Journal Article

Kinetics of cytomegalovirus and Epstein-Barr virus DNA in whole blood and plasma of kidney transplant recipients: Implications on management strategies

Turello, Gabriele, Campanini, Giulia, Gabrielli, Liliana, Gregorini, Marilena, Baldanti, Fausto, Biancone, Luigi, Rampino, Teresa, Cavallo, Rossana, Bianco, Gabriele, La Manna, Gaetano, Chiereghin, Angela, Greco, Francesca, Piralla, Antonio, Mauro, Maria Vittoria, Gibertoni, Dino, Piccirilli, Giulia, Costa, Cristina, Comai, Giorgia, Sidoti, Francesca, Lazzarotto, Tiziana

2020

Overview

This retrospective multicenter cohort study investigated the kinetics (ascending and descending phases) of cytomegalovirus (CMV) and Epstein-Barr virus (EBV)-DNA in whole blood (WB) and plasma samples collected from adult kidney transplant (KT) recipients. CMV-DNA kinetics according to antiviral therapy were investigated. Three hundred twenty-eight paired samples from 42 episodes of CMV infection and 157 paired samples from 26 episodes of EBV infection were analyzed by a single commercial molecular method approved by regulatory agencies for both matrices. CMV-DNAemia followed different kinetics in WB and plasma. In the descending phase of infection, a slower decay of viral load and a higher percentage of CMV-DNA positive samples were observed in plasma versus WB. In the 72.4% of patients receiving antiviral therapy, monitoring with plasma CMV-DNAemia versus WB CMV-DNAemia could delay treatment interruption by 7-14 days. Discontinuation of therapy based on WB monitoring did not result in relapsed infection in any patients. Highly different EBV-DNA kinetics in WB and plasma were observed due to lower positivity in plasma; EBV positive samples with a quantitative result in both blood compartments were observed in only 11.5% of cases. Our results emphasize the potential role of WB as specimen type for post-KT surveillance of both infections for disease prevention and management.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Antiviral agents / Antiviral drugs / Automation / Biology and Life Sciences / Blood / Complications and side effects / Cytomegalovirus / Cytomegalovirus infections / Deoxyribonucleic acid / Diagnosis / Disease control / DNA / Epstein-Barr virus / Epstein-Barr virus diseases / Hemodialysis / Immunosuppressive agents / Infections / Kidney transplantation / Kidney transplants / Kidneys / Kinetics / Laboratories / Medicine / Medicine and Health Sciences / Monitoring / Nephrology / Plasma / Postoperative complications / Regulatory agencies / Risk factors / Supervision / Telemedicine / Therapy / Virology / Viruses