Human Cytomegalovirus Seroprevalence and Titres in Solid Organ Transplant Recipients and Transplant Donors in Seoul, South Korea

Abstract

Background: Human cytomegalovirus (HCMV) can cause poor outcomes in solid organ transplant (SOT) recipients; moreover, it is associated with cardiovascular diseases (CVD) in the general population. Accordingly, anti-HCMV immunoglobulin G (IgG) seroepidemiology may be useful in identifying the risk of post-SOT HCMV infection or disease as well as immunosenescence or CVD. However, HCMV seroprevalence and titre have not been fully evaluated with regard to age distribution or compared between SOT recipients and healthy individuals in South Korea. Methods: We retrospectively retrieved all unduplicated anti-HCMV IgG results of individuals aged > 1 year evaluated between July 2006 and November 2017 at Severance Hospital in Seoul. The cohort, excluding haematopoietic stem cell transplant recipients and subjects with equivocal values, included 2184 SOT recipients and 3015 healthy transplant donors. All IgG results in the SOT recipients were measured during the pre-transplant period. Results: The overall IgG seroprevalence and titres were significantly higher among SOT recipients than among healthy donors (98.7% vs. 88.6%, p < 0.001, and 64.7 ± 44.3 vs. 49.8 ± 20.6 arbitrary units/mL, p < 0.001, respectively). The lowest seropositive rate in the SOT group was observed in recipients aged between 11 and 15 years (70.6%). The frequency of seropositivity among adults aged ≥ 41 years increased to ≥ 90% in SOT recipients and healthy donors. Age was independently associated with higher HCMV seroprevalence (41–60 years, OR, 76.4, 95% CI, 24.5–238.9, p < 0.001; ≥ 61 years, OR, 4.4, 95% CI, 1.3–14.9, p < 0.001, compared to ≤ 40 years). The healthy donor group had an independently low HCMV seropositive rate (OR, 0.1, 95% CI, 0.1–0.2, p < 0.001). Conclusions: HCMV seropositivity was the lowest among school-aged children and adolescents. IgG testing revealed an intermediate serostatus risk of post-transplant HCMV infection and disease for most adult SOT recipients in South Korea.

Phenotypic and functional characterisation of circulating cytomegalovirus-specific T cells in healthy virus carriers and lung transplant candidates

“…A study reported previously have shown that CMV-seropositive kidney transplant recipients posttransplant had significantly higher levels of CMV-specific IFN-γ + CD8 + T cells response compared to healthy controls [39]. Another retrospective study have shown that SOT recipients pre-transplant had significantly higher CMV IgG titres compared to healthy individuals [40]. Interestingly, the findings in the study presented here demonstrates significantly higher frequency of CD107a, IFN-γ, TNF-α and IL-2 producing IE1-specific CD8 + and CD4 + T cells and CD107a, IFN-γ, TNF-α and IL-2 producing pp65-specific CD4 + T cells in CMV-seropositive lung transplant candidates pre-transplant compared to healthy virus carriers.…”

“…Interestingly, the findings in the study presented here demonstrates significantly higher frequency of CD107a, IFN-γ, TNF-α and IL-2 producing IE1-specific CD8 + and CD4 + T cells and CD107a, IFN-γ, TNF-α and IL-2 producing pp65-specific CD4 + T cells in CMV-seropositive lung transplant candidates pre-transplant compared to healthy virus carriers. These observations might be associated with endogenous CMV reactivation of the latent virus and intermittent virus shedding and immune boosting against CMV in end stage organ disease leading to SOT [40].…”