Epstein-Barr virus in pediatric patients after renal transplantation.
BACKGROUND
Pediatric allograft recipients are at an increased risk for lymphotropic virus-associated disorders, particularly in association with primary EBV infection.


METHODS
Twenty-nine children, adolescents and young adults after renal transplantation were studied in comparison with a healthy young adult control group for evidence of primary, reactivated or chronic active EBV infection at two different time points.


RESULTS
Prevalence of antibodies against viral capsid antigen (VCA) was > or = 90% in both groups, whereas anti-Epstein-Barr nuclear antigen (EBNA) was detected only in 19 of 26 seropositive patients compared with seropositive controls (p = 0.01). Persistence of EBV DNA in leukocytes for > or = 6 months was observed in 11 seropositive patients (38%) and one control patient (p < 0.007) using nested polymerase chain reaction. In the transplant recipients, 3 cases of primary EBV infection and 3 cases of chronic active EBV infection were identified. One of these cases developed a non-Hodgkin lymphoma one year later.


CONCLUSIONS
The results suggest that determination of pretransplant antibody status in recipients, rapid detection of EBV infection in seronegative symptomatic recipients, and regular screening for persistent EBV DNA in patients at risk to develop post-transplantation lymphoproliferative disease should be performed.
Schwab
M
M
Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany.
Böswald
M
M
Korn
K
K
Ruder
H
H
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D000956:Antigens, Viral / Q000276:immunology; D002213:Capsid / Q000276:immunology; D036022:Capsid Proteins; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004279:DNA, Viral / Q000097:blood; D020031:Epstein-Barr Virus Infections / Q000276:immunology / Q000821:virology; D019309:Epstein-Barr Virus Nuclear Antigens / Q000276:immunology; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology; D008297:Male; D011183:Postoperative Complications / Q000276:immunology / Q000821:virology; D012008:Recurrence
D000914:Antibodies, Viral; D000956:Antigens, Viral; D036022:Capsid Proteins; D004279:DNA, Viral; D019309:Epstein-Barr Virus Nuclear Antigens; C041788:Epstein-Barr viral capsid antigen