Lack of antibodies against the antigen domain 2 epitope of cytomegalovirus (CMV) glycoprotein B is associated with CMV disease after renal transplantation in recipients having the same glycoprotein H serotypes as their donors

The aim of the present study was to identify the virulence of glycoprotein B (gB), glycoprotein N (gN), and glycoprotein H (gH) genotypes of cytomegalovirus(CMV) and assess possible relationships between genotypes and CMV-associated thrombocytopenia. CMV gB, gN, and gH strains were determined by nested PCR and restriction length polymorphism from 30 CMV-associated thrombocytopenia infants infected postnatally and 40 non-thrombocytopenic infants. The gN2 (p = 0.043) and gH2 (p = 0.038) genotypes were associated with an elevated risk of developing thrombocytopenia. gB1 genotype was detected in 80.0% (16/20) of infants with moderately to severely symptomatic CMV disease and was associated with severe manifestations in CMV-associated thrombocytopenia infants (p = 0.022). Conversely, the gN1 genotype was detected in 5.0% (1/20) of infants with moderately to severely symptomatic CMV disease and represent less pathogenic CMV strains (p = 0.044). There may be potential associations between the gN2 and gH2 genotypes of CMV and infantile thrombocytopenia, and that the detection of the gB1and gN1 genotypes may help define the severity of CMV disease in infants.

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Effectiveness of Valganciclovir 900mg Versus 450mg for Cytomegalovirus Prophylaxis in Renal Transplantation: A Systematic Review and Meta-Analysis

Journal of Pharmacy & Pharmaceutical Sciences ◽

10.18433/j3805b ◽

2017 ◽

Vol 20 ◽

pp. 168 ◽

Cited By ~ 3

Author(s):

Wang Xin ◽

Yang Hui ◽

Zhang Xiaodong ◽

Cui Xiangli ◽

Wang Shihui ◽

...

Keyword(s):

Renal Transplantation ◽

Acute Rejection ◽

Low Dose ◽

Opportunistic Infections ◽

Meta Analysis ◽

High Dose ◽

Renal Transplant Recipients ◽

Significant Difference ◽

Allograft Loss ◽

Cmv Disease

Objectives: Valganciclovir 900 mg/day is approved for cytomegalovirus (CMV) prophylaxis, but 450 mg/day is seems also effective. We systematically reviewed the efficacy and safety of low-dose versus high-dose valganciclovir prophylaxis in renal transplantation recipients. Methods: An electronic search was conducted up to November 29, 2016. The primary outcomes were incidences of CMV, CMV disease, mortality and opportunistic infection. The second outcomes were acute rejection, allograft loss, adverse drug reaction (ADR). Results: 7 cohort studies, all with high quality involving (1431 patients) were included. There was no significant difference of the incidence of following CMV disease (1271 patients, odds ratio [OR] 0.74, 95% confidence interval [CI], 0.38-1.43, p=0.36), acute rejection (1343 patients, OR 0.77, 95%CI 0.53-1.14, p=0.19), allograft loss (1271 patients, OR 0.64, 95%CI 0.31-1.35, p=0.24), mortality (1271 patients, OR 0.55, 95%CI 0.20-1.47, p=0.23) and opportunistic infections (OI) (985 patients, OR 0.76, 95%CI 0.52-1.10, p=0.14) between the low-dose and the high-dose valganciclovir prophylaxis. And no significant difference was observed for premature valganciclovir discontinuation (1010 patients, OR 0.81, 95%CI 0.52-1.25, p=0.33) and the incidence of leukopenia (1082 patients, OR 0.65, 95%CI 0.34-1.22, p=0.18) between the two regimens. Conclusion: 450 mg and 900 mg doses of valganciclovir are equipotent for CMV universal prophylaxis. CMV 450 mg prophylaxis should be used for renal transplant recipients. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

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MP61-08 THE PRESENCE OF ANTIBODIES AGAINST THE AD2 EPITOPE OF CYTOMEGALOVIRUS GLYCOPROTEIN B IS ASSOCIATED WITH ACUTE REJECTION AFTER RENAL TRANSPLANTATION

The Journal of Urology ◽

10.1016/j.juro.2018.02.1987 ◽

2018 ◽

Vol 199 (4S) ◽

Author(s):

Akihumi Onagi ◽

Kei Ishibashi ◽

Ryo Tanji ◽

Ruriko Takinami ◽

Kanako Matsuoka ◽

...

Keyword(s):

Renal Transplantation ◽

Acute Rejection ◽

Glycoprotein B

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Revisiting cytomegalovirus serostatus and replication as risk factors for inferior long-term outcomes in the current era of renal transplantation

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfz268 ◽

2020 ◽

Vol 35 (2) ◽

pp. 346-356

Author(s):

Nicole Bischof ◽

Caroline Wehmeier ◽

Michael Dickenmann ◽

Patricia Hirt-Minkowski ◽

Patrizia Amico ◽

...

Keyword(s):

Risk Factors ◽

Renal Transplantation ◽

Patient Survival ◽

Long Term Outcomes ◽

Single Centre ◽

Centre Study ◽

Single Centre Study ◽

Cmv Disease ◽

The Impact

Abstract Background Cytomegalovirus (CMV) serostatus and CMV replication are considered as risk factors for inferior graft and patient survival after renal transplantation, but long-term outcome data are limited. The aim of this retrospective single-centre study was to investigate the impact of CMV serostatus and CMV replication/disease on long-term outcomes in a well-defined cohort managed by a standardized CMV prevention/treatment protocol. Methods We investigated 599 consecutive kidney transplantations having a CMV prevention protocol consisting of either prophylaxis (D+/R− and R+ with ATG induction) or screening/deferred therapy (R+ without ATG induction). Patients were grouped according to CMV serostatus [high risk (D+/R−): n = 122; intermediate risk (R+): n = 306; low risk (D−/R−): n = 171] and occurrence of CMV replication/disease (no CMV replication: n = 419; asymptomatic CMV replication: n = 110; CMV syndrome: n = 39; tissue-invasive CMV disease: n = 31). The median follow-up time was 6.5 years. Results Graft and patient survival were not different among the three CMV serostatus groups as well as the four CMV replication/disease groups (P ≥ 0.44). Eighty-seven patients died, 17 due to infections (21%), but none was attributable to CMV. The overall hospitalization incidence for CMV-related infection was 3% (17/599 patients). The incidence of clinical and (sub)clinical rejection was similar among the groups (P ≥ 0.17). In a multivariate Cox proportional hazard model, neither CMV serostatus, nor CMV replication, nor CMV disease were independent predictors for patient death or graft failure, respectively. Conclusions This retrospective single-centre study suggests that the negative impact of CMV infection on long-term patient and allograft survival as well as on allograft rejection can be largely eliminated with current diagnostic/therapeutic management.

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