title: Cytomegalovirus infection in renal transplant recipients: one center's experience.
abstract: BACKGROUND
  Cytomegalovirus (CMV) is the most common opportunistic viral infection that causes morbidity, graft loss, and mortality among renal transplant recipients (RTRs). The aim of this study was to evaluate the impact of CMV infection on allograft function, graft/patient survival, and the possible asssociations between CMV infection and HLA typing.
  
  
  METHODS
  This retrospective study included 162 RTRs who had at least 1 year regular post-transplantatioin follow-up between January 2007 and December 2011. Recipients who had positive quantative CMV-polymerase chain reaction (PCR) were assigned to the study group (n = 17) and PCR-negative patients were assigned to the control group (n = 145). To determine whether CMV infection was related to HLA specificities, the incidence of CMV infection was analyzed in relation to HLA-A, -B, and -DR typing.
  
  
  RESULTS
  Study groups were similar in terms of demographic, clinical, and basal laboratory findings. Duration of dialysis before transplantation was significantly longer in this study group (P = .018). Although the total HLA mismatches of both groups were similar, we found that HLA-B51-positive recipients had a lower risk for CMV infection (P = .018). CMV infection was more frequent in patients with a double-J stent (P = .001). Although basal creatinine levels of the two groups were similar, the study group patients' creatinine levels were significantly increased during the 1-year post-transplantation period compared to controls (P = .0001). Frequency of acute rejection was significantly higher in the study group (41.2% vs 11%, P = .001). Graft loss due to any cause was also significantly higher in the study group (29.4% vs 6.9%, P = .01). Patients who had preoperative induction therapy and post-transplantatioin tacrolimus-based regimens were prone to CMV infection (P = .0001, .006).
  
  
  CONCLUSIONS
  Despite recent advances in prophylaxis, CMV infection is still a risk factor for RTRs. According to our data, long pretransplantation dialysis duration, being HLA-B51-negative, having a double-J stent, preoperative induction therapy, and post-transplantation tacrolimus-based regimens might induce development of CMV infection by 1-year post-transplantation follow-up.
authors: Department of Nephrology, Başkent University Faculty of Medicine, Ankara, Turkey.
authors: Z
authors: Z
authors: Bal
authors: M E
authors: ME
authors: Uyar
authors: E
authors: E
authors: Tutal
authors: E
authors: E
authors: Erdogan
authors: T
authors: T
authors: Colak
authors: S
authors: S
authors: Sezer
authors: M
authors: M
authors: Haberal
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology*; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D006085:Graft Survival; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology*; D015234:HLA-A Antigens / Q000276:immunology; D015235:HLA-B Antigens / Q000276:immunology; D006684:HLA-DR Antigens / Q000276:immunology; D006648:Histocompatibility; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D006680:HLA Antigens; D015234:HLA-A Antigens; D015235:HLA-B Antigens; D006684:HLA-DR Antigens; D007166:Immunosuppressive Agents