title: Relationship between IgM antibody to human cytomegalovirus, virus load, donor and recipient serostatus, and administration of methylprednisolone as risk factors for cytomegalovirus disease after liver transplantation.
abstract: A retrospective study was performed on a selected cohort of 40 liver transplant recipients derived from the previous prospective follow-up of 162 liver transplant patients. The criterion for selection of this cohort was the presence of human cytomegalovirus (HCMV) DNAemia after transplantation, as determined by qualitative polymerase chain reaction (PCR). These 40 patients were followed longitudinally by quantitative PCR and by the new recombinant antigen-based AxSYM immunoassay for IgM to HCMV. The detection of IgM to CMV after transplantation was significantly associated with the development of HCMV disease in patients who had evidence of active HCMV replication in the blood by PCR (P=.01). On the basis of multivariate logistic regression analyses, the maximum titer of IgM detected after transplantation was a risk factor that was independent of augmented methylprednisolone and donor seropositivity. However, in multivariate analyses, elevated virus load continued to be the predominant risk factor for progression to HCMV disease.
authors.affiliation: Dept. of Virology, Royal Free and University College Medical School, Royal Free Campus, London NW3 2PF, UK, USA. vincent@rfhsm.ac.uk
authors.forename: V C
authors.initials: VC
authors.lastname: Emery
authors.forename: A V
authors.initials: AV
authors.lastname: Cope
authors.forename: C A
authors.initials: CA
authors.lastname: Sabin
authors.forename: A K
authors.initials: AK
authors.lastname: Burroughs
authors.forename: K
authors.initials: K
authors.lastname: Rolles
authors.forename: T
authors.initials: T
authors.lastname: Lazzarotto
authors.forename: M P
authors.initials: MP
authors.lastname: Landini
authors.forename: S
authors.initials: S
authors.lastname: Brojanac
authors.forename: J
authors.initials: J
authors.lastname: Wise
authors.forename: G T
authors.initials: GT
authors.lastname: Maine
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D000914:Antibodies, Viral / Q000097:blood*; D015331:Cohort Studies; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D004279:DNA, Viral / Q000097:blood; D018450:Disease Progression; D006801:Humans; D007118:Immunoassay / Q000379:methods; D007075:Immunoglobulin M / Q000097:blood; D016031:Liver Transplantation; D008775:Methylprednisolone / Q000008:administration & dosage*; D015999:Multivariate Analysis; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications / Q000097:blood*; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012698:Serologic Tests; D013997:Time Factors; D014019:Tissue Donors; D019562:Viral Load
chemical_list: D000893:Anti-Inflammatory Agents; D000914:Antibodies, Viral; D004279:DNA, Viral; D007075:Immunoglobulin M; D008775:Methylprednisolone