Comparison between Serological and Molecular Diagnosis of Epstein Barr Virus Infection among Egyptian Renal Transplant Recipients

Abstract

Background: Kidney transplantation is the best treatment for end-stage kidney diseases. Lifelong immunosuppression preserves graft function. However, they usually lead to severe viral infections; as Epstein Barr Virus (EBV) which lead to development Post Transplant Lymphoproliferative Disorders (PTLD). Objectives: The aim of this study is to compare between serological and molecular assays as methods of detection of EBV infection. Presumed risk factors for development of EBV infection and its impact on transplant outcome were studied. Patients and Methods: A total of 50 Egyptian kidney transplant recipients received their renal allografts from living-related donors were studied. Recipients were tested for EBV infection by serological markers; anti-EBV viral capsid antigen (VCA) IgM and molecular assay by detection BamHI region by PCR. Different co-morbid risk factors for development of EBV infection (pre-transplant hemodialysis & blood transfusion, diabetes mellitus, CMV, and HCV infection) were studied. Likewise, the impact of EBV infection on transplant outcomes was evaluated. Results: Of the 50 patients, 66% were positive for VCA IgM and 42% were positive BamHI region of EBV. BamHI positivity was significantly correlated with duration of transplantation, and severity of rejections episodes. On the other hand, none of these risk factors were correlated with the positivity of VCA IgM. Among the studied recipients, EBV infection detected by either serological or molecular assay has no impact on the transplant outcome. Conclusions: Although serological diagnosis for EBV infection is a simple method for screening and follow-up. Yet, molecular diagnosis seems to be more accurate diagnostic test.