Active CMV and EBV infections in renal transplant recipients with unexplained fever and elevated serum creatinine

Hasannia, T. and Moosavi Movahed, S. M. and Vakili, R. and Rafatpanah, H. and Hekmat, R. and Valizadeh, N. and Rezaeec, S. A. (2016) Active CMV and EBV infections in renal transplant recipients with unexplained fever and elevated serum creatinine. Renal Failure, 38 (9). pp. 1418-1424.

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Abstract

Proper identification of active cytomegalovirus (CMV) and Epstein-Barr virus (EBV) infections are helpful for monitoring antiviral treatment in transplant recipients. Qualitative and quantitative CMV, EBV DNA PCR techniques in the context of serological tests are performed for early detection and differentiation of active and latent CMV and EBV infections in renal transplantation. Basically, 129 renal transplanted recipients monitored carefully and hospitalized for unexplained elevated creatinine levels or high fever and 21 of their donors were studied. CMV DNA was detected in 63.5 of the febrile episodes following transplantation and in 46.42 of readmitted patients using qualitative PCR method. In the first group, 15 of the patients and in the second group 42.85 of the patients had copy numbers more than cutoff point (900 copies/mL). Cutoff point had 100 sensitivity and 82.5 specificity for active and symptomatic CMV infection. Only 15.5 of the subjects were positive for EBV infection by qualitative PCR method. Among them 5 had >2000 copies/mL and were symptomatic. One subject with a history of three times hospitalization had higher EBV viral load and developed post-transplant lymphoproliferative disorder. CMV load was significantly correlated with elevated creatinine levels (OR = 3.1, p = 0.006), abnormal heart sounds (OR = 4.7; p = 0.02) and hypertension (OR = 3.6; p = 0.03). Only qRT-PCR could differentiate between latent and active infections and might be clinically useful for monitoring symptomatic CMV and EBV infections and initiation of the antiviral therapy. Elevated creatinine levels, hypertension, and abnormal heart sounds could be considered as main manifestations of HCMV infection in kidney recipients. © 2016 Informa UK Limited, trading as Taylor & Francis Group.

Item Type: Article
Additional Information: Cited By :3 Export Date: 16 February 2020 CODEN: REFAE Correspondence Address: Rezaeec, S.A.; Immunology Research Center, Inflammation and Inflammatory Diseases Division, Faculty of Medicine, Mashhad University of Medical SciencesIran; email: rezaeer@mums.ac.ir
Uncontrolled Keywords: Cytomegalovirus Epstein-Barr virus Q-PCR renal transplant patients creatinine virus DNA abdominal pain adolescent adult aged Article child controlled study creatinine blood level cytomegalovirus infection diarrhea dyspnea Epstein Barr virus Epstein Barr virus infection fatigue female fever gene dosage graft recipient heart sound human hyperlipidemia hypertension kidney graft rejection kidney transplantation major clinical study male nausea priority journal prospective study urinary tract infection virus load weakness blood complication diagnostic imaging genetics kidney middle aged polymerase chain reaction virology young adult Cytomegalovirus Infections DNA, Viral Epstein-Barr Virus Infections Herpesvirus 4, Human Humans Transplant Recipients
Subjects: WJ Urogenital System
Divisions: Mashhad University of Medical Sciences
Depositing User: mr lib4 lib4
Date Deposited: 02 Mar 2020 06:17
Last Modified: 02 Mar 2020 06:17
URI: http://eprints.mums.ac.ir/id/eprint/13021

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