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Clinical usefulness of Epstein‐Barr viral load in solid‐organ transplantation
Author(s) -
Buteau Chantal,
Paya Carlos V.
Publication year - 2001
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1053/jlts.2001.0070157
Subject(s) - asymptomatic , medicine , viral load , peripheral blood mononuclear cell , immunology , epstein–barr virus , transplantation , organ transplantation , virus , gastroenterology , biology , in vitro , biochemistry
Epstein‐Barr virus (EBV) DNA was quantitated in peripheral blood mononuclear cells (PBMC) from 25 healthy subjects, 105 asymptomatic solid‐organ transplant (SOT) recipients, and 15 SOT recipients with symptomatic EBV infections by using a newly developed quantitative‐PCR technique. Patients with symptomatic EBV infections had significantly higher ( P < 0.001) median EBV DNA levels than asymptomatic SOT recipients and immunocompetent individuals. In SOT recipients, the positive predictive value of EBV DNA levels of > 1,000 genome equivalents (GE)/0.5 μg of total PBMC DNA was 64.7% for symptomatic EBV infection, while the negative predictive value was 96.1%. In 19 of 32 (59.3%) asymptomatic SOT recipients, EBV DNA levels were consistently below 1,000 GE for as long as 18 months, while 10 of 32 (31.2%) patients had 1,000 to 5,000 EBV GE at least once during follow‐up. In a minority of patients (3 of 32; 9.3%), ≥ 5,000 GE could be detected at least once during follow‐up. Reduction of immunosuppressive treatment decreased EBV DNA levels by ≥ 1 log 10 unit in patients with symptomatic EBV infections. Quantification of EBV DNA is valuable for the diagnosis and monitoring of symptomatic EBV infections in SOT recipients.