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Pre-transplant cytomegalovirus immunoglobulin G antibody levels could prevent severe cytomegalovirus infections post-transplant in liver transplant recipients: Experience from a tertiary care liver centre.

Abstract：

BACKGROUND:Humoral immune responses in cytomegalovirus (CMV) are not studied well. Pre-transplant CMV immunoglobulin G (IgG) antibody levels (Pre-Tx IgG) could influence the occurrence of post-transplant CMV infections. OBJECTIVE:Correlation between pre-Tx IgG and post-Tx risk of acquiring CMV infection was investigated. MATERIALS AND METHODS:A total of 146 liver Tx recipients, not on CMV prophylaxis, were included. Pre-Tx IgG in donor (D) and recipient (R) were estimated and all the recipients were followed up for 1 year for CMV infections. RESULTS:D+ R+ serostatus was seen in 142 (97.3%) and D- R+ in 4 (2.7%). A total of 113 (77.4%) recipients had pre-Tx IgG of ≥250 AU/ml. Overall, post-Tx CMV infections were seen in 54 (36.9%) recipients. In 32 (59.2%) patients, CMV infection was seen during the 1st month after TX. Incidences of post-Tx CMV infection in recipients with pre-Tx IgG <250 AU/mL and ≥250 AU/mL were 42.4% and 34.5%, respectively (P = 0.99). Median viral load was significantly higher in patients with pre-Tx IgG <250 AU/ml: 4log10 (R: 2.8-6.6 log 10) copies/ml than those with ≥250 AU/ml: 2.2 log10 (R: 1.6-3.8 log10) copies/ml, P = 0.04. There was no difference in the time of occurrence of CMV infection in both the groups. Concurrent occurrence of rejection and CMV infection was seen in significantly more patients 18/54 (32.7%) than in patients without CMV infection (12/99, 12%, P = 0.002). CONCLUSIONS:Higher pre-Tx CMV IgG levels might prevent severe CMV infections post-Tx. Recipients with low pre-Tx CMV titre might be benefitted by CMV prophylaxis or aggressive pre-emptive treatment.

journal_name

Indian J Med Microbiol

journal_title

Indian journal of medical microbiology

authors

Gupta E,Pamecha V,Verma Y,Kumar N,Rastogi A,Hasnian N,Bhadoria AS

doi

10.4103/ijmm.IJMM_17_201

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

499-503

issue

eissn

0255-0857

issn

1998-3646

pii

IndianJMedMicrobiol_2017_35_4_499_224427

journal_volume

pub_type

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Pre-transplant cytomegalovirus immunoglobulin G antibody levels could prevent severe cytomegalovirus infections post-transplant in liver transplant recipients: Experience from a tertiary care liver centre.