Study of Epstein Barr Virus Infection in kidney Transplant Recipients: One Egyptian Center Study

Abstract

Background: Epstein–Barr virus (EBV) is the causative agent of infectious mononucleosis (IM). EBV infection is common in renal transplant recipients, due to the use of immunosuppressive drugs, and may lead to post-transplant lymphoproliferative disorders (PTLD). Thus, EBV accounts for high morbidity and mortality rates in solid organ transplant recipients. Objectives: The aim of this study was to examine the prevalence of EBV infection among Egyptian kidney transplant recipients and the relation between different immunosuppressive regimens, and EBV infection. Methodology: A total of one hundred kidney transplant recipients were included in this study (50 recent transplants and 50 late transplants). All cases were subjected to pre- and post-transplant evaluation, and post-operative immunosuppressive therapy. EBV infection was identified by serological testing for anti-EBV viral capsid antigen (VCA) IgG and IgM, and by molecular detection of Bacillus amyloliquefaciens H one (BamHI) region using conventional polymerase chain reaction (PCR). Results: BamHI region detection showed significant difference between the recent and late transplant groups (higher in late group) and was significantly associated with EBV VCA IgM; positive BamHI has 5.1 times higher odds of exhibiting positive IgM adjusted for the date of transplantation. Neither VCA IgM nor IgG were significantly different between the two studied groups. Conclusion: Despite the lack of association between EBV and immunosuppression drugs, hematological abnormalities, or graft function in this study, EBV monitoring in renal transplant recipients is required for early diagnosis of EBV infections and prevention of PTLD development. Serological diagnosis for EBV is of clinical importance as a simple, inexpensive tool for screening and follow-up of EBV infection. Molecular diagnosis of EBV by BamHI fragment detection had 5.1 times higher odds to exhibit positive IgM adjusted for the date of transplantation.