Epidemiology and Morbidity of Epstein-Barr Virus Infection in Pediatric Renal Transplant Recipients: A Multicenter, Prospective Study

Höcker, Britta; Fickenscher, Helmut; Delecluse, Henri Jacques; Böhm, Stephan; Küsters, Uta; Schnitzler, Paul; Pöhl, Martin; John, U; Kemper, Markus J.; Fehrenbach, Henry; Wigger, Marianne; Holder, Martin; Schröder, Monika; Billing, Heiko; Fichtner, Alexander; Feneberg, Reinhard; Sander, Anja; Köpf-Shakib, S.; Süsal, Caner; Tönshoff, Burkhard

doi:10.1093/cid/cis823

Cited by 87 publications

(93 citation statements)

References 37 publications

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“…Since HLA-DR 13 is genetically linked to HLA-DQ6 (DQ β1 *06), especially in populations of European descent (35), it is possible that DQ β1 *06 might have contributed to EBV seronegativity as an HLA-DR β1*13-DQ β1 *06 haplotype in their cohort. In a study of 106 pediatric allograft recipients, Hocker and colleagues identified HLA-DR7 as an independent risk factor for EBV infection (36). Since HLA-DR7 is genetically associated with DQ β1 *02/*02, these results are consistent with our observation of a higher than expected proportion of HLA-DQ β1 *02 subjects that are seropositive.…”

Section: Discussionsupporting

confidence: 88%

HLA-DQ β1 alleles associated with Epstein-Barr virus (EBV) infectivity and EBV gp42 binding to cells

Li¹,

Bu²,

Gabriel³

et al. 2017

JCI Insight

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Section: Discussionsupporting

confidence: 88%

HLA-DQ β1 alleles associated with Epstein-Barr virus (EBV) infectivity and EBV gp42 binding to cells

Li¹,

Bu²,

Gabriel³

et al. 2017

JCI Insight

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“…Though EB VL measurement in the whole blood was the most commonly used assay in this study (68 of 85 children), the actual peak VL was not helpful in predicting PTLD. A recent study by Hocker et al did not find correlation between EB VL and duration of VL with PTLD or EBV associated diseases [18]. Thus, this study and that by Hocker et al show that EB PVL alone has a low predictive value for PTLD.…”

Section: Discussioncontrasting

confidence: 46%

Significance of Asymptomatic Persistent Epstein-Barr Viral Load in Pediatric Renal Transplant Recipients: North American Pediatric Renal Trials and Collaborative Studies Report

Moudgil¹,

Martz²,

Moore³

et al. 2014

TOUNJ

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Methods: NAPRTCS centers invited to enter data on children with asymptomatic PVL (≥ 6 months) into the EB VL registry. Comparison group included children into the NAPRTCS TX arm during the same period without PVL or VL monitoring. EB VL were arbitrarily divided into low (1-10), medium (>10-100) and high (>100times detection limit for the center) ratio.Results: Of 645 children (18 centers), 85 (13.2%) developed onset of PVL at a mean of 6.4 ± 6.3 months post-TX. PVL children were more likely to be younger (< 5 years) at TX and less likely to be African-American and majority (75.3%) was mismatched for EBV (donor EBV IgG positive and recipient negative). Thymoglobulin induction was used in 29.4% children with PVL versus 37% in controls (p=ns). PTLD developed in 7/85 (8.2%) children with PVL versus 5/560 (0.9%) controls (p < 0.0001). EB VL ratios were not different in those with and without PTLD. EB PVL as time varying covariate did not affect patient survival, GF and AR (HR, 0.85, 0.53 and 0.99). The change in GFR overtime in children with PVL was comparable to controls. Conclusion:Children with PVL (actual load not predictive) are at increased risk for PTLD, but not for AR, death, GF or loss of graft function.

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“…In our center, PTLD has been diagnosed in seven of the 252 RTx patients (3.7 %) and four of these had received their kidney graft as infants. Excellent articles on the management of CMV, EBV, and PV infections have recently been published [57][58][59][60][61].…”

Section: Infectionsmentioning

confidence: 99%

Renal transplantation in infants

2015

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Renal transplantation (RTx) has become an accepted mode of therapy in infants with severe renal failure. The major indications are structural abnormalities of the urinary tract, congenital nephrotic syndrome, polycystic diseases, and neonatal kidney injury. Assessment of these infants needs expertise and time as well as active treatment before RTx to ensure optimal growth and development, and to avoid complications that could lead to permanent neurological defects. RTx can be performed already in infants weighing around 5 kg, but most operations occur in infants with a weight of 10 kg or more. Perioperative management focuses on adequate perfusion of the allograft and avoidance of thrombotic and other surgical complications. Important long-term issues include rejections, infections, graft function, growth, bone health, metabolic problems, neurocognitive development, adherence to medication, pubertal maturation, and quality of life. The overall outcome of infant RTx has dramatically improved, with long-term patient and graft survivals of over 90 and 80 %, respectively.

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Epidemiology and Morbidity of Epstein-Barr Virus Infection in Pediatric Renal Transplant Recipients: A Multicenter, Prospective Study

Cited by 87 publications

References 37 publications

HLA-DQ β1 alleles associated with Epstein-Barr virus (EBV) infectivity and EBV gp42 binding to cells

HLA-DQ β1 alleles associated with Epstein-Barr virus (EBV) infectivity and EBV gp42 binding to cells

Significance of Asymptomatic Persistent Epstein-Barr Viral Load in Pediatric Renal Transplant Recipients: North American Pediatric Renal Trials and Collaborative Studies Report

Renal transplantation in infants

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