title: KIR and Human Leukocyte Antigen Genotype Associated Risk of Cytomegalovirus Disease in Renal Transplant Patients.
abstract: BACKGROUND
  Cytomegalovirus(CMV) infections have a significant effect on morbidity and mortality in kidney transplants. We conducted a study to ascertain the association of natural killer cell killer immunoglobulin-like receptors and human leukocyte antigen (HLA) genotype with risk of CMV disease.
  
  
  METHODS
  The 90 CMV-negative patients receiving a first renal transplantation from a CMV-positive donor in this study received triple immunosuppressive therapy and prophylactic CMV treatment for up to 3 months after transplantation.
  
  
  RESULTS
  We observed a 43.3% incidence rate of CMV disease within the first year after transplantation. Twenty-seven recipients experienced a rejection episode, 14 of which had CMV disease, mostly after rejection, suggesting that in this group, CMV disease is not a risk factor for rejection. KIR gene or genotype distribution were similar between the CMV diseased and CMV disease-free group. Twenty-seven recipients (30%) carried KIR-AA genotype, of which nine (33%) had CMV disease. Of the remaining 63 (70%) recipients with KIR-BX genotype, 30 (48%) had CMV disease. There was no significant difference between the two genotype groups with regard to occurrence of CMV disease, although there was a trend toward a lower incidence of CMV disease in recipients carrying the KIR-AA genotype. For CMV disease, we found no significant risk associated with the number of activating or inhibitory KIRs. Neither was missing KIR ligands for the inhibitory KIRs (HLA-C1/C2/Bw4) in recipients associated with lower rates of CMV disease.
  
  
  CONCLUSIONS
  In CMV-negative recipients, genotypic analysis of KIR repertoire and HLA ligands does not provide risk factors for primary CMV disease after renal transplantation.
authors.affiliation: 1 Department of Laboratory Medicine, Laboratory of Medical Immunology, Radboud University Medical Center, Nijmegen, the Netherlands. 2 Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, the Netherlands. 3 Department of Nephrology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Clive M
authors.initials: CM
authors.lastname: Michelo
authors.forename: Arnold
authors.initials: A
authors.lastname: van der Meer
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Tijssen
authors.forename: Ramona
authors.initials: R
authors.lastname: Zomer
authors.forename: Foekje
authors.initials: F
authors.lastname: Stelma
authors.forename: Luuk B
authors.initials: LB
authors.lastname: Hilbrands
authors.forename: Irma
authors.initials: I
authors.lastname: Joosten
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000235:genetics* / Q000276:immunology / Q000517:prevention & control / Q000821:virology; D004359:Drug Therapy, Combination; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D006084:Graft Rejection / Q000453:epidemiology / Q000235:genetics / Q000276:immunology; D006680:HLA Antigens / Q000235:genetics* / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D054340:Receptors, KIR / Q000235:genetics* / Q000276:immunology; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D006680:HLA Antigens; D007166:Immunosuppressive Agents; D054340:Receptors, KIR