Epstein-Barr virus infection in 59 orthotopic liver transplant patients.
Fifty-nine orthotopic liver transplant (OLT) patients were studied after transplantation to detect Epstein-Barr virus (EBV) primoinfection and reactivation. Nineteen, all children under 10 years, were EBV seronegative. Seroconversion occurred in 12 (63.3%) of the seronegative patients. Most of these patients (10/12) seroconverted 2 or 3 months after transplantation; 11 out of the 12 demonstrated clinical signs at the time of seroconversion. From 9 primoinfected patients tested for EBV excretion, 8 were found to be positive. Serological evidence of reactivation was found in 9 out 40 (22.5%) seropositive patients and EBV was isolated from 5 (56%). Eleven pediatric OLT patients with primoinfection showed high and persistent titers of anti-EA antibodies (from 1:32 to greater than or equal to 1:256), when tested at least 3 months after seroconversion; however, anti-EBNA antibodies failed to develop in 5 patients and remained persistently low in 4. These patients with high EA and with negative or low EBNA titers constitute an "at risk" group for EBV-related lymphoproliferative syndrome (LpS). At presently, after a period of follow-up ranging from 3 months to 3 years, none of our 12 primoinfected patients have developed any lymphoproliferative evolution. However, in 1, during the acute phase, lymphoblasts and lymphoproliferation were observed in a tonsil biopsy.
Lamy
M E
ME
Department of Virology, Catholic University of Louvain, Brussels, Belgium.
Favart
A M
AM
Cornu
C
C
Salizzoni
M
M
Cimadamore
N
N
de Hemptinne
B
B
Otte
J B
JB
D000209:Acute-Phase Proteins / Q000276:immunology; D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D000956:Antigens, Viral / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D004854:Herpesvirus 4, Human / Q000254:growth & development / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects*; D014775:Virus Activation / Q000276:immunology
D000209:Acute-Phase Proteins; D000914:Antibodies, Viral; D000956:Antigens, Viral; C033305:Epstein-Barr virus early antigen