Which CMV Viral Load Threshold Should Be Defined as CMV Infection in Kidney Transplant Patients?

Eshraghi, Hamid; Hekmat, Reza

doi:10.1016/j.transproceed.2014.11.066

Cited by 6 publications

(4 citation statements)

References 15 publications

(10 reference statements)

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“…Yet, there is limited information to guide CMV management in belatacept‐treated recipients. The incidence of viremia above a specific threshold, peak viral load, and AUC among other metrics have been used to identify CMV risk factors to predict clinical outcomes and to inform treatment management in transplant recipients 7,32–36 . However, these traditional measures fail to capture viral load dynamics over time 28 .…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of viremia above a specific threshold, peak viral load, and AUC among other metrics have been used to identify CMV risk factors to predict clinical outcomes and to inform treatment management in transplant recipients. 7 , 32 , 33 , 34 , 35 , 36 However, these traditional measures fail to capture viral load dynamics over time. 28 Access to granular clinical data creates the opportunity to leverage MSM models for additional insights on viral load dynamics such as probabilities of bidirectional viral load state transitions and duration in viral load states.…”

Section: Discussionmentioning

confidence: 99%

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Impact of belatacept and tacrolimus on cytomegalovirus viral load control and relapse in moderate and high‐risk cytomegalovirus serostatus kidney transplant recipients

Magua

Johnson

Karadkhele

et al. 2022

Transplant Infectious Dis

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Background Belatacept improves long‐term graft survival, but control of some primary viral infections may be impaired. We evaluated the impact of belatacept and tacrolimus on cytomegalovirus (CMV) viral control, remission and relapse in CMV high‐risk and moderate‐risk recipients. Methods Using a multistate Markov model, we evaluated viral load state transitions of 173 kidney transplant recipients with at least one episode of viremia within 1 year after transplant: state 1, undetectable/low viral load; state 2, moderate viremia; and state 3, severe viremia. Results Among high‐risk recipients, belatacept‐treated recipients exhibited a significantly higher probability of entering moderate viremia (.36; 95% CI = .31, .41) than tacrolimus‐treated recipients (.20; 95% CI = .13, .29). The expected number of days in viremic states differed. High‐risk belatacept‐treated recipients persisted in moderate viremia for significantly longer (128 days, 95% CI = 110, 146) than did tacrolimus‐treated recipients (70.0 days, 95% CI = 45.2, 100) and showed a trend of shorter duration in low/undetectable viral load state (172 days, 95% CI = 148, 195) than did tacrolimus‐treated recipients (239 days, 95% CI = 195, 277). Moderate‐risk recipients showed better viral load control and with no differences by immunosuppression. Conclusion High‐risk belatacept‐treated recipients showed defects in sustaining viral control relative to tacrolimus‐treated recipients. Avoidance of initial use belatacept in high‐risk recipients or development of modified management protocols should be considered.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of belatacept and tacrolimus on cytomegalovirus viral load control and relapse in moderate and high‐risk cytomegalovirus serostatus kidney transplant recipients

Magua

Johnson

Karadkhele

et al. 2022

Transplant Infectious Dis

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“…Customarily, CMV-DNA copy number has been used to identify viral reactivation (10), but the cellular immunity mediated by T lymphocytes is more relevant for controlling CMV infection (11). Immunity to CMV depends on the provision of adequate help from CMV-specific CD4+ T cells that enable production of neutralizing antibodies by CMV-specific B-cells/plasma blasts, and effective cytotoxic CD8+ T cell (CTL) responses (12).…”

Section: Introductionmentioning

confidence: 99%

Effect of Type of Dialysis on CMV-Specific CD8+ T Cells in Kidney Transplant Candidates

Vidal-Castiñeira¹,

Corte-Iglesias²,

Sobrino-Díaz

et al. 2019

Front. Immunol.

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Background: Dialysis is the first procedure to partially replace renal function in end-stage renal diseases, despite several adverse side effects, such as infections. The primary aim of this study was to evaluate the levels of immune CMV-specific CD8+ T cells in a representative cohort of pre-transplant patients receiving hemodialysis (HD) or peritoneal dialysis (PD). The secondary aim was to monitor the CMV-specific CD8+ T cells in kidney transplant recipients undergoing different types of dialysis during the first year following their transplant. Methods: Sixty-nine patients were enrolled and examined with respect to the type of dialysis they received. HLA class I dextramers for CMV were used to determine the quantity of CMV-specific CD8+ T cells. The CMV DNA viral load was also determined. Forty-two of the patients enrolled in the study underwent solid organ transplantation and were analyzed during their first year post-transplantation. Results: Patients receiving HD had fewer CMV-specific CD8+ T cells than those in PD ( p < 0.05). We also observed that patients in PD had more CMV-specific CD8+ T cells during the follow-up period than those in HD ( p < 0.05), independently of the CMV DNA. Finally, PD patients had a higher frequency of CD8+ Effector-Memory RA T cells (TEMRA) and a lower frequency of central memory T cells (TCM) than did HD patients. Conclusions: These results indicate the better status of CMV-specific T cell immunity in PD patients. The use of CMV T cell dextramers would be advantageous for monitoring the CD8+ T-specific response, enabling the use of prophylactic treatment to be optimized.

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“…The viral 'threshold load' is very sensitive and specific for predicting both white blood cell and platelet quantification in kidney transplant patients. The threshold value is more than 10000 copies/mL considered as HCMV infection [5]. In infected adults, HIV viral load is predictive of progression to AIDS [6,7] and HCMV DNAaemia predicts progression to disease, particularly retinitis [8].…”

Section: Introductionmentioning

confidence: 99%

<i>In vitro</i> Evaluation of Biofield Treatment on Viral Load Against Human Immunodeficiency-1 and Cytomegalo Viruses

Trivedi¹,

Branton²,

Trivedi³

et al. 2015

AJHR

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Viral load quantification is the amount of particular viral DNA or RNA in a blood samples. It is one of the surrogate biomarker of AIDS. High viral load indicates that the immune system is failed to fight against viruses. The aim of this study was to evaluate the impact of biofield treatment on HIV-1 and HCMV in terms of viral loads as surrogate marker. The viral load assay was performed on stored stock cultures of HIV infected human plasma samples before and after 7 days of biofield treatment using Roche COBAS ® AMPLICOR analyzer. Viral load (HIV-1 RNA and HCMV DNAaemia) was considered as surrogate marker for assessment of the impact of Mr. Trivedi's biofield treatment in HIV infected stored plasma samples. The viral load quantification of HIV-1 RNA in infected stored plasma samples was significantly reduced by 65% in biofield treated group as compared to control. Additionally, viral load of HCMV DNAaemia in infected stored plasma samples was also reduced by 80% in the biofield treated group as compared to control. Because, children are more prone to HCMV infection and adults are generally liable to suffer from HIV-1 infection. As the biofield treatment has reduced HCMV DNAaemia, it could be beneficial for HIV infected children populations. Altogether, data suggest that biofield treatment has significantly reduced the viral load quantification in HIV-1 and HCMV infected stored plasma samples and could be a suitable alternative treatment strategy for AIDS patients in near future.

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Which CMV Viral Load Threshold Should Be Defined as CMV Infection in Kidney Transplant Patients?

Cited by 6 publications

References 15 publications

Impact of belatacept and tacrolimus on cytomegalovirus viral load control and relapse in moderate and high‐risk cytomegalovirus serostatus kidney transplant recipients

Impact of belatacept and tacrolimus on cytomegalovirus viral load control and relapse in moderate and high‐risk cytomegalovirus serostatus kidney transplant recipients

Effect of Type of Dialysis on CMV-Specific CD8+ T Cells in Kidney Transplant Candidates

<i>In vitro</i> Evaluation of Biofield Treatment on Viral Load Against Human Immunodeficiency-1 and Cytomegalo Viruses

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Which CMV Viral Load Threshold Should Be Defined as CMV Infection in Kidney Transplant Patients?

Cited by 6 publications

References 15 publications

Impact of belatacept and tacrolimus on cytomegalovirus viral load control and relapse in moderate and high‐risk cytomegalovirus serostatus kidney transplant recipients

Impact of belatacept and tacrolimus on cytomegalovirus viral load control and relapse in moderate and high‐risk cytomegalovirus serostatus kidney transplant recipients

Effect of Type of Dialysis on CMV-Specific CD8+ T Cells in Kidney Transplant Candidates

&lt;i&gt;In vitro&lt;/i&gt; Evaluation of Biofield Treatment on Viral Load Against Human Immunodeficiency-1 and Cytomegalo Viruses

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<i>In vitro</i> Evaluation of Biofield Treatment on Viral Load Against Human Immunodeficiency-1 and Cytomegalo Viruses