title: Epstein-Barr virus DNAemia in Iranian liver transplant recipients and assessment of its variation in posttransplant lymphproliferative disorder patients by quantitative polymerase chain reaction assay.
abstract: OBJECTIVE
  Epstein-Barr virus primary infection and/or reactivation may play a major role in the incidence of posttransplant lymphoproliferative disorder in organ recipients. We assessed Epstein-Barr virus viral load in liver transplant patients suspected of having Epstein-Barr virus/ posttransplant lymphoproliferative disorder at specified times after transplant and evaluated the clinical findings and posttransplant complications.
  
  
  METHODS
  In the 696 patients who underwent liver transplant in this retrospective study, Epstein-Barr virus viral load was examined intermittently in 127 liver transplant recipients who were suspected to have Epstein-Barr virus infection/disease. Sampling was performed during 4 years from July 2009 to May 2013 using real-time polymerase chain reaction assay. Clinical and pathologic data were gathered by reviewing medical records.
  
  
  RESULTS
  There were 78 of the 127 suspected patients (61%) who exhibited Epstein-Barr virus DNAemia and 19 patients had posttransplant lymphoproliferative disorder. The median EBV viral load of posttransplant lymphoproliferative disorder patients was significantly higher than unaffected patients. Posttransplant lymphoproliferative disorder was diagnosed clinically in 34 subjects (4.9%). Estimated mortality rate of posttransplant lymphoproliferative disorder patients was 35% during 1.5-year follow-up after transplant.
  
  
  CONCLUSIONS
  Monitoring Epstein-Barr virus load may enable detection of Epstein-Barr virus infection/disease in liver transplant patients suspected of having the virus, even several weeks before the onset of any clinical manifestations, especially in pediatric patients who have high incidence and mortality from posttransplant lymphoproliferative disorder.
authors.affiliation: From the Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Nemazee Hospital, Shiraz; and the Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Jamalidoust
authors.forename: Bita
authors.initials: B
authors.lastname: Geramizadeh
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Pouladfar
authors.forename: Mandana
authors.initials: M
authors.lastname: Namayandeh
authors.forename: Sadaf
authors.initials: S
authors.lastname: Asaie
authors.forename: Nasrin
authors.initials: N
authors.lastname: Aliabadi
authors.forename: Saman
authors.initials: S
authors.lastname: Nikeghbalian
authors.forename: Mazyar
authors.initials: M
authors.lastname: Ziyaeyan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000097:blood / Q000235:genetics*; D020031:Epstein-Barr Virus Infections / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000821:virology; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics*; D006801:Humans; D007223:Infant; D007492:Iran; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008232:Lymphoproliferative Disorders / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000821:virology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D013997:Time Factors; D019562:Viral Load; D014766:Viremia / Q000175:diagnosis / Q000821:virology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004279:DNA, Viral