Title |
Diagnostic utility of monitoring cytomegalovirus-specific immunity by QuantiFERON-cytomegalovirus assay in kidney transplant recipients
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Published in |
BMC Infectious Diseases, April 2018
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DOI | 10.1186/s12879-018-3075-z |
Pubmed ID | |
Authors |
Dominika Deborska-Materkowska, Agnieszka Perkowska-Ptasinska, Anna Sadowska, Jolanta Gozdowska, Michał Ciszek, Marta Serwanska-Swietek, Piotr Domagala, Dorota Miszewska-Szyszkowska, Elzbieta Sitarek, Agnieszka Jozwik, Artur Kwiatkowski, Magdalena Durlik |
Abstract |
Despite universal prophylaxis, late cytomegalovirus (CMV) infection occurs in a high proportion of kidney transplant recipients. We evaluated whether a specific viral T-cell response allows for the better identification of recipients who are at high risk of CMV infection after prophylaxis withdrawal. We conducted a prospective study in 19 pretransplant anti-CMV seronegative kidney graft recipients R- (18 from seropositive donors [D+] and one from a seronegative donor [D-]) and 67 seropositive recipients R(+) (59 from seropositive donors and eight from seronegative donors) who received antiviral prophylaxis with valganciclovir. The QuantiFERON-CMV (QF-CMV) assay was performed within the first and third months after transplantation. Blood samples were monitored for CMV DNAemia using a commercial quantitative nucleic acid amplification test (QNAT) that was calibrated to the World Health Organization International Standard. Twenty-one of the 86 patients (24%) developed CMV viremia after prophylaxis withdrawal within 12 months posttransplantation. In the CMV R(+) group, the QF-CMV assay yielded reactive results (QF-CMV[+]) in 51 of 67 patients (76%) compared with 7 of 19 patients (37%) in the CMV R(-) group (p = 0.001). In the CMV R(+) group, infection occurred in seven of 16 recipients (44%) who were QF-CMV(-) and eight of 51 recipients (16%) who were QF-CMV(+). In the CMV R(-) group, infection evolved in five of 12 recipients (42%) who were QF-CMV(-) and one of 7 recipients (14%) who were QF-CMV(+). No difference was found in the incidence of CMV infection stratified according to the QF-CMV results with regard to the recipients' pretransplant CMV IgG serology (p = 0.985). Cytomegalovirus infection occurred in 15 of 36 patients (42%) with hypogammaglobulinemia (HGG) 90 days posttransplantation compared with two of 34 patients (6%) without HGG (p = 0.0004). Cytomegalovirus infection occurred in seven of 13 patients (54%) with lymphocytopenia compared with 14 of 70 patients (20%) without lymphocytopenia (p = 0.015). The multivariate analysis revealed that the nonreactive QuantiFERON-CMV assay was an independent risk factor for postprophylaxis CMV infection. In kidney transplant recipients who received posttransplantation prophylaxis, negative QF-CMV results better defined the risk of CMV infection than initial CMV IgG status after prophylaxis withdrawal. Hypogammaglobulinemia and lymphocytopenia were risk factors for CMV infection. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Comoros | 1 | 100% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 1 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 34 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Master | 5 | 15% |
Researcher | 5 | 15% |
Other | 4 | 12% |
Student > Postgraduate | 3 | 9% |
Student > Ph. D. Student | 2 | 6% |
Other | 3 | 9% |
Unknown | 12 | 35% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 16 | 47% |
Agricultural and Biological Sciences | 3 | 9% |
Immunology and Microbiology | 2 | 6% |
Nursing and Health Professions | 1 | 3% |
Unknown | 12 | 35% |