Serological evidence for reactivation of EBV infection due to uraemic immunodeficiency

Winkelspecht, Bernd; Mueller-Lantzsch, N.; Köhler, Heinz‐R.

doi:10.1093/ndt/12.10.2099

Cited by 18 publications

(7 citation statements)

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“…Both cancers are known to be associated with human papillomavirus (HPV) and it has been postulated that uremic immune dysfunction, supported by the evidence of reactivation of latent Epstein-Barr virus infection in uremic immunodeficiency [27] could be a possible cause. In addition, the use of immunosuppressive agents during treatment of the underlying diseases leading to ESKD could also result in a higher risk of these HPV-related cancers.…”

Section: Discussionmentioning

confidence: 99%

Cancer Incidence and Mortality in Chronic Dialysis Population: A Multicenter Cohort Study

Cheung

Chan

et al. 2016

Am J Nephrol

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Background: Different studies in the past have shown that the risk of cancer development is increased in chronic dialysis patients. However, data concerning the cancer risk in Asian dialysis patients was scarce. More importantly, there was lack of information about the cancer-specific mortality in dialysis patients. Methods: A multicenter retrospective cohort study of 6,254 patients who started either chronic peritoneal dialysis or hemodialysis between 1994 and 2014 in 4 renal units in Hong Kong. Patterns of cancer incidence and mortality in our dialysis patients were compared with those of the general population using standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) respectively. Results: With 14,887 person-years of follow-up, 220 cancers were recorded. The SIR of all cancers was 1.44 (95% CI 1.26-1.65). A trend of an increased SIR was observed in young patients and within the first year of dialysis. Colorectum was the most common site of cancer (20%) while kidney cancer carried the highest risk (SIR 12.28, 95% CI 8.44-17.08). The SMR of all cancers was 0.91 (95% CI 0.72-1.13) and only kidney cancer had higher cancer mortality risk (SMR 4.92, 95% CI 1.80-10.70). SMR was highest in young patients and then decreased with age. Conclusions: The incidence of cancers in our chronic dialysis patients was elevated. Our findings of substantially increased risks in young patients, particularly in relation to kidney cancer, suggest that we can adopt a more individualized approach to cancer screening in chronic dialysis patients.

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Section: Discussionmentioning

confidence: 99%

Cancer Incidence and Mortality in Chronic Dialysis Population: A Multicenter Cohort Study

Cheung

Chan

et al. 2016

Am J Nephrol

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“…19,20 This explanation is supported by evidence of reactivation of latent Epstein-Barr virus infection in uremic immunodeficiency. 21 A contributing factor may be the use of immunosuppressive agents to treat diseases that cause ESKD.…”

Section: Commentmentioning

confidence: 99%

Cancer Incidence Before and After Kidney Transplantation

Vajdic¹,

McDonald²,

McCredie³

et al. 2006

JAMA

1,007

800

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Kidney transplantation is associated with a marked increase in cancer risk at a wide variety of sites. Because SIRs for most types of cancer were not increased before transplantation, immune suppression may be responsible for the increased risk. These data suggest a broader than previously appreciated role of the interaction between the immune system and common viral infections in the etiology of cancer.

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“…The anti-EBNA-1/anti-EBNA-2 ratio also was examined, with a ratio of Յ 1.0 considered as serologic evidence of a deregulated immune response in other clinical settings. [4][5][6][7][8][9] Masked repeat samples (5% of specimens) were included to enable monitoring of within-batch reproducibility of antibody titers. The withinbatch coefficients of variation from the blind quality control samples were 9.9% for anti-VCA, 38.9% for anti-EA complex, 12.4% for anti-EBNA complex, 16.8% for anti-EBNA-1, and 37.5% for anti-EBNA-2.…”

Section: Serologic Specimens and Assaysmentioning

confidence: 99%

“…5 Persistent anti-EBNA-1/anti-EBNA-2 antibody ratios of Յ 1.0 have been described in patients with inherited immunologic disorders, severe infectious mononucleosis, chronic EBV infection, rheumatoid arthritis, chronic renal failure, and AIDS. [4][5][6][7][8][9] Recently, it has been shown that an anti-EBNA-1/EBNA-2 ratio Յ 1.0 is associated with Hodgkin lymphoma risk, independent of a history of infectious mononucleosis. 10 Henle et al have suggested that this atypical pattern is indicative of inadequate host regulation of latent EBV infection.…”

Section: Introductionmentioning

confidence: 99%

Atypical prediagnosis Epstein-Barr virus serology restricted to EBV-positive Hodgkin lymphoma

Levin

Chang

Ambinder

et al. 2012

Blood

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Serological evidence for reactivation of EBV infection due to uraemic immunodeficiency

Cited by 18 publications

References 0 publications

Cancer Incidence and Mortality in Chronic Dialysis Population: A Multicenter Cohort Study

Cancer Incidence and Mortality in Chronic Dialysis Population: A Multicenter Cohort Study

Cancer Incidence Before and After Kidney Transplantation

Atypical prediagnosis Epstein-Barr virus serology restricted to EBV-positive Hodgkin lymphoma

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