Prospective Study of Prevalence, Incidence, and Source of Herpesvirus Infections in Patients with Renal Allografts

Naraqi, S; Jackson, George Gee; Jonasson, Olga; Yamashiroya, Herbert M.

doi:10.1093/infdis/136.4.531

Cited by 119 publications

(35 citation statements)

References 49 publications

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“…Our findings in cancer patients are consistent with previous reports of a high risk of HZ among individuals who are immunocompromised, such as patients infected with HIV (37-39), patients receiving hematopoeitic stem cell transplant or solid organ transplant, or patients with autoimmune diseases treated by immunosuppressing therapies (40)(41)(42)(43)(44)(45)(46)(47).…”

Section: Discussionsupporting

confidence: 91%

The Epidemiology of Herpes Zoster in Patients with Newly Diagnosed Cancer

Habel

Ray

Silverberg

et al. 2013

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Given the limited literature, we conducted a study to examine the epidemiology of herpes zoster (HZ) among newly diagnosed cancer patients.Methods: We identified adult health plan members of Kaiser Permanente Northern California diagnosed with invasive cancer from 2001 to 2005. Electronic health records with inpatient and outpatient diagnoses, laboratory tests, and antiviral medications were used to identify HZ diagnoses from 2001 to 2006. HZ diagnoses and associated complications were confirmed by medical chart review. Treatment with chemotherapy and corticosteroids was used to classify patients by immunosuppression level.Results: Among 14,670 cancer patients, 424 were diagnosed with HZ during follow-up (median 22 months). The incidence of HZ was 31/1,000 person-year (PY) in patients with hematologic malignancies and 12/1,000 PY in patients with solid tumors. The corresponding 2-year cumulative incidence of HZ was approximately 6% and 2%, respectively. Compared with incidence rates of HZ reported in a general US population, the age-and sex-standardized rates of HZ were 4.8 times higher [95% confidence interval (CI), 4.0-5.6] in patients with hematologic malignancies and 1.9 times higher (95% CI, 1.7-2.1) in those with solid tumors. HZ risk increased with increasing level of immunosuppression. Among HZ cases, 19% with hematologic malignancies and 14% with solid tumors had HZ-associated pain for at least 30 days. The corresponding numbers for nonpain-related complications were 30% and 18%, respectively.Conclusions: Cancer patients are at substantially increased risk of HZ and among those with HZ, complications are relatively common.Impact: Better HZ prevention and treatment options for cancer patients are needed. Cancer Epidemiol Biomarkers Prev; 22(1); 82-90. Ó2012 AACR.

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Section: Discussionsupporting

confidence: 91%

The Epidemiology of Herpes Zoster in Patients with Newly Diagnosed Cancer

Habel

Ray

Silverberg

et al. 2013

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…In the present investigation, as in several previous investigations [14][15][16][17], CMV infection was the most common viral infection identified in renal transplant recipients following transplantation. Sixty-four percent of our subjects developed CMV infection after receiving renal allografts -41 % had reactivation infections and 23 % primary CMV infections.…”

Section: D)iscufssionsupporting

confidence: 79%

Relationship between cytomegalovirus and colonization of the oropharynx by Gram-negative bacilli following renal transplantation

et al. 1991

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SUMMARYNumerous investigators have reported an increased incidence of pneumonia caused by Gram-negative bacilli and other secondary pathogens in transplant recipients infected by cytomegalovirus (CMV). To determine if CMV infections are related to colonization of the upper respiratory tract by Gram-negative bacilli, we examined prospectively 22 renal transplant recipients with sequential bacteriological, virological and biochemical examinations performed just prior to and at various times after transplantation. Only 11 % of subjects had Gram-negative bacilli isolated from gargle specimens prior to transplantation, as compared to 54 % after transplantation. More importantly, after transplantation, subjects with active CMV infections were more likely to have prolonged oropharyngeal carriage of Gram-negative bacilli than subjects without CMV infections (36 % v. 25 %). During active CMV infections, the rate at which Gram-negative bacilli were isolated from gargle specimens rose from 28 to 47 %. During culture-positive CMV infections, the isolation rate reached 57 % and was significantly different from that of CMV-negative samples (P < 0O01). The increased rate of Gram-negative bacillary isolation from gargle specimens during CMV infections was not a function of type of immunosuppresive agents used, rejection episodes, antibiotic administration, concomitant hepatitis B, Epstein-Barr (EBV) virus, or herpes simplex virus infections, or alterations in salivary fibronectin concentrations.

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“…This observation is in agreement with the reports by Anderson and Spencer (1) and Fiala et al (2) who found that H-CMV infection occurred about 2 months after renal transplantation as judged from the rise in CF antibody. The isolation of H-CMV from the recipients became positive at a similai timing (2,12,14), suggesting that the seroconversion to H-CMV in renal transplantation reflects the multiplication of H-CMV in the recipients.…”

Section: Discussionmentioning

confidence: 99%

“…In an attempt to examine clinical significance of the detection of antibody to PENA, we studied relations between the development of anti-PENA and the increase in other antibodies to H-CMV in renal transplant recipients in which seroconversion to H-CMV has been observed at a high frequency (1,2,7,10,12,14). Although the number of patients so far tested are not large, correlation or dissociation was observed between the antibody response to PENA and that to other antibodies.…”

mentioning

confidence: 99%

Seroconversion to Human‐Cytomegalovirus‐Specific Pre‐Early Nuclear Antigens in Renal Transplant Recipients

Ohtsuka

Tanaka

Saitho

et al. 1979

Microbiology and Immunology

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Seroconversion to human cytomegalovirus (H-CMV)-specific antigens was observed in 8 out of 9 renal transplant recipients. In 7 of the 8 recipients antibody to "pre-early nuclear antigens" (PENA), which are detectable in human embryonic lung cells within 1 hr of H-CMV infection by anti-complement immunofluorescence staining, developed concomitantly with the increase in other antibodies including anti-early antigens (EA), anti-nuclear inclusions (NI), and complement-fixing (CF) antibody in 1-2 months after transplantation.About 1 year later, anti-PENA and anti-EA titers were concomitantly decreased in 2 recipients, whereas anti-NI and CF antibody titers were maintained at elevated levels in all the seroconverted recipients. These results support the idea that the development of antibody to PENA, like antibody to EA, may represent a current or recent infection with (or reactivation of) H-CMV. In one patient, antibody to PENA did not develop through the observation period despite increases in antibody to EA and other antibodies; this lends support to immunological distinctness of PENA from EA.

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Prospective Study of Prevalence, Incidence, and Source of Herpesvirus Infections in Patients with Renal Allografts

Cited by 119 publications

References 49 publications

The Epidemiology of Herpes Zoster in Patients with Newly Diagnosed Cancer

The Epidemiology of Herpes Zoster in Patients with Newly Diagnosed Cancer

Relationship between cytomegalovirus and colonization of the oropharynx by Gram-negative bacilli following renal transplantation

Seroconversion to Human‐Cytomegalovirus‐Specific Pre‐Early Nuclear Antigens in Renal Transplant Recipients

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