title: Monitoring of Epstein-Barr virus load and antibody in pediatric renal transplant patients.
abstract: BACKGROUND
  Epstein-Barr virus (EBV) infection can lead to life-threatening post-transplant lymphoproliferative disorder (PTLD). The aim of the present study was to establish EBV monitoring methods to prevent PTLD.
  
  
  METHODS
  EBV-DNA load was investigated, using real-time polymerase chain reaction (PCR) and anti-EBV antibody titers, in peripheral blood mononuclear cells of 21 renal transplant patients (seven recipients who were EBV-seronegative, R[-]; 14 who were EBV-seropositive, R[+]) before grafting. The mean age at entry and the mean follow-up period was 7.8 years of age (range, 3.3-12.0 years) and 1.8 years (range, 0.4-4.0 years), respectively, in the R(-) group, and 12.5 years of age (range, 3.9-17.7 years) and 3.8 years (range, 0.8-8.2 years) in the R(+) group, respectively.
  
  
  RESULTS
  The mean maximum load of the EBV genome was 1071 copies/microg DNA (range, 106-20700 copies/microg DNA) in the R(-) group, and 61 copies/microg DNA (range, <50-552 copies/microg DNA) in the R(+) group. During follow up no patient in the R(+) group had any noticeable symptoms that could be related to EBV, but three recipients in the R(-) group developed EBV-related symptoms including adenoid hypertrophy, cervical lymphadenopathy, and PTLD (B cell lymphoma), in one patient each. In the R(-) group the first leukocyte-associated viremia was detected at 30-180 days, and seroconversion at 43-266 days after transplantation.
  
  
  CONCLUSIONS
  Viral DNA detection using PCR is a useful tool for EBV surveillance, but the maximum EBV load was not markedly elevated (2474 copies/microg DNA) in a patient with PTLD. Therefore, EBV surveillance using only monitoring of EBV load in peripheral leukocyte may be insufficient. Histology may therefore be necessary to accurately diagnose PTLD.
authors.affiliation: Department of Pediatrics, Kochi Medical School, Kochi University, Kohasu Oko, Nankoku, Kochi, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sato
authors.forename: Mikiya
authors.initials: M
authors.lastname: Fujieda
authors.forename: Eriko
authors.initials: E
authors.lastname: Tanaka
authors.forename: Masakazu
authors.initials: M
authors.lastname: Miyamura
authors.forename: Hiroko
authors.initials: H
authors.lastname: Chikamoto
authors.forename: Masataka
authors.initials: M
authors.lastname: Hisano
authors.forename: Yuko
authors.initials: Y
authors.lastname: Akioka
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Ishiura
authors.forename: Sumitaka
authors.initials: S
authors.lastname: Dohno
authors.forename: Akihiko
authors.initials: A
authors.lastname: Maeda
authors.forename: Motoshi
authors.initials: M
authors.lastname: Hattori
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wakiguchi
mesh_terms: D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D016030:Kidney Transplantation; D008232:Lymphoproliferative Disorders / Q000821:virology; D008297:Male; D008991:Monitoring, Physiologic; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications; D019562:Viral Load
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral