title: Clinical correlations of human cytomegalovirus strains and viral load in kidney transplant recipients.
abstract: Little is known about clinical differences associated with cytomegalovirus (CMV) infection by distinct strains in renal transplant patients. Different clinical pictures may be associated with specific viral genotypes, viral load, as well as host factors. The objective of this study was to identify CMV strains to determine viral load (antigenemia), and their correlation with clinical data in renal transplant recipients. Seventy-one patients were enrolled, comprising 91 samples. After selection, polymorphonuclear cells were used to amplify and sequence the gB region of CMV DNA. The sequences were analyzed to ascertain the frequency of different genotypes. Additionally, the results of this study showed that the gB coding gene presents a great variability, revealing a variety of patterns: classical gB1 (1.4%), gB1V (46.4%), classical gB2 (35.2%), gB2V (2.8%), gB3 (1.4%), classical gB4 (4.9%) and gB4V (4.9%). The mean viral load in kidney transplant patient was 75.1 positive cells (1-1000). A higher viral load was observed in patients with genotype 4 infection. Statistically significant differences were detected between gB1 and gB4 (p=0.010), and between gB2 and gB4 (p=0.021). The average numbers of positive cells in relation to clinical presentation were: 34.5 in asymptomatic, 49.5 in CMV associated syndrome and 120.7 in patients with invasive disease (p=0.048). As a group, gB1 was the most frequent strain and revealed a potential risk for developing invasive disease. Viral load also seemed to be important as a marker associated with clinical presentation of the disease.
authors.affiliation: Clinical Virology Laboratory, Division of Infectious Diseases, Universidade Federal de São Paulo (UNIFESP), Brazil. enogueira@nefro.epm.br
authors.forename: Eliana
authors.initials: E
authors.lastname: Nogueira
authors.forename: Kikumi Suzete
authors.initials: KS
authors.lastname: Ozaki
authors.forename: Helena
authors.initials: H
authors.lastname: Tomiyama
authors.forename: Niels Olsen Saraiva
authors.initials: NO
authors.lastname: Câmara
authors.forename: Celso Francisco Hernandes
authors.initials: CF
authors.lastname: Granato
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003587:Cytomegalovirus / Q000235:genetics*; D003586:Cytomegalovirus Infections / Q000473:pathology* / Q000821:virology*; D004279:DNA, Viral / Q000097:blood; D005260:Female; D005838:Genotype; D006084:Graft Rejection / Q000821:virology; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000145:classification; D010750:Phosphoproteins / Q000097:blood; D010802:Phylogeny; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016896:Treatment Outcome; D019562:Viral Load; D014763:Viral Matrix Proteins / Q000097:blood; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D010750:Phosphoproteins; D014763:Viral Matrix Proteins; C065418:cytomegalovirus matrix protein 65kDa