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Detection of Epstein–Barr virus DNA emia after lung transplantation and its potential relationship with the development of post‐transplant complications
Author(s) -
Silva J.T.,
LópezMedrano F.,
AlonsoMoralejo R.,
FernándezRuiz M.,
PabloGafas A.,
PérezGonzález V.,
SanJuan R.,
PérezJacoiste Asín M.A.,
RuizMerlo T.,
Folgueira M.D.,
Aguado J.M.
Publication year - 2016
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12541
Subject(s) - medicine , immunosuppression , hazard ratio , confidence interval , lung transplantation , transplantation , gastroenterology , viral load , epstein–barr virus , lung , surrogate endpoint , virus , immunology
Background Recent studies suggest that Epstein–Barr virus DNA emia ( EBV d) may act as a surrogate marker of post‐transplant immunosuppression. This hypothesis has not been tested so far in lung transplant ( LT ) recipients. Methods We included 63 patients undergoing lung transplantation at our center between October 2008 and May 2013. Whole blood EBV d was systematically assessed by real‐time polymerase chain reaction assay on a quarterly basis. The occurrence of late complications (overall and opportunistic infection [ OI ] and chronic lung allograft dysfunction [ CLAD ]) was analyzed according to the detection of EBV d within the first 6 months post transplantation. Results Any EBV d was detected in 30 (47.6%) patients. Peak EBV d was higher in patients with late overall infection (2.23 vs. 1.73 log 10 copies/mL; P = 0.026) and late OI (2.39 vs. 1.74 log 10 copies/mL; P = 0.004). The areas under receiver operating characteristic curves for predicting both events were 0.806 and 0.871 respectively. The presence of an EBV d ≥2 log 10 copies/mL during the first 6 months post transplantation was associated with a higher risk of late OI (adjusted hazard ratio [ aHR ] 7.92; 95% confidence interval [ CI ] 2.10–29.85; P = 0.002). Patients with detectable EBV d during the first 6 months also had lower CLAD ‐free survival ( P = 0.035), although this association did not remain statistically significant in the multivariate analysis ( aHR 1.26; 95% CI 0.87–5.29; P = 0.099). Conclusions Although preliminary in nature, our results suggest that the detection of EBV d within the first 6 months after transplantation is associated with the subsequent occurrence of late OI in LT recipients.