Premium
Usefulness of quantitative real‐time polymerase chain reaction in following up patients with Epstein–Barr virus infection after liver transplantation
Author(s) -
Orii Takashi,
Ohkohchi Nobuhiro,
Kikuchi Hiroyuki,
Koyamada Nozomi,
Chubachi Seiji,
Satomi Susumu,
Kimura Hiroshi,
Hoshino Yo,
Morita Makoto
Publication year - 2000
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1034/j.1399-0012.2000.140406.x
Subject(s) - medicine , polymerase chain reaction , real time polymerase chain reaction , virus , transplantation , epstein–barr virus , liver transplantation , in situ hybridization , herpesviridae , lymphoma , virology , immunology , viral disease , gene , biology , messenger rna , biochemistry
Background. Post‐transplant lymphoproliferative disease (PTLD), which is mainly induced by Epstein–Barr virus (EBV) infection, is a cause of significant morbidity and mortality for patients undergoing liver transplantation, especially when it is detected at such an advanced stage as monoclonal malignant lymphoma.
Methods. In this series, 6 of 22 1iver transplant patients suffered from EBV infection. We tested quantitative DNA (Qt‐DNA) by real‐time polymerase chain reacton (PCR), qualitative DNA in plasma (Ql‐pDNA) by PCR, and EBV‐encoded mRNA 1 (EBER 1) by in situ hybridization to clarify which of them is a better marker for the early diagnosis and prediction of EBV‐associated disorders.
Results. Four had signs or symptoms of PTLD, but 2 did not develop individualized lymphoid lesions. In all patients, both Qt‐DNA and EBER 1 exceeded the cut‐off level of 10 2.5 copies/μg DNA and 0.002%, respectively, at the time of diagnosis. In 2 patients, when Qt‐DNA had a poor decline, EBER 1, even if it seemed to decrease after antiviral therapy, increased again after a few months and the clinical symptoms recurred. In 2 patients, Qt‐DNA and EBER 1 increased again after a few months of antiviral therapy, and Ql‐pDNA remained positive, whereas, in 3 patients, no reaction of EBV could be detected once Ql‐pDNA became negative, even after the cessation of therapy.
Conclusions. These results suggest that real‐time PCR for Qt‐DNA was more sensitive to the real‐time activity of EBV and that Ql‐pDNA could indicate when to stop antiviral therapy.