title: Subclinical Epstein-Barr virus viremia among adult renal transplant recipients: incidence and consequences.
abstract: The natural history and clinical significance of posttransplant Epstein-Barr virus (EBV) infection remain largely unknown. The aims of this study are to describe the incidence, risk factors and consequences of EBV infection after kidney transplantation. A total of 383 consecutive patients having received a kidney transplant between January 2002 and December 2010 were included. EBV polymerase chain reaction (PCR) was performed every 2 weeks for 3 months, and every 4 weeks for the next 9 months. A total of 155 of the 383 patients (40%) had at least one positive viremia during the first year posttransplant. The median time to viremia was day 31 posttransplant (14-329). A total of 73 (47%) had EBV viremia > 10(3) log and 23 (15%) had positive viremia for more than 6 months. EBV D+/R- patients (12/18 (67%) versus 143/365 (39%), p = 0.02) and those having received antithymocyte globulins (ATG) (54% vs. 35%; p<0.001) were more likely to develop EBV infection. EBV infection (hazard ratio [HR], 3.03; 95% confidence interval [CI], 1.72-8.29; p = 0.01) was associated with the occurrence of opportunistic infections. A positive EBV PCR during the first 6 months posttransplant was associated with graft loss (HR, 3.04; 95% CI, 1.36-6.79; p = 0.014). EBV reactivation is frequent after transplantation and reflects overimmunosuppression. Prospective studies should examine the association between EBV and graft loss.
authors: INSERM, UMR1098, Besançon, France.
authors: J
authors: J
authors: Bamoulid
authors: C
authors: C
authors: Courivaud
authors: A
authors: A
authors: Coaquette
authors: J-M
authors: JM
authors: Chalopin
authors: E
authors: E
authors: Gaiffe
authors: P
authors: P
authors: Saas
authors: D
authors: D
authors: Ducloux
mesh_terms: D000328:Adult; D004279:DNA, Viral / Q000235:genetics; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D005260:Female; D005602:France; D006084:Graft Rejection / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D006085:Graft Survival; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000628:therapy / Q000821:virology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D019562:Viral Load; D014766:Viremia / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology
chemical_list: D004279:DNA, Viral