title: Prospective, comprehensive, and effective viral monitoring in Cuban children undergoing solid organ transplantation.
abstract: OBJECTIVE
  In Cuba, viral monitoring in the post-transplant period was not routinely performed. The aim of this research is to identify the most frequent viruses that affect transplanted Cuban children, by implementing a viral follow-up during the post-transplant period.
  
  
  METHODS
  The study population included all Cuban pediatric patients who underwent solid organ transplantation (SOT) between November 2009 and December 2012. A total of 34 transplanted pediatric patients of kidney (n = 11) and liver (n = 23) were prospectively monitored during a 34-week period for viral DNAemia and DNAuria by simultaneous detection of cytomegalovirus (CMV), Epstein-Barr virus, herpes simplex virus type 1 and 2, varicella zoster virus, human herpesvirus 6, human adenovirus, and polyomaviruses (BKV and JCV) using quantitative real-time polymerase chain reaction (qRT-PCR).
  
  
  RESULTS
  Viral genome of at least one virus was detected in 21 of 34 recipients, 18 patients excreted virus in urine while 12 presented DNAemia. CMV (41.2%) and BKV (35.3%) were the most frequent viruses detected during the follow-up. CMV was the virus mainly associated with clinical symptoms and DNAemia. Its excretion in urine (with cut off value of 219 copies/mL) was associated with detection in plasma (p < 0.001); furthermore, CMV viruria was predictive of CMV viremia (OR:8.4, CI:2.4-29.1, p = 0.001). There was no association between high viral load and clinical complications, due to the prompt initiation of preemptive ganciclovir.
  
  
  CONCLUSIONS
  This comprehensive viral monitoring program effectively prevents the development of critical viral disease, thus urge the implementation of qRT-PCR as routine for viral monitoring of transplanted Cuban organ recipients.
authors.affiliation: Sexually Transmitted Diseases Laboratory, Virology Department, Institute of Tropical Medicine "Pedro Kourí", Havana City, Cuba ; Virology Department, Institute of Tropical Medicine ¨Pedro Kourí¨, Autopista Novia del Mediodia Km 6., La Lisa, Havana City, Cuba.
authors.forename: Vivian
authors.initials: V
authors.lastname: Kourí
authors.affiliation: Sexually Transmitted Diseases Laboratory, Virology Department, Institute of Tropical Medicine "Pedro Kourí", Havana City, Cuba.
authors.forename: Consuelo
authors.initials: C
authors.lastname: Correa
authors.affiliation: Sexually Transmitted Diseases Laboratory, Virology Department, Institute of Tropical Medicine "Pedro Kourí", Havana City, Cuba.
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Martínez
authors.affiliation: Epidemiology and Statistic Department, Institute of Tropical Medicine "Pedro Kourí", Havana City, Cuba.
authors.forename: Lizet
authors.initials: L
authors.lastname: Sanchez
authors.affiliation: Sexually Transmitted Diseases Laboratory, Virology Department, Institute of Tropical Medicine "Pedro Kourí", Havana City, Cuba.
authors.forename: Alina
authors.initials: A
authors.lastname: Alvarez
authors.affiliation: Respiratory Viruses Laboratory, Virology Department, Institute of Tropical Medicine "Pedro Kourí", Havana City, Cuba.
authors.forename: Grehete
authors.initials: G
authors.lastname: González
authors.affiliation: University Pediatric Hospital "William Soler", Havana City, Cuba.
authors.forename: César E
authors.initials: CE
authors.lastname: Silverio
authors.affiliation: University Pediatric Hospital "William Soler", Havana City, Cuba.
authors.forename: Norma
authors.initials: N
authors.lastname: Hondal
authors.affiliation: University Pediatric Hospital of "Centro Habana", Havana City, Cuba.
authors.forename: Jose
authors.initials: J
authors.lastname: Florin
authors.affiliation: University Pediatric Hospital of "Centro Habana", Havana City, Cuba.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Pérez
authors.affiliation: University Pediatric Hospital of "Centro Habana", Havana City, Cuba.
authors.forename: Diana P
authors.initials: DP
authors.lastname: Duran
authors.affiliation: University Pediatric Hospital of "Centro Habana", Havana City, Cuba.
authors.forename: Yardelis
authors.initials: Y
authors.lastname: Perez
authors.affiliation: University Pediatric Hospital of "Centro Habana", Havana City, Cuba.
authors.forename: Nancy
authors.initials: N
authors.lastname: Cazorla
authors.affiliation: University Pediatric Hospital of "Centro Habana", Havana City, Cuba.
authors.forename: Dalmaris
authors.initials: D
authors.lastname: Gonzalez
authors.affiliation: National Institute of Haematology and Immunology, Havana City, Cuba.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Jaime
authors.affiliation: National Institute of Haematology and Immunology, Havana City, Cuba.
authors.forename: Alberto
authors.initials: A
authors.lastname: Arencibia
authors.affiliation: National Institute of Haematology and Immunology, Havana City, Cuba.
authors.forename: Sandra
authors.initials: S
authors.lastname: Sarduy
authors.affiliation: Sexually Transmitted Diseases Laboratory, Virology Department, Institute of Tropical Medicine "Pedro Kourí", Havana City, Cuba.
authors.forename: Lissette
authors.initials: L
authors.lastname: Pérez
authors.affiliation: Sexually Transmitted Diseases Laboratory, Virology Department, Institute of Tropical Medicine "Pedro Kourí", Havana City, Cuba.
authors.forename: Yudira
authors.initials: Y
authors.lastname: Soto
authors.affiliation: University Pediatric Hospital "William Soler", Havana City, Cuba.
authors.forename: Mabel
authors.initials: M
authors.lastname: González
authors.affiliation: University Pediatric Hospital "William Soler", Havana City, Cuba.
authors.forename: Iliana
authors.initials: I
authors.lastname: Alvarez
authors.affiliation: National Institute of Haematology and Immunology, Havana City, Cuba.
authors.forename: Elvira
authors.initials: E
authors.lastname: Dorticós
authors.affiliation: University Pediatric Hospital of "Centro Habana", Havana City, Cuba.
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Marchena
authors.affiliation: University Pediatric Hospital of "Centro Habana", Havana City, Cuba.
authors.forename: Luis
authors.initials: L
authors.lastname: Solar
authors.affiliation: Respiratory Viruses Laboratory, Virology Department, Institute of Tropical Medicine "Pedro Kourí", Havana City, Cuba.
authors.forename: Belsy
authors.initials: B
authors.lastname: Acosta
authors.affiliation: Respiratory Viruses Laboratory, Virology Department, Institute of Tropical Medicine "Pedro Kourí", Havana City, Cuba.
authors.forename: Clara
authors.initials: C
authors.lastname: Savón
authors.affiliation: Haut Zentrum (Skin Center), Duesseldorf, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hengge
keywords: CMV; Cuba; Pediatric; Transplant; Viruses