title: Asymptomatic high Epstein-Barr viral load carriage in pediatric renal transplant recipients.
abstract: High viral load carriage of EBV is one of the risks for PTLD in transplant recipients. We reviewed retrospectively in pediatric renal transplant recipients with EBV seronegative. EBV loads in peripheral blood and EBV-CTLs were measured every 1-3 months in 13 patients after grafting. Immunosuppressants were reduced when the patients were considered to have persistent high EBV loads (>1000 copies/μgDNA for over six months). All showed primary EBV infection: six with asymptomatic persistent high EBV loads (group A) and seven with neither EBV-associated symptoms nor persistent high EBV loads (group B). No patient developed PTLD in either group. Chronic rejection occurred in one patient in group A after immunosuppressants' reduction. There was no difference in renal dysfunction rates between the two groups. The maximum and increase rates in EBV loads were significantly higher in group A. The CTLs' percentage was significantly lower in group A when EBV loads first rose above 100 copies/μg DNA. This study suggests the possibility that EBV loads and CTLs' monitoring may be useful for avoidance of PTLD, as patients with asymptomatic persistent high EBV loads had higher EBV loads and lower percentages of CTLs.
authors.affiliation: Department of Pediatric Nephrology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
authors.forename: Eriko
authors.initials: E
authors.lastname: Tanaka
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sato
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ishihara
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Tsutsumi
authors.forename: Masataka
authors.initials: M
authors.lastname: Hisano
authors.forename: Hiroko
authors.initials: H
authors.lastname: Chikamoto
authors.forename: Yuko
authors.initials: Y
authors.lastname: Akioka
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
authors.forename: Mikiya
authors.initials: M
authors.lastname: Fujieda
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000235:genetics; D020031:Epstein-Barr Virus Infections / Q000821:virology*; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics*; D006801:Humans; D007107:Immune System; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D008232:Lymphoproliferative Disorders / Q000821:virology; D008297:Male; D016133:Polymerase Chain Reaction / Q000379:methods; D011183:Postoperative Complications; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000821:virology; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D004279:DNA, Viral; D007166:Immunosuppressive Agents