Viral factors influencing the outcome of human cytomegalovirus infection in liver transplant recipients

Scott, Gillian; Naing, Zin; Pavlovic, J; Iwasenko, Jenna M.; Angus, Peter W; Jones, Robert M.; Rawlinson, William D.

doi:10.1016/j.jcv.2011.05.012

Cited by 20 publications

(13 citation statements)

References 41 publications

(62 reference statements)

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“…In addition, 15 noncomparative observational studies were included in this meta‐analysis. The results on dose, duration and route of administration of GCV/VGCV along with follow‐up and CMV diagnostic methods are reported in Tables and .…”

Section: Resultsmentioning

confidence: 99%

Universal Prophylaxis or Preemptive Strategy for Cytomegalovirus Disease After Liver Transplantation: A Systematic Review and Meta-Analysis

Mumtaz

Faisal

Husain

et al. 2015

American Journal of Transplantation

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We systematically reviewed and meta-analyze the efficacy of universal prophylaxis (UP) and preemptive (PE) strategies (using ganciclovir or valganciclovir) in preventing cytomegalovirus (CMV) disease (CMD) among liver transplant recipients (LTRs). We performed an electronic search of MEDLINE, EMBASE and the Cochrane Database till December 2013. Studies that assessed UP or PE for preventing CMD in LTRs were included. The risk of bias was assessed using the Newcastle-Ottawa scale. The primary outcome was CMD, secondary outcomes being acute cellular rejection (ACR), graft loss (GL) and mortality. Due to the heterogeneity of comparative studies, an indirect comparison was performed. Pooled incidence rates with 95% confidence interval (CI) are calculated for each outcome using a random-effects model. Thirty-two studies involving 2456 LTRs were included. The majority of the studies were of low risk of bias. Irrespective of donor/recipient CMV sero-status, CMD was 10% with UP (95% CI: 6-14; I 2 ¼ 87%; 16 studies, n ¼ 1581) and 7% with PE (95% CI: 3-10; I 2 ¼ 84%; 16 studies, n ¼ 875) (mean difference 2.6; 95% CI: À3.25 to 8.45, p ¼ 0.34). Likewise, ACR and mortality were similar with the two strategies. However, GL was significantly lower in the UP group, regardless of donor/recipient sero-status. In indirect comparison, the incidence of CMD, ACR and mortality in LTRs were similar with two strategies. Trials comparing the two strategies directly are needed.

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Section: Resultsmentioning

confidence: 99%

Universal Prophylaxis or Preemptive Strategy for Cytomegalovirus Disease After Liver Transplantation: A Systematic Review and Meta-Analysis

Mumtaz

Faisal

Husain

et al. 2015

American Journal of Transplantation

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“…A infecção por HCMV após o transplante de órgãos é uma das complicações virais mais importantes que pode acometer o paciente. 1,2,6,8,10,13,19,23 Essa importância torna-se ainda mais evidente nesse contexto quando se observa que pode estar relacionada a uma miríade de complicações, como doenças oportunistas, rejeição celular aguda e crônica, infecções bacterianas, dentre outras. 18,[20][21][22][23][24][25][26][27][28][29][30][31][32] Nesse estudo, investigouse a incidência das infecções pelos betaherpesvírus HCMV, HHV-6 e HHV-7 através de N-PCR, antigenemia e sorologia, e procurou-se determinar as correlações dos testes aplicados com os possíveis fatores de riscos relacionados ao impacto clínico após o transplante de fígado.…”

Section: ____________________________________________________________...unclassified

“…5 Nos últimos anos, HCMV, HHV-6 e HHV-7 têm sido relacionados, por vários autores, devido a sua alta prevalência na população e estar freqüentemente relacionados a grande impacto clinico após o transplante. [14][15][16][17][18][19][20][21][22] Nesse contexto, métodos eficazes e precoces de diagnósticos laboratoriais são de grande importância no prognóstico desses pacientes. A antigenemia é considerada uma técnica para detecção precoce com alto valor preditivo para doença, sendo uma ferramenta de diagnóstico útil no pós-transplante, assim como a sorologia, e N-PCR têm sido bastante utilizados como métodos eficazes de diagnóstico para o monitoramento clinico-laboratorial.…”

Section: Introductionunclassified

Vigilância Clinico-Laboratorial Da Infecção Pelo Herpesvírus Humano 6 (Hhv-6) E Herpesvírus Humano 7 (Hhv-7) E Da Co-Infecção Com Citomegalovírus Humano (Hcmv) Após O Transplante Hepático

Sampaio

Udo

Bodine

et al. 2012

bjt

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Os herpesvírus humanos HHV-6 e HHV-7, após infecção primária, permanecem latentes no organismo, podendo reativar-se por período de imunossupressão. Objetivo: Realizar vigilância laboratorial da infecção por HHV-6, HHV-7 e infecção com citomegalovírus Humano (HCMV) no pós-transplante hepático, através das técnicas de antigenemia, N-PCR e sorologia. Métodos: Amostras de 32 pacientes, com idade mediana de 47 (18-66) anos, sendo 20 (62,5%) do sexo masculino e 12 (37,5%) do sexo feminino. A monitorização laboratorial iniciou-se no pré-operatório e, após o transplante, de modo semanal, do 1º ao 2º mês, quinzenal no 3º mês, e mensal do 4º ao 6º mês. A partir de extração de linfócitos, realizou-se a detecção de HHV-6 e HHV-7, pela técnica de antigenemia. A detecção de anticorpos IgM anti HHV-6 foi realizada pelo teste Elisa. Realizou-se antigenemia, N-PCR e sorologia para HCMV, HHV-6 e HHV-7. Resultados: Com essas metodologias, a detecção de IgM anti HHV-6 foi positiva em 15,6% dos pacientes no pré-transplante, 25% na quarta semana, 40,6% na 12a semana e em 46,9% na 24a semana, após o enxerto. A antigenemia para HCMV, HHV-6 e HHV- 7 foi positiva em 46,9%, 62,5% e 46,8% respectivamente. A N-PCR para HCMV e HHV-6 ocorreu em 81% dos casos, e para HHV-7 em 46,8%. Detectou-se que 50% dos pacientes estudados tiveram doença por HCMV. A doença causada pelo HHV-6 foi observada em 46,8% dos pacientes e em 15,6% para HHV-7. A concomitância de doenças foi observada nos pacientes com HCMV e HHV-6 em 21,9% e em 15,6% dos pacientes com HHV-6 e HHV-7. A doença causada pelos betaherpesvirus foi detectada com maior frequência ao redor da quinta semana. Os episódios de doença para HHV-6 e HHV-7 precederam ao aparecimento da doença por HCMV. Conclusão: Este estudo confirma a relevância da infecção pelo HCMV, HHV-6 e HHV-7 e a importância do monitoramento para a detecção precoce desses agentes, possibilitando a utilização de um tratamento preemptivo, com redução do risco de doença.

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“…Evaluation of MagNA Pure 96 nucleic acid extraction using clinical respiratory specimens for identifying viruses by qualitative realtime PCR was recently reported (2). Rapid, sensitive, accurate, and predictive molecular cytomegalovirus (CMV) assays in the routine diagnostic laboratory are of increasing interest for the prevention and management of CMV diseases in immunocompromised patients, such as transplant recipients (3,4). In addition, CMV screening is of particular importance concerning pregnancy, because CMV is one of the most common causes of congenital infections (5,6).…”

mentioning

confidence: 99%

Performance of the MagNA Pure 96 System for Cytomegalovirus Nucleic Acid Amplification Testing in Clinical Samples

et al. 2013

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A critical feature for reliability of results in routine molecular diagnostics is the extraction of target DNA and RNA. The Roche MagNA Pure 96 system was launched in 2009 for automated nucleic acid extraction applicable in life science research. To use this automated platform also for in vitro diagnostics, it has to be shown that the performance of the MagNA Pure 96 system complies with the essential requirements of European Directive 98/79/EC on in vitro diagnostic medical devices (1). Accordingly, CE marking on the MagNA Pure 96 system declares the capability of the product to extract pure nucleic acids with high recovery and reproducibility, which ensures reliable clinical diagnostics. Evaluation of MagNA Pure 96 nucleic acid extraction using clinical respiratory specimens for identifying viruses by qualitative realtime PCR was recently reported (2). Rapid, sensitive, accurate, and predictive molecular cytomegalovirus (CMV) assays in the routine diagnostic laboratory are of increasing interest for the prevention and management of CMV diseases in immunocompromised patients, such as transplant recipients (3, 4). In addition, CMV screening is of particular importance concerning pregnancy, because CMV is one of the most common causes of congenital infections (5, 6).The present study evaluated the performance of the MagNA Pure 96 system for CMV DNA isolation from 200 l of cell culture (standard material) and of clinical plasma specimens. The extraction on the MagNA Pure 96 system was carried out with the "Viral NA Plasma Protocol" and/or with the "Pathogen Universal Protocol" (elution volume, 50 l). In comparison, the "Cell-free Protocol" on the QIAsymphony SP platform (Qiagen, Hilden, Germany) was used for sample processing (elution volume, 85 l) in our in-house CMV workflow. Data of studies that have evaluated the QIAsymphony SP extraction platform in diagnostic laboratories were previously published (7-9).Isolated CMV DNA was quantified using a real-time PCR assay according to Mori et al. (10) by applying a two-step protocol on a Roche LightCycler 2.0 instrument. All samples were processed together with 100 copies of a plasmid-based internal control of lambda DNA flanked by CMV primer sequences to exclude falsenegative results.At the beginning of the study, the viral load of our CMV standard material was verified on a Cobas Amplicor Analyzer using the Cobas Amplicor CMV Monitor test (Roche Diagnostics). Then, dilutions of the standard material were subjected to multiple processing in one run and in runs on several days according to the recommendations of the European Pharmacopoeia to determine performance parameters. The obtained low intra-and interrun variations demonstrated a good recovery of the viral loads tested (coefficient of variation, Յ2%; standard deviation, less than Ϯ0.5 copies/ml). The limit of detection (LOD), the point at which 95% of the replicates of a given viral load are detected, was determined by a statistical approach (Probit analysis). The LOD of the CMV workflow that included MagNA Pur...

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Viral factors influencing the outcome of human cytomegalovirus infection in liver transplant recipients

Cited by 20 publications

References 41 publications

Universal Prophylaxis or Preemptive Strategy for Cytomegalovirus Disease After Liver Transplantation: A Systematic Review and Meta-Analysis

Universal Prophylaxis or Preemptive Strategy for Cytomegalovirus Disease After Liver Transplantation: A Systematic Review and Meta-Analysis

Vigilância Clinico-Laboratorial Da Infecção Pelo Herpesvírus Humano 6 (Hhv-6) E Herpesvírus Humano 7 (Hhv-7) E Da Co-Infecção Com Citomegalovírus Humano (Hcmv) Após O Transplante Hepático

Performance of the MagNA Pure 96 System for Cytomegalovirus Nucleic Acid Amplification Testing in Clinical Samples

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