Natural History of Epstein-Barr Virus Load in Pediatric Thoracic Recipients With Post Transplant Lymphopro-Liferative Disorders and Other Primary Ebv Infections

Webber, Steven A.; Rowe, David; Boyle, G J; Michaels, Marian G.; Fitzsimmons, Alec; Law, Yuk M.; Miller, Steven A.; Green, M; Kurland, Geoffrey; Bentlejeweski, C; Zeevi, Adriana; Qu, L

doi:10.1097/00007890-199904150-00860

Cited by 7 publications

(7 citation statements)

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“…Two of the children who initially had viral load drop below 200 copies/10 5 cells showed a transient rebound to above 200 copies/10 5 cells without clinical symptoms. Two of the four patients with primary EBV syndrome, but not PTLD, showed a drop in EBV load below 200 copies/10 5 cells, while the remaining two had chronic loads >200 copies/10 5 cells despite resolution of clinical symptoms (79).…”

Section: Viral Load Monitoring In Post‐ptld Managementmentioning

confidence: 99%

Epstein–Barr virus load monitoring: its role in the prevention and management of post‐transplant lymphoproliferative disease

Rowe

Webber

Schauer

et al. 2001

Transplant Infectious Dis

156

122

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The Epstein-Barr virus load in the peripheral blood at the time of diagnosis of post-transplant lymphoproliferative disease (PTLD) is elevated 1000- to 10,000-fold compared to the level detected in normal latency. With the use of quantitative polymerase chain reaction (PCR), changes in the viral load over time can be measured with a two- to fourfold accuracy. This has allowed early detection of first-time infections and reactivations that may lead to PTLD and has provided an opportunity to intervene before symptomatic disease has occurred. Viral load monitoring has also been used to follow patients with PTLD and, along with other parameters, provided an assessment of the effectiveness of therapeutic protocols. Viral load monitoring has led to the discovery that at least two-thirds of transplant recipients become persistent viral load carriers. While the persistent load appears to be largely carried in latently infected memory B cells, more work is needed to clearly define this type of persistent infection and determine the risks associated with it. New diagnostic tests need to be developed to distinguish the persistent latent viral loads from viral loads that are likely to become symptomatic PTLD.

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Section: Viral Load Monitoring In Post‐ptld Managementmentioning

confidence: 99%

Epstein–Barr virus load monitoring: its role in the prevention and management of post‐transplant lymphoproliferative disease

Rowe

Webber

Schauer

et al. 2001

Transplant Infectious Dis

156

122

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“…Monitoring of Epstein-Barr virus (EBV) DNA load in peripheral blood lymphocytes (PBLs) from transplant patients by competitive PCR (cPCR) has been shown to be useful in the diagnosis and management of EBV infection and EBV-associated posttransplant lymphoproliferative disease (PTLD) (2,3,9,12). Although the viral load has also been measured in plasma and whole blood by real-time TaqMan PCR (4,5,8), the comparability of viral load results in different sample types, determined by different PCR methods, is unclear.…”

mentioning

confidence: 99%

“…To facilitate selection, results from the cPCR assay were categorized into one of four load groups: group I, Ͻ8 copies/10 5 PBLs; group II, 8 to 100 copies/10 5 PBLs; group III, 200 to 1,000 copies/10 5 PBLs; and group IV, Ͼ1,000 copies/10 5 PBLs. Viral load cutoffs for these groups were based on how we have typically interpreted results from the testing of PBLs by the cPCR assay for the past 7 years (2,3,9,12). Group I represents either a value not detected or a detectable (albeit very low) value, similar to values seen in latent infection in immunocompetent individuals.…”

mentioning

confidence: 99%

Measurement of Epstein-Barr Virus DNA Loads in Whole Blood and Plasma by TaqMan PCR and in Peripheral Blood Lymphocytes by Competitive PCR

et al. 2003

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Epstein-Barr virus (EBV)DNA load values were measured in samples of whole blood (n ‫؍‬ 60) and plasma (n ‫؍‬ 59) by TaqMan PCR and in samples of peripheral blood lymphocytes (PBLs) (n ‫؍‬ 60) by competitive PCR (cPCR). The samples were obtained from 44 transplant recipients. The whole-blood and PBL loads correlated highly (r 2 > 0.900), whereas the plasma and PBL loads correlated poorly (r 2 ‫؍‬ 0.512). Testing of whole blood by TaqMan PCR is an acceptable alternative to testing of PBLs by cPCR for quantifying EBV DNA load.

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“…Similar to the study by Baldanti et al, 5 they also observed a clearance of EBV viral load during the treatment of PTLD in a small number of transplant recipients with PTLD. In a group of 13 pediatric thoracic transplant recipients with EBV-associated PTLD, Webber et al 8 reported that all patients had high viral loads at the time of diagnosis of their EBV syndrome. Clearance of EBV viral loads differed between heart, heart and lung, and lung transplant recipients.…”

Section: Commentsmentioning

confidence: 99%

Clinical usefulness of Epstein-Barr viral load in solid-organ transplantation

Buteau

Payá

2001

Liver Transpl

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Epstein‐Barr virus (EBV) DNA was quantitated in peripheral blood mononuclear cells (PBMC) from 25 healthy subjects, 105 asymptomatic solid‐organ transplant (SOT) recipients, and 15 SOT recipients with symptomatic EBV infections by using a newly developed quantitative‐PCR technique. Patients with symptomatic EBV infections had significantly higher (P < 0.001) median EBV DNA levels than asymptomatic SOT recipients and immunocompetent individuals. In SOT recipients, the positive predictive value of EBV DNA levels of > 1,000 genome equivalents (GE)/0.5 μg of total PBMC DNA was 64.7% for symptomatic EBV infection, while the negative predictive value was 96.1%. In 19 of 32 (59.3%) asymptomatic SOT recipients, EBV DNA levels were consistently below 1,000 GE for as long as 18 months, while 10 of 32 (31.2%) patients had 1,000 to 5,000 EBV GE at least once during follow‐up. In a minority of patients (3 of 32; 9.3%), ≥ 5,000 GE could be detected at least once during follow‐up. Reduction of immunosuppressive treatment decreased EBV DNA levels by ≥ 1 log10 unit in patients with symptomatic EBV infections. Quantification of EBV DNA is valuable for the diagnosis and monitoring of symptomatic EBV infections in SOT recipients.

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Natural History of Epstein-Barr Virus Load in Pediatric Thoracic Recipients With Post Transplant Lymphopro-Liferative Disorders and Other Primary Ebv Infections

Cited by 7 publications

References 0 publications

Epstein–Barr virus load monitoring: its role in the prevention and management of post‐transplant lymphoproliferative disease

Epstein–Barr virus load monitoring: its role in the prevention and management of post‐transplant lymphoproliferative disease

Measurement of Epstein-Barr Virus DNA Loads in Whole Blood and Plasma by TaqMan PCR and in Peripheral Blood Lymphocytes by Competitive PCR

Clinical usefulness of Epstein-Barr viral load in solid-organ transplantation

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