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Viral loads in transplant patients and Cytomegalovirus genotyping

Authors

  • Elizabeth Rojas-Cordero Hospital San Juan de Dios, Laboratorio de Biología Molecular
  • María Rodríguez-Sevilla Hospital San Juan de Dios, Servicio de Hematología
  • Álvaro Herrera-Muñoz Hospital San Juan de Dios, Servicio de Nefrología
  • James Karkashian-Córdoba Universidad de Costa Rica, Escuela de Biología, Laboratorio de Biología Molecular,

DOI:

https://doi.org/10.51481/amc.v63i2.1192

Keywords:

Transplantation, Immunosuppression, Viral load, Genotype

Abstract

Aim:  The objective of this study was to determine the course of viral infections during a period one year, by measuring viral loads for Adenovirus, BK virus, Epstein-Barr virus, Cytomegalovirus and Human herpesvirus 6, in 30 patients from the San Juan de Dios National Hospital, undergoing kidney or hematopoietic progenitor cell transplants.

Methods: Viral loads were determined in ten blood samples from each patient: a pre-transplant sample, eight samples obtained at two-week intervals post-transplant and one last sample at six months post-transplant. Viral quantification was performed by real-time polymerase chain reaction and, only for Adenovirus, by end-point polymerase chain reaction. Also, Cytomegalovirus genotypes were determined in patients that tested positive for this virus, by polymerase chain reaction directed towards the glycoprotein B gene and sequencing of the amplified fragments. These sequences were compared and aligned with a reference sequence, using the Clustal Omega Program.

Results: The results of the study indicated that 77% of the patients had at least one of the five viruses detected and the virus with the highest prevalence was Cytomegalovirus, exhibiting 57% positivity in the total population studied. The most frequent Cytomegalovirus genotype detected was genotype 3. The viral load behavior was monitored for each virus analyzed as well as the incidence proportion between male and female patients.

Conclusions. Viral quantification and characterization in transplant patients allows for better clinical management of patients with opportunistic infections and also a better management of pharmacological therapies.

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References

Rouchi H, Mazdeh M. Regenerative Medicine in Organ and Tissue Transplantation: Shortly and Practically Achievable?. Int J Organ Transplant Med. 2015;6(3):93-5

Chinen J, Buckley RH. Transplantation immunology: solid organ and bone marrow. J Allergy Clin Immunol. 2010;125(2): S324-35.

Braun DK, Domínguez G, Pellett PE. Human herpesvirus 6. Clin Microbiol Rev. 1997;10(3):521-67.

Cervera C, Lumbreras C. Factores de riesgo de la enfermedad por citomegalovirus en el receptor de un trasplante de órgano sólido. Enferm Infecc Microbiol Clin. 2011;29:11-7.

Echavarria M, Basilotta N, Aguiar A, Davalos M, Ricarte C, Iotti A, et al . Neuropatía por virus BK post trasplante renal diagnóstico y seguimiento por PCR en tiempo real. Medicina (B Aires). 2007;67(6):719-22.

Crough T, Khanna R. Immunobiology of human cytomegalovirus: from bench to bedside. Clin Microbiol Rev. 2009;22(1):76-98.

Boeckh M, Boivin G. Quantitation of cytomegalovirus: methodologic aspects and clinical applications. Clin Microbiol Rev. 1998;11(3):533-54.

Kanj SS, Sharara AI, Clavien PA, Hamilton JD. Cytomegalovirus infection following liver transplantation: review of the literature. Clin Infect Dis. 1996;22(3):537-49.

Arista S, De Grazia S, Giammanco GM, Di Carlo P, Iannitto E. Human cytomegalovirus glycoprotein B genotypes in immunocompetent, immunocompromised, and congenitally infected Italian populations. Arch Virol. 2003;148(3):547-54.

Navarro D, Paz P, Tugizov S, Topp K, La Vail J, Pereira L. Glycoprotein B of human cytomegalovirus promotes virion penetration into cells, transmission of infection from cell to cell, and fusion of infected cells. Virology. 1993;197(1):143-58.

Cunha AA, Aquino VH, Mariguela V, Nogueira ML, Figueiredo LTM. Evaluation of glycoprotein B genotypes and load of CMV infecting blood leukocytes on prognosis of AIDS patients. Rev Inst Med Trop Sao Paulo. 2011;53(2):82-8.

Chou S, Dennison KM. Analysis of interstrain variation in cytomegalovirus glycoprotein B sequences encoding neutralization-related epitopes. J Infect Dis. 1991;163(6):1229-34.

Chakrabarti S, Mautner V, Osman H, Collingham KE, Fegan CD, Klapper PE, et al. Adenovirus infections following allogeneic stem cell transplantation: incidence and outcome in relation to graft manipulation, immunosuppression, and immune recovery. Blood. 2002;100(5):1619-27.

Ison MG. Adenovirus infections in transplant recipients. Clin Infect Dis. 2006;43(3):331-9.

Khanna R, Smith C. Cellular immune therapy for viral infections in transplant patients.

Indian J Med Res. 2013;138(5):796-807.

Green M. Management of Epstein-Barr Virus-induced Post-transplant Lymphoproliferative Disease in Recipients of Solid Organ Transplantation. Am J Transplant. 2001;1(2):103-8.

Mercorelli B, Lembo D, Palu? G, Loregian A. Early inhibitors of human cytomegalovirus: state-of-art and therapeutic perspectives. Pharmacol Ther. 2011;131(3):309-29.

Drew WL, Chou S, Miner RC, Mohr BA, Busch MP, Van der Horst CM, et al. Cytomegalovirus glycoprotein B groups in human immunodeficiency virus-infected patients with incident retinitis. J Infect Dis. 2002;186(1):114-7.

Ahumada-Ruiz S, Taylor-Castillo L, Visoná K, Luftig RB, Herrero-Uribe L. Determination of human cytomegalovirus genetic diversity in different patient populations in Costa Rica. Rev Inst Med Trop Sao Paulo. 2004;131:87-92.

Lion T, Baumgartinger R, Watzinger F, Matthes-Martin S, Suda M, Preuner S, et al. Molecular monitoring of adenovirus in peripheral blood after allogeneic bone marrow transplantation permits early diagnosis of disseminated disease. Blood. 2003;102(3):1114-20.

Published

2021-11-16

Versions

How to Cite

Viral loads in transplant patients and Cytomegalovirus genotyping. (2021). Acta Médica Costarricense , 63(2), 78-87. https://doi.org/10.51481/amc.v63i2.1192