title: Onset and duration of cytomegalovirus immediate early 1 mRNA expression in the blood of renal transplant recipients.
abstract: Human cytomegalovirus (CMV) messenger (m) RNA expression in circulating leukocytes reflects directly viral activity in the human host. In this study, sixty-nine patients were monitored prospectively for CMV infection and mRNA expression during the first year after renal transplantation. Of the 69 recipients, 58 (84%) recipients were positive for CMV immediate early 1 (IE1) mRNA as detected by nucleic acid sequence-based amplification. The median onset of IE1 expression started at day 22 after transplantation and continued for a median duration of 82 days. IE1 mRNA expression started significantly earlier in recipients who developed an active CMV infection (P = 0.001) and in mycophenolate mofetil (MMF) treated recipients (P = 0.002). The duration of IE1 mRNA expression was significantly longer in recipients that had previously an early onset of IE1 mRNA expression (P = 0.001) and in recipients with active CMV infection (P = 0.007). Remarkably, longer prednisolone intake was correlated with a significantly (P = 0.02) shorter duration of IE1 expression compared to a longer duration of IE1 expression in recipients with only a short prednisolone intake. In recipients infected with glycoprotein B (gB) type 1 CMV strains, the duration of IE1 expression was significantly (P = 0.04) shorter compared to recipients infected with non-gB type 1 CMV strains (64 days vs. 150 days). The study indicates that multiple factors play a role in the onset and/or duration of CMV IE1 mRNA expression, for example, MMF treatment, prednisolone intake, and gB type of the specific CMV strain. The clinical significance of these correlations remains to be studied in more detail.
authors.affiliation: Department of Medical Microbiology, University Hospital Maastricht, Maastricht, The Netherlands. VVGO@LMIB.AZM.NL
authors.forename: Valère J
authors.initials: VJ
authors.lastname: Goossens
authors.forename: Maarten H L
authors.initials: MH
authors.lastname: Christiaans
authors.forename: Marinus J
authors.initials: MJ
authors.lastname: Blok
authors.forename: Peter H W
authors.initials: PH
authors.lastname: Terporten
authors.forename: Peter
authors.initials: P
authors.lastname: Sillekens
authors.forename: Angela
authors.initials: A
authors.lastname: Lukacsi
authors.forename: Johannes P
authors.initials: JP
authors.lastname: Van Hooff
authors.forename: Cathrien A
authors.initials: CA
authors.lastname: Bruggeman
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003587:Cytomegalovirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D017874:Immediate-Early Proteins / Q000097:blood* / Q000235:genetics; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010750:Phosphoproteins / Q000378:metabolism; D011239:Prednisolone / Q000627:therapeutic use; D012333:RNA, Messenger / Q000097:blood* / Q000235:genetics; D012367:RNA, Viral / Q000097:blood; D021161:Self-Sustained Sequence Replication; D013997:Time Factors; D014759:Viral Envelope Proteins / Q000235:genetics / Q000378:metabolism; D014763:Viral Matrix Proteins / Q000378:metabolism; D014764:Viral Proteins
chemical_list: D005938:Glucocorticoids; C088645:IE1 protein, cytomegalovirus; D017874:Immediate-Early Proteins; D010750:Phosphoproteins; D012333:RNA, Messenger; D012367:RNA, Viral; D014759:Viral Envelope Proteins; D014763:Viral Matrix Proteins; D014764:Viral Proteins; C040495:glycoprotein B, Simplexvirus; C464963:pp67 protein, human cytomegalovirus; D011239:Prednisolone