There was one death due to HSV-1 pneumonia. One patient with EBV reactivation developed post-transplant lymphoproliferative disorder two years after transplant. INTERPRETATION & CONCLUSIONS: Transplant recipient were at highest risk of acquiring HSV-1 and -2 more so for HSV-2. CMV exposure in transplant recipients and donors were very high and at greatest risk for recipient reactivation rate. Despite this, death related to CMV reactivation was low. |
format | Online Article Text |
id | pubmed-5663172 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-56631722017-11-02 Seroprevalence of cytomegalovirus in donors & opportunistic viral infections in liver transplant recipients Varghese, Joy Subramanian, S. Reddy, Mettu Srinivas Shanmugam, Naresh Balajee, G. Srinivasan, Vijaya Venkataraman, Jayanthi Mohamed, Rela Indian J Med Res Original Article BACKGROUND & OBJECTIVES: Opportunistic virus infections are common in liver transplant (LT) recipients. There is a risk of developing infection with cytomegalovirus (CMV) and herpes-related viruses such as herpes simplex virus-1 and 2 (HSV-1 & 2), Epstein-Barr virus (EBV) and Varicella Zoster virus (VZV), reactivation of infection and recurrent infection. This study was conducted to determine CMV seropositivity in donors and its influence on LT recipients and seropositivity of CMV, HSV-1 and 2, EB viral capsid antigen (EBVCA) and VZV in LT recipients and their reactivation. METHODS: Pre-transplant data for IgG and IgM for CMV (and donor), HSV-1 and -2, EB viral capsid antigen (VCA) and VZV were available for 153 recipients. All recipients were on ganciclovir or valganciclovir prophylaxis for three months after LT. For reactivation rates, findings of post-transplant CMV quantitative reverse transcription polymerase chain reaction (CMV qRT-PCR) assay were associated with pre-transplant serological profile. RESULTS: Of the 153 LT recipients, 131 were men (85.6%). The median age of LT was 46 yr (range 9 months-71 yr). Overall exposure to CMV was 71.8 per cent followed by EB VCA (61.4%) and VZV (49.6%). Susceptibility to both HSV-1 and -2 was high across all decades (P<0.001). Seropositivity of CMV in donor was 90.9 per cent (100 out of 110). Post-transplant CMV qRT- PCR was positive in 17 (26.6%; 3 in recipient negative) of 64 samples tested. qRT-PCR assay was positive in one out of four (25%) tested for HSV-1 and nine out of 19 (47.4%) tested for EBV. Two recipients tested for HSV-2 and one for VZV were negative. There were three deaths in recipients (D+ R+) who were also positive for CMV qRT PCR. There was one death due to HSV-1 pneumonia. One patient with EBV reactivation developed post-transplant lymphoproliferative disorder two years after transplant. INTERPRETATION & CONCLUSIONS: Transplant recipient were at highest risk of acquiring HSV-1 and -2 more so for HSV-2. CMV exposure in transplant recipients and donors were very high and at greatest risk for recipient reactivation rate. Despite this, death related to CMV reactivation was low. Medknow Publications & Media Pvt Ltd 2017-04 /pmc/articles/PMC5663172/ /pubmed/28862190 http://dx.doi.org/10.4103/ijmr.IJMR_1024_14 Text en Copyright: © 2017 Indian Journal of Medical Research http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Varghese, Joy Subramanian, S. Reddy, Mettu Srinivas Shanmugam, Naresh Balajee, G. Srinivasan, Vijaya Venkataraman, Jayanthi Mohamed, Rela Seroprevalence of cytomegalovirus in donors & opportunistic viral infections in liver transplant recipients |
title | Seroprevalence of cytomegalovirus in donors & opportunistic viral infections in liver transplant recipients |
title_full | Seroprevalence of cytomegalovirus in donors & opportunistic viral infections in liver transplant recipients |
title_fullStr | Seroprevalence of cytomegalovirus in donors & opportunistic viral infections in liver transplant recipients |
title_full_unstemmed | Seroprevalence of cytomegalovirus in donors & opportunistic viral infections in liver transplant recipients |
title_short | Seroprevalence of cytomegalovirus in donors & opportunistic viral infections in liver transplant recipients |
title_sort | seroprevalence of cytomegalovirus in donors & opportunistic viral infections in liver transplant recipients |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5663172/ https://www.ncbi.nlm.nih.gov/pubmed/28862190 http://dx.doi.org/10.4103/ijmr.IJMR_1024_14 |
work_keys_str_mv | AT varghesejoy seroprevalenceofcytomegalovirusindonorsopportunisticviralinfectionsinlivertransplantrecipients AT subramanians seroprevalenceofcytomegalovirusindonorsopportunisticviralinfectionsinlivertransplantrecipients AT reddymettusrinivas seroprevalenceofcytomegalovirusindonorsopportunisticviralinfectionsinlivertransplantrecipients AT shanmugamnaresh seroprevalenceofcytomegalovirusindonorsopportunisticviralinfectionsinlivertransplantrecipients AT balajeeg seroprevalenceofcytomegalovirusindonorsopportunisticviralinfectionsinlivertransplantrecipients AT srinivasanvijaya seroprevalenceofcytomegalovirusindonorsopportunisticviralinfectionsinlivertransplantrecipients AT venkataramanjayanthi seroprevalenceofcytomegalovirusindonorsopportunisticviralinfectionsinlivertransplantrecipients AT mohamedrela seroprevalenceofcytomegalovirusindonorsopportunisticviralinfectionsinlivertransplantrecipients |