Cytomegalovirus infection after organ transplantation: an update with special emphasis on renal transplantation

Son, W. J. van; The, T. H.

doi:10.1007/bf02414602

Cited by 32 publications

(7 citation statements)

References 167 publications

(143 reference statements)

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“…Latent CMV infection may persist without causing any harm in healthy individuals [1]. Even though it has been widely accepted that CMV infection may lead to severe or even fatal illnesses in immunocompromised conditions, such as HIV infection, hematologic malignancies, organ transplantation, or immunosuppressive therapy [3], only a few studies have investigated the association between CMV infection and patient survival in autoimmune disorders [12–14].…”

Section: Discussionmentioning

confidence: 99%

“…Cytomegalovirus (CMV) is a common virus that can adversely affect the prognosis of immunocompromised patients, especially those with AIDS and solid organ or hematopoietic stem cell transplantation [1]. CMV is transmitted via multiple routes, including direct contact with infected saliva or breast milk, sexual transmission, vertical transmission, and blood transfusions.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of mortality in autoimmune disease patients with concurrent cytomegalovirus infections detected by quantitative real-time PCR

et al. 2017

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ObjectiveCytomegaloviruses (CMV) can have a significant impact on the prognosis of immunocompromised patients. Unlike in the transplantation and AIDS fields, only a few studies on CMV infections have been published in the field of autoimmunity. In this study, we examined the clinical outcomes of CMV infections in patients with autoimmune diseases at a single tertiary medical institution.MethodsA retrospective study was performed to identify the mortality risk factors associated with CMV infections in patients with autoimmune diseases. We reviewed the medical records of patients with autoimmune diseases who were diagnosed with CMV infections using real-time quantitative polymerase chain reaction between December 2005 and March 2016. Clinical and laboratory parameters as well as treatment outcomes were analyzed.ResultsSeventy-three CMV infected patients were separated into survivors and non-survivors. Non-survivors had significantly higher median CMV-DNA copy numbers than survivors (95,500 vs 6,700 copies/mL, p = 0.005) and demonstrated significantly more frequent incidents of CMV pneumonitis (69.2 vs 36.2%, p = 0.007). After adjusting for multiple confounding covariates, the log CMV-DNA copies/mL (hazard ratio, 1.48; 95% confidence interval, 1.14–1.92; p = 0.003) and the presence of concurrent infections (hazard ratio, 22.00; 95% confidence interval, 2.75–175.97, p = 0.004) were identified as independent mortality risk factors. Furthermore, patients with high CMV copy numbers (> 60,000 copies/mL) had higher in-hospital mortality than those with low CMV copy numbers (p < 0.05).ConclusionsCMV-DNA copy numbers and concurrent infections are predictors of in-hospital mortality in CMV-infected patients with autoimmune diseases. Therefore, serial measurements of CMV-DNA copy numbers and close observation for signs of other infections are recommended for patients with autoimmune diseases who have concurrent CMV infection.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predictors of mortality in autoimmune disease patients with concurrent cytomegalovirus infections detected by quantitative real-time PCR

et al. 2017

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“…Of all patients who develop clinical manifestations of CMV infection more than 90% do so within 1–6 months after transplantation, and 60% of the febrile episodes during this period are due to CMV infections. Most of the patients have the so-called self-limiting syndrome, consisting of fever (often spiking), arthralgia, leukopenia and/or thrombocytopenia, and abnormal liver enzymes [6, 7]. …”

Section: Discussionmentioning

confidence: 99%

“…CMV pneumonia after solid organ transplantation is the manifestation that distinguishes serious illness from the more benign disease, and the condition is associated with high mortality, especially when assisted ventilation is required [6, 7, 18]. …”

Section: Discussionmentioning

confidence: 99%

Guillain-Barré Syndrome due to CMV Reactivation after Cardiac Transplantation

Steger

Antretter

Höfer

2012

Case Reports in Cardiology

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A 40-year-old male patient suffered from end-stage heart failure due to ischemic cardiomyopathy and received orthotopic cardiac transplantation in June 2005. The instantaneous postoperative course was uneventful, but, seven months later, he suffered from paralysis in the lower extremities finally resulting in quadriplegia and was admitted to hospital. After laboratory testings the diagnosis of a Guillain-Barré syndrome due to cytomegalovirus reactivation was confirmed.

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“…HCMV infection is an important cause of morbidity and mortality in immunosuppressed organ transplant recipients. [1–3]…”

Section: Introductionmentioning

confidence: 99%

Determination of human cytomegalovirus pp65 antigenemia among renal transplant patients

Moses¹,

Malathi²,

Singha³

et al. 2012

Indian J Nephrol

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Human cytomegalovirus (HCMV) is an important cause of morbidity and mortality in immunosuppressed transplant recipients. Isolation of HCMV from peripheral blood leukocytes (PBLs) is considered a reliable marker of disseminated HCMV infection. HCMV pp65 antigenemia is widely used for monitoring CMV infection and guiding preemptive therapy. The aim of this study was to compare pp65 antigenemia with culture technique for detection of HCMV in PBLs among kidney transplant patients and also to determine the threshold value of significant pp65 antigenemiat. Fifty-one peripheral blood samples from post-renal transplant patients collected during August 2009 to March 2011 were processed for pp65 antigenemia assay. These were also tested for isolation of the virus by inoculation into human corneal fibroblast cells. The results of pp65 antigenemia and culture were compared to determine the clinical significance of pp65 antigenemia. HCMV was isolated in 21 cases. On comparing the pp65 antigenemia results with that of the viral isolation, a mean of 23 cells was determined to yield a positive isolation of HCMV. The values of pp65 antigenemia and isolation results were correlated (paired t-test, P = 0.0029). A pp65 count of 23 and above was considered significant in our clinical settings since we found that these clinical specimens yield positive culture result.

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Cytomegalovirus infection after organ transplantation: an update with special emphasis on renal transplantation

Cited by 32 publications

References 167 publications

Predictors of mortality in autoimmune disease patients with concurrent cytomegalovirus infections detected by quantitative real-time PCR

Predictors of mortality in autoimmune disease patients with concurrent cytomegalovirus infections detected by quantitative real-time PCR

Guillain-Barré Syndrome due to CMV Reactivation after Cardiac Transplantation

Determination of human cytomegalovirus pp65 antigenemia among renal transplant patients

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