title: Human Leukocyte Antigen Alleles and Cytomegalovirus Infection After Renal Transplantation.
abstract: BACKGROUND
  Several studies have been conducted on the relationship between a number of human leukocyte antigen (HLA) alleles and cytomegalovirus infection (CMV), in kidney transplant recipients, after transplantation. However, only a limited number of HLAs have been investigated, so far, and the results have been contradictory.
  
  
  OBJECTIVE
  This study aimed to investigate the relationship between 59 HLA alleles and the CMV infection, in transplant recipients, after kidney transplantation.
  
  
  METHODS
  This retrospective cohort study was conducted on 200 patients, receiving a kidney transplant, in Baqiyatallah Hospital, in Tehran, during 2013. Throughout a one-year follow-up of kidney transplant recipients, in case of detecting the CMV antigen in patients' blood, at any time, they were placed in the group of patients with CMV infection, whereas, if no CMV-specific antigen was developed, over a year, patients were placed in the group of patients without CMV infection, after transplantation. This study investigated the relationship between CMV infection in kidney transplant recipients and 59 HLA alleles, including 14 HLA-A, 28 HLA-B, and 17 HLA-DRB1 cases.
  
  
  RESULTS
  Of all participants, 104 patients (52%) were diagnosed with CMV infection. There was no significant difference between the two groups, with and without CMV infection, in terms of patient's characteristics. The CMV infection, in patients receiving a transplanted organ from deceased donor, was significantly more prevalent than in those receiving kidney transplant from living donor (63% vs. 39%, respectively, P = 0.001). Recipients with HLA-B44 were more infected with CMV compared with patients without this allele (80% vs. 50%, respectively, P = 0.024); on the contrary, kidney recipients with HLA-DRB1-1 were less infected with CMV than patients without this allele (31% vs. 55%, respectively, P = 0.020). There was no significant relationship between CMV infection and other HLA alleles. Results of multivariate logistic regression analysis showed that deceased donor renal transplantation (OR = 3.018, 95%CI: 1.662 - 5.480, P < 0.001), presence of HLA-B44 (OR = 4.764, 95%CI: 1.259 - 18.032, P = 0.022) and lack of HLA-B8 (OR = 3.246, 95%CI: 1.030 - 10.230, P = 0.044) were the independent risk factors for developing CMV infection, after kidney transplantation.
  
  
  CONCLUSIONS
  The findings of this study showed that deceased donor renal transplantation and the presence of HLA-B44 can make the kidney recipient susceptible to CMV infection after kidney transplantation; on the other hand, the presence of HLA-B8 can have a protective effect.
authors: Department of Nephrology, Rajaie Cardiovascular Medical and Research Center, Tehran, IR Iran.
authors: Farzaneh
authors: F
authors: Futohi
authors: Department of Nephrology, Kerman University of Medical Sciences, Kerman, IR Iran.
authors: Azadeh
authors: A
authors: Saber
authors: Department of Nephrology, Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors: Eglim
authors: E
authors: Nemati
authors: Department of Nephrology, Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors: Behzad
authors: B
authors: Einollahi
authors: Department of Nephrology, Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors: Zohre
authors: Z
authors: Rostami
keywords: Cytomegalovirus; Cytomegalovirus Infections; Human Leukocyte Antigen; Kidney Transplantation