Incidence of opportunistic viral infections in hepatitis C virus nucleic acid test negative recipients of kidneys from hepatitis C virus nucleic acid test positive donors.

IF 2.6 4区医学 Q3 IMMUNOLOGY

Transplant Infectious Disease Pub Date : 2024-10-01 Epub Date: 2024-08-26 DOI:10.1111/tid.14364

Krishna Shah, Goni Katz-Greenberg, Julie Steinbrink, Lana Crona, Alaattin Erkanli, Hui-Jie Lee, Chengxin Yang, Jennifer Byrns

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Abstract

Background: In kidney transplantation, concerns have been raised regarding increased incidence of viral opportunistic infections in hepatitis C virus (HCV) nucleic acid test (NAT)-negative (-) recipients who received HCV NAT-positive (+) donor kidneys, specifically BK polyomavirus (BKPyV), cytomegalovirus (CMV), and Epstein-Barr virus (EBV). The purpose of this study was to determine the incidence of these three viral opportunistic infections in HCV NAT- recipients who have undergone kidney transplantation with HCV NAT+ donor kidneys at our institution.

Methods: This was an Institutional Review Board-approved, single-center, retrospective case-control study of HCV NAT- kidney transplant recipients with HCV NAT+ donors from 2018 to 2021. The primary outcome was the cumulative incidence of viral infections of BKPyV, CMV, and/or EBV within 1 year following kidney transplantation.

Results: A total of 231 patients were included, 77 in the exposed (donor HCV NAT+) group and 154 in the control (donor HCV NAT-) group. The adjusted cumulative incidence of viremia within 1 year did not statistically differ between groups (77% exposed group versus 66% for the control group, hazard ratio 1.34, 95% confidence interval 0.95-1.89). In addition, no statistically significant differences were observed for secondary outcomes with the exception of CMV viremia (62% exposed versus 49% control, p = 0.021). However, there were more patients in the exposed group at high risk for CMV viremia based on serostatus (CMV Donor+/Recipient-, D+/R-).

Conclusion: Among patients who received HCV NAT+ donor kidneys, no clear association was observed between exposure to HCV NAT+ donor kidneys and viral infections of BKPyV, CMV, or EBV.

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接受丙型肝炎病毒核酸检测阳性供体肾脏的丙型肝炎病毒核酸检测阴性受体的机会性病毒感染发生率。

背景：在肾移植过程中，丙型肝炎病毒（HCV）核酸检测（NAT）阴性（-）受者接受HCV NAT阳性（+）供肾后，病毒机会性感染的发病率增加，特别是BK多瘤病毒（BKPyV）、巨细胞病毒（CMV）和爱泼斯坦-巴氏病毒（EBV），这引起了人们的关注。本研究的目的是确定在我院接受 HCV NAT+ 供肾移植的 HCV NAT 受体中这三种病毒机会性感染的发生率：这是一项经机构审查委员会批准的、单中心、回顾性病例对照研究，研究对象为2018年至2021年接受HCV NAT+供体肾移植的HCV NAT-受者。主要结果是肾移植后1年内BKPyV、CMV和/或EBV病毒感染的累积发生率：共纳入231名患者，其中暴露组（供体HCV NAT+）77人，对照组（供体HCV NAT-）154人。调整后的 1 年内病毒血症累积发生率在各组之间没有统计学差异（暴露组 77% 对对照组 66%，危险比 1.34，95% 置信区间 0.95-1.89）。此外，除 CMV 病毒血症（暴露组 62% 对对照组 49%，P = 0.021）外，其他次要结果在统计学上也未观察到显著差异。然而，根据血清状态（CMV 供体+/受体-，D+/R-），暴露组中 CMV 病毒血症高风险患者更多：结论：在接受HCV NAT+供肾的患者中，没有观察到暴露于HCV NAT+供肾与BKPyV、CMV或EBV病毒感染之间有明显的关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplant Infectious Disease 医学-传染病学

CiteScore

5.30

自引率

7.70%

发文量

210

审稿时长

4-8 weeks

期刊介绍： Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal. Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.