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Cytomegalovirus and cancer after kidney transplantation: Role of the human leukocyte antigen system?
Author(s) -
Wong Germaine,
Chakera Aron,
Chapman Jeremy R.,
Chadban Steve C.,
Pilmore Helen,
Craig Jonathan C.,
Lim Wai H.
Publication year - 2017
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.12631
Subject(s) - medicine , hazard ratio , human leukocyte antigen , serology , cancer , kidney transplantation , transplantation , immunology , cytomegalovirus , human cytomegalovirus , kidney cancer , confidence interval , gastroenterology , antigen , herpesviridae , viral disease , virus , antibody
Background The role of cytomegalovirus ( CMV ) in cancer development after transplantation remains uncertain. We aimed to determine the association between donor and recipient CMV serological status and the risk of cancer development after kidney transplantation. Methods Using data from the Australian and New Zealand Dialysis and Transplant ( ANZDATA ) Registry, we assessed the association between CMV donor/recipient (D/R) serological status and the risk of solid organ cancers in primary adult deceased‐donor kidney transplant patients between 1990 and 2012. Results Of 8140 recipients, a total of 895 (11%) recipients developed incident cancers during a follow‐up time of 51 555 person‐years. Human leukocyte antigen ( HLA ) mismatches was an effect modifier between CMV serological status and cancer ( P =.03 for interaction). In recipients who have received 0‐2 HLA ‐ ABDR mismatched kidneys, the adjusted hazard ratios for cancer incidence among those with CMV D−/R−, CMV D−/R+, and CMV D+/R− were 0.47 (95% confidence interval [ CI ]: 0.24‐0.91), 1.42 (95% CI : 0.97‐2.07), and 1.02 (95% CI : 0.67‐1.57), respectively compared with the reference of CMV D+/R+. A similar association was not observed in those with >2 HLA ‐ ABDR mismatches. Conclusion CMV D−/R− status was associated with a reduced risk of cancer in kidney transplant recipients who have received well‐matched renal allografts, suggesting a potential role of HLA matching in cancer development.